Biology of Trauma: How Trauma Fuels Autoimmunity & Hashimoto’s – With Dr. Aimie Apigian

Introduction: Trauma and Autoimmunity 0:00

Hey, everybody. Welcome to the Thyroid Pharmacists Healing Conversations podcast. Today, we're going to get into a topic. I like to think of it as perhaps the elephant in the room. So if you're struggling with autoimmunity or thyroid disease, Hashimoto's thyroiditis, you've probably been on this healing journey and you are trying a lot of different things. Perhaps you were trying different supplements, You're trying different medications, cutting out different foods, and yet something might be keeping you stuck and something may be predisposed you to autoimmunity.

Now, this elephant in the room is not gluten, it's not dairy, not like a lack of selenium, although those things can be very, very important for healing hypothyroidism and helping with Hashimoto's antibodies, but trauma. So trauma can get stuck in the body and this can actually predispose us to autoimmunity and lead us, to get in this cycle where we're doing all the right things but we are still not healing and our nervous system is off. Today I have a wonderful guest joining us today, Dr. Amy Epigian and we will dive into What exactly is trauma?

How do we store trauma, how does it contribute to autoimmune disease, and how do you get unstuck? So welcome, Dr. Amy. It's so great to have you here with us. I'm really excited for this conversation because this is so much of my personal experience. So I am loving that you are opening this discussion and this big elephant in the room for your audience. And I looking forward to diving into the science. That's amazing. Can you tell us a little bit about your background? How did you become interested in trauma?

I was not ever planning to be a trauma expert. And in fact, when I going through medical school, I knew the one field that I never going to go into, which was going be psychiatry. It was just after finishing my master's in biochemistry, jumping back into third year of medical, and I decided to use that time, about two, three months of free time that wanted to become a foster parent. I had no intention of it becoming what it did become. For me, I was just saying I want to use my time in a meaningful way.

And I always had a heart for hurting children. So I signed up to be a foster parent. Well, it wasn't actually until I back in the third year of medical school, in fact, internal medicine rotation, that I got the phone call from Rosa, the social worker. And she told me about this four-year-old. And he had been in the foster care system since age nine months, and he'd been through many homes. He needed a home now. It was an immediate yes for me. My heart was wide open already. As Miguel came into my home, I saw in real time, the challenges that he had been having, where it was no longer safe to place him with other families who had children or pets because of his behaviors.

But even with all of that, I just knew in my heart of hearts that time was going to allow him to have that stability and that security. And so I focused on loving him and being his friend and helping him feel stable and secure in my home. And what I discovered though was that the therapies that I was taking him to were not helping. Time was not healing and my love was enough. And I didn't know where to go from there. So that's what started my deep study into trauma. It started with studying attachment and attachment trauma and how our earliest experiences shape our nervous system, which then led to me understanding

Dr. Amyu2019s Path Into Trauma Work 4:12

so much more about myself. And then when I developed thyroid issues and autoimmunity, it was my gateway into saying, all right, Amy, It's time to do your own trauma work. and learning what that means as an adult who already has this damage in their biology for what is even possible at this point. That's so powerful. And you said, you know, love is not enough because I feel like sometimes we're taught that that's all we need is love to take care of our children with our spouse and that love. Is always going to be enough.

But with trauma, it it prevents the person from feeling the love, expressing love experiencing love and really garnering the safety no matter what kind of an environment that they're in. And I think this this is very relatable to people with autoimmunity right and thyroid issues their bodies get stuck in this cycle where the body essentially feels like it's unsafe and it gets wired into the stress response and you could be living a beautiful life. I know I work with many clients that have amazing families, wonderful husbands, and wonderful children and they're like, my life is amazing.

Like I do not have trauma, I don't have any kind of issues, right now. I don't have quote unquote stress, right? But the thing is, some of those really early childhood things can get really wired into our system. That then makes us feel unsafe in whatever situation we're in. Can you talk a little bit about the connection between trauma, autoimmune disease, thyroid conditions and and how does like how Does it all connect? And how is it? How does it happen? Why can't we just like, you know, shake it off, If only we could make that conscious decision to move on with our life.

And when we move out of our family of origin, be able to truly leave that behind and just step into our lives and our adulthood and create the life that we want. But that's not what happens, as you've said. And this is exactly what I saw happening with my son, is that he was in a completely new environment. I was not the mother who had abandoned him. And his perception was that I cannot let myself open my heart and connect with other people, especially someone who calls himself mom because of the danger that that means.

So even if my love were the medicine, he wasn't even letting the medicines in. And this is how our nervous system gets programmed from early on. This was so important for me that I wrote a whole chapter just on attachment in my book. Because attachment, our early years, becomes our normal. It becomes a default where we don't even realize that it's there. Its creating the lens through which we experience everything in life though. And it is the foundation then for this filter. that every experience comes through and so I liken it to wearing glasses and I started wearing classes when I was 12 and i still remember the day that I got my glasses and this is exactly how trauma becomes embedded into our nervous system, is that I, until I had those glasses, I didn't even know that had bad sight.

I thought that that was normal. This is how everybody sees, everybody's struggling to see the chalkboard from their desk in the classroom. No, that's not normal, because it was the only thing that i'd ever known. And so many people are using language that tells me that they have never truly felt safe in their body. But because that's the only way that They've ever felt, they don't know that that actually means your body is holding on to trauma. And yet that is exactly what autoimmunity is. Autoimmunity is your Body does not feel safe being the real you.

Your body is telling us that it has not felt safe for a very long time since we know that autoimmunity takes a long to develop underneath the surface. This has been going on for long and it's not safe to be the real you. In fact, many people may have felt that they've lost themselves over the years. They don't even really know who they are anymore, and they certainly don' t like themselves. That's a classic trauma emotion that gets stored with those with autoimmunity. And so as I was discovering my own autoimmune,y and what happened was that in 2014, I went through the biggest grief and loss that I've ever had in my life.

And honestly, it was too big for me to even be able to feel and to process. And what I did was what i had always done, which is let me bury it. Let me throw myself into busyness. so that I don't have to feel this. I do not have be alone with myself because that's when all of these feelings surface. And if I have do have alone by myself, well then let it always be with a pan of brownies or a tub of ice cream so I can not feel overwhelming sadness. and grief and anger and resentment and everything that can come with an unexpected and very hard loss.

And that's then what precipitated me not being able to wake up or get up out of bed one morning when I woke up. I had no idea that auto-muty was building underneath the surface. And for me, like many people with autoimmunity, it started with fatigue. And so I started this pathway of, well, is it adrenal fatigue? Is it, what is this? And that's how I discovered functional medicine. But when I saw my labs and it was very clear, no, you have autoimmune markers in my ANA or anti-nuclear antibodies. were very high.

My thyroid hormones were imbalanced. They weren't at the level that it was Hashimoto's, but they were definitely imbalanced. And that was when I really got my eyes opened to the connection between my unresolved trauma, my unsolved grief, and how stressful that had been on my body to a point where it was no longer just a stress. My body had gone into a trauma response and created this trauma biology. But really, then as I started my trauma work, what I discovered and what became my idea of the biology of trauma is that that autoimmunity, as well as all the other imbalances in my metabolism and my gut and the toxins and inflammation in general, all of that was actually now creating signals of danger to my nervous system.

and I had thought that I just needed to clean up my environment. I needed choose better friends, I need to not be around toxic people, and to surround myself with love and support, not realizing that my internal environment

How Trauma Shapes Autoimmune Disease 12:24

was one of danger at this point. so that the biology that trauma creates now creates a feedback loop and perpetuates us living in trauma patterns and living, protecting our heart, living hypervigilant and guarded and just waiting for the next shoe to drop, even if our life right now seems relatively good. We're still waiting For the next problem because that's our lens. That's are filter through which we're seeing the world so auto-immunity and trauma auto immunity is a manifestation of a biology of trauma and I say that because It's a chicken or a thing whether or not a person can look back on their life and see trauma, which I would argue that We often don't see a trauma because we haven't defined it properly.

I didn't say trauma in my background but The biology that we can develop from imbalances, from toxins, for mitochondrial compromise, those things can actually create the susceptibility to our body going into a trauma response. So it all becomes a pattern now. It all become a feedback loop. And this is where we find ourselves with trauma biology when we have autoimmunity. Thank you so much for sharing that I can relate to all of that. I know a lot of times people tend to want to focus on like, okay, I'm going to get medications in my system.

I started doing some outcomes research with them looking at some of the research behind how trauma can impact our, let's just say, adrenals, right? So where our cortisol patterns are going to be impacted. We're going have also more likely to in that fight or flight state if we've had experienced trauma or perhaps in the fawn or freeze state. And there have been a few people that I've worked with where trauma was very, very clearly what preceded their autoimmune symptoms. There was one gentleman who had thyroid antibodies in the, I want to say in, the 8,000 plus range, and that was from a sudden after he lost his father.

That was the really big traumatic event that was a really trigger. This is something that I see very, very commonly, and I've personally experienced it as well. When I was in my 20s, somebody close to me died by suicide, essentially starting to have a lot of hormonal imbalances. I started to feel exhausted and fatigued and obviously I was grieving and I think that was a really, really big part of that. But it also left me in this fight or flight state where I ended up having nightmares. for I want to say at least 10 years after that point until I actually went through and did some trauma work and processing all of that.

But you don't really realize it until you face it straight on. You don t realize all the negative thought patterns that you have. I was always waiting for something bad to happen if there was like a really happy situation that I wasn't that. Oh, I'm just waiting first. Something really bad happened that was. Always in the back of my mind. It was, always I, was feeling guilty I had like survivors guilt and a lot of these different thought. Patterns I you know what kind of beat myself up I have some perfectionist tendencies and all of the things can really stack up to.

essentially it's like when I was diagnosed within Hashimoto's, I told my husband I have an autoimmune condition when my body's attacking itself and he was kind of like, so you don't like yourself and you're attacking yourself. And I'm like well, not really, but kind-of, right? Because when you kind make that connection, that can be what is happening. I feel like one of the keys to getting past the autoimmunity and getting into a healing state is really shifting that conversation that we have with our body and shifting ourselves into that safety sphere.

Now, you talked about unresolved trauma and it stays in the body and not many people realize that they have trauma. And there's certain clues, like you had said, you and I were always waiting for something bad to happen. What are some of these other clues we might have that you might sport trauma? Because sometimes you may not even remember that it happened, right? That's also true. That is also possible. So you can be like me and look back at your child and be You know, no, I didn't have neglect.

I did have abuse and especially compare our childhood to someone else who did like I had my son to compare to and compared to his past. Who was I to say that I have had any problems, let alone use the word trauma for my childhood. And then there can be this level of dissociation that we have where We cannot even remember and there are many people who just kind of have gaps in their childhood and they're like, it's kind fuzzy. Don't remember details and that sometimes can be because you were so scared at that time in your life.

that your body and your brain just block that. And it has not felt safe to go back and open that up. So that is one aspect that I'm hoping that we'll get to is just this idea of how do we create the safety to even open this stuff up? Because it's terrifying to think of opening up and unpacking all of this pain that We've been carrying sometimes for decades and sometimes that, we don't even know about because we've packed it so well. But this idea that how would we recognize that we're holding trauma?

And I start my book with the story of my patient Elena who developed autoimmunity one year after a car accident. she thought that it had no connection. She thought this was just a condition that was coming out of the blue. And she, like many others, was looking at her family, genetics, is this something that my family carries? And so when she and I had this conversation, she also looked back and she's like, oh, I mean, okay, i can tell you about some childhood experiences where I it was stressful.

But again, she wouldn't have used the word trauma. And as we look back, one of the key things that I would want people to understand is, let's stop looking for the big bad event. Let's start using a scorecard. Seeing is what I went through bad enough. Does this qualify? Because that's asking the wrong question. What we really need to look at is Did I experience something that was so overwhelming at that time that I didn't know how to understand it? I don't how process it and I did not have someone who was in it with me?

And I specifically say that because there are three elements that make a trauma actually be a Trauma. Meaning it takes our physiology into a Trama response. And that's what I lay out in my book is this car accident and what were those five steps that Elena went through to show that she actually did go into a trauma response with that car incident. It wasn't just a stress. And there are three elements are what is happening has to feel unbelievable. meaning we have the thought that I can't believe this is happening.

It has to come at a shock to us that this so misaligned with what we expected in life or that we expect it from a person, whether our parent or a spouse. This is often that initial aspect where a betrayal actually is a trauma response because we can't believe that they could betray us, that could do this. So even with a loss, a death, grief, whatever it is, there's this element of this is unbelievable and it also is unbearable. What we're experiencing is creating internal sensations that are so uncomfortable that we are finding ourselves unable to feel the intensity of those feelings in that moment.

Now, these are actual real sensations, so they're the twisting of the gut, or it's the ache and dropping of heart. We use these expressions, but these actual, real, sensations and those are the sensations that unbearable. It's interesting that we can tolerate physical pain much more easily than we cannot emotional pain. And if we get a paper cut or we break a bone, like it's uncomfortable. It is very uncomfortable, but we are able to feel those feelings better than if it is the ache in the heart.

Because how do I actually fix that? There is no band-aid that reaches that deep. or that knot or twisting in my gut that I can't seem to reach it to tone it down and just decrease the intensity of it. So it creates sensations that are unbearable. Our mind says, I don't want to be feeling my body right now. And then that's when the disconnect starts. But that part of this process then of the trauma responses, being all alone in that experience. Because when we have someone who's in it with us, we can tolerate such circumstances much more than what we tolerate if we're all alone.

And not just physically alone, because sometimes we all have people around us. But we still feel alone because they're not seeing what were going through, they are not understanding us And so we can still feel that experience of being all alone. And as I was talking with Elena and looking back at her childhood, she started talking about how she was raised by a single mom, and so her mom was working a lot. As her moms started dating other people, there was a boyfriend that she had, that boyfriend would be at the home without the mom.

Whether he had bipolar or some other mood disorder, we don't know and we want to have to label that. What it created was what we wanna focus on. It created the sensation for Elena of I'm scared and not just scared, I am terrified. And she remembered hiding in her room, finding a corner where she could just go and hide and try to be all alone and away and make herself small, make her self invisible. Then she started having these feelings of I'm not enough. My mother sees me as a failure that she has to bring these other people in.

That's where that self-talk started and her relationship with herself and seeing herself as not-enough, seeing her self as the problem. I want to say that's the perfect soil for autoimmunity to develop. And so not only was she experiencing terror, which really is the emotion behind a trauma response, terror. It's not just feeling afraid, it's feeling terror and then accompanied by this belief that we form and often it formed when we're very young of I'm the problem. I'm not enough. If I were only perfect, my mother might not do that.

if I was only better, My father might drink. And again, many people like Alina look back at their childhood and they're like, but that's not trauma. but it was. And there is a very specific stress response and there was a specific trauma response. Those are very different physiology and so to know, be able to recognize that, know what I went through or even what i'm going through right now feels terrifying for me. what feels terrifying to me in my life right now that I don't know if I'm going to be okay.

That's when our body goes into this trauma physiology and it creates imbalances in our hormones and immune system and nervous system, and digestive system that the stress response and the fight or flight, the sympathetic is not going create that same type of problem. So it's really important for those with autoimmunity to know you have trauma biology. That's not just stress, that is trauma, biology, which then allows us to. Know what to do about it, because if it were just stressed, well, then we should do better stress management.

Recognizing Trauma Responses and Clues 26:36

as you teach, stress management is not going to be enough. It's because it's not the real problem. The nervous system is stuck in stress. Some people will say they get sick after like a stressful life event, let's say it's like, a pregnancy or a divorce or loss or even going through graduate school, car accident. And I think they're kind of like why, why like did I get after this? Like the stressor wasn't really like that big a deal in the grand scheme of things and other people go through the same stressors.

and they don't get sick, but I think you just perfectly painted the predispositions that get us there, whether that is some of that early attachment trauma or things that happen, beliefs that you have come to form when you're a young child. There's also, I you alluded to toxins. I know a lot of my colleagues and I have talked about how somebody that grows up in a moldy home, for example, they might actually experience stress in different way and different toxins can lead you to, I guess, be more turned on to that fight or flight system.

Can you talk a little bit more about that and perhaps the cell danger response? Yes, and this is coming to what I feel is the most important concept at the end of the day of my book, this idea of capacity. And we have a certain capacity and we can look at everything that goes into that capacity, but that is our current capacity. It's dynamic, so it changes even throughout the day. But from one day to the next, it's a different capacity And when I am trying to do something that's beyond my sense of capacity my body will go into a trauma response.

So it really comes down to, what is my capacity? And what are the demands that are being asked of me? Does that match my ability or does that exceed my capability? Because when we talk about it in terms of capacity, it no longer becomes the conversation of only emotional trauma. We can see how toxins, we can how mitochondrial compromise, and we see the hormonal imbalances. The low cortisol especially will be creating an environment in which my capacity is not very high. And when our capacity has been exceeded by what is being asked of us, our body says, I've got to switch survival strategies.

And now that is no longer stress. Stress is a high energy state. stress is driven by adrenaline that then drives cortisol and that generates a very active response. So the stress response is this high sympathetic drive of action and taking movement. Adrenaline is all about moving us to take action. And so anytime that we're not taking action, anytime we've gone into that sense of, now I'm just overwhelmed. Even though we would still normally use the word stress for that, because that's the only word that know to use, that is not the stress physiology.

That is actually this trauma physiology, and it is mediated by the vagus nerve, not the sympathetic nervous system. So that's another important distinction for people, especially those who are looking to do breath work or other types of vagal toning. You have to actually be really careful with that because the Vegas nerve does communicate parasympathetic, rest and digest, and it communicates this shutdown after experiencing a freeze moment or the freeze response. And when we're doing vagal work, it can bring up both of those.

It can calm us down and bring us back to a sense of safety, but it could also tap into the stored trauma since that's the state in which we go into that is communicated by the vagus nerve when going into overwhelm. So this idea of capacity then, we can look at everything that fills up our cup, right? And whether we have a poor night's sleep. Well, that's going to decrease my capacity. But you look my day yesterday and oh my goodness, it was not just a stressful day. I did go into overwhelm. And when I go in to overwhelme, I know that my detoxification pathways, they shut down because that is not what's Most important when I am trying to conserve energy and that's the purpose of the trauma response is to help us conserve Energy not use up Energy so it shuts down everything that is going to take up energy.

And if my detoxification system is not working, well, then I know that that non-organic food that I ate, and then, I eat it out of my plastic Tupperware and that, you know, like I drink the non filtered water, all of these things, All of those toxins that i'm exposed to in my everyday are now accumulating simply because my system, my whole body is in a shut down trauma physiology that's not clearing that out. And so when we look at kind of the trifecta for autoimmunity, right, it's this idea of toxins, leaky gut and trauma.

And they all go together, and so they really are inseparable. And when I look at then kind of what becomes that trigger, it really is crossing the line of overwhelm, where something has no longer just been a stress. A stress is something that matches our capacity. Now, this is trauma. And when that happens at a cellular level, our cells are shutting down. This is what's called the cell danger response that you alluded to. So, we often will recognize that we've gone into a trauma response based on our emotion and that feeling of I give in, I gave up.

I just wanna curl up into a ball and go into fetal position. Anytime that we feel that way, that's how we know, oh, my body has just gone into trauma response. No longer is it in the stress response, but then that becomes what changes our cells and what's happening at the cellular level is that the cells are shutting down, the mitochondria are shut down. And it's doing that because it is now entering this other survival strategy where it no longer trying to fight and run away like it was in the stress response.

This survival to not use energy, to, not die, but really stay barely alive. And that's where we can also notice our breath and the difference between our breathe and a stress response and trauma response. In a stressed response, our breaths is fast and shallow. Why? Because we need to make a lot of energy. We need a make lot ATP, which takes oxygen. So I'm going to be breathing in a lots of oxygen and because I am also making a of ATP I create a more CO2 and that needs to let off. And so this idea that all of the physiology is changing to help us make more energy when we are in the stress response.

But as soon as we go into that trauma response, our breath becomes very shallow, but very slow. In fact, I remember when I first started going to therapy, and my therapist would have to tell me like, Amy, can you take a breath, please? Because my chest, i don't know if I wasn't breathing or if i was just breathing so slow and so shallow that my test was barely moving. And that's not what our breath is when we're in the parasympathetic. When we are in parasympathy, there's this nice rhythmic in and out inhalation, expiration, but even in these three different states that we have, we can see just how our breathe is different in each one of them, and that can help us recognize when were in a trauma response.

It's so fascinating, but I feel like it's important to recognize when you're in a trauma response because a lot of the mainstream advice for people out there focuses on if you are stressed, right? When you stress, you have high cortisol, here's how to lower your cortisol. If you stressed go for a run, if your stressed do a cold plunge, If your stress do X, Y and Z. And the majority of women that I've worked with They are literally in that energy conservation mode, they are fatigued. They're like, I'm doing everything to conserve energy.

Everything is overwhelming. everything is just too much for me. I, you know, i can't do simple day to day activities. and I see low cortisol patterns, majority of them, if I were to do an adrenal saliva or a Dutch test, I do see mitochondrial dysfunction for a lot of then. A big thing that I recommend is oftentimes, you know, really trying to shift into that parasympathetic state and mitochondria support, adaptogens, all of these amazing things to get into more of a, i guess, supporting your body from the stress response, but there's also some things that

Capacity, Overwhelm, and the Cell Danger Response 36:36

they shouldn't be necessarily doing and you alluded to vagal, the vagus nerve and perhaps the sympathetic nervous system. Can you give us a little bit of information of what that might be and what it might look like? So, you know, for me, a lot of my thyroid ladies, they're like, everybody's cold plunging and I'm like maybe you shouldn' t be right. So can you potentially not to if you are in that trauma response. Yes. Oh, this is so important because there's so many women especially who will guilt themselves because they're not doing these things.

And yet actually they are listening to their body and I would want them to be celebrating that they meeting their bodies where it's at. When we have this trauma biology, and again, this is what it is, whether it's the low cortisol, the autoimmunity, we are talking about trauma of biology. When have that, The most important thing is to learn how to shift that into a biology of safety. And so like you're encouraging them to do, yes, let's do some nervous system work. Let's shift into that parasympathetic on an emotional level because in that moment that will shift our state.

And that's wonderful. The more trauma biology we have, the less that that is going to stick. So the more that we're going need to that all throughout the day because we'll put ourselves into a feeling of safety and then five minutes later we are back into our doom and gloom type of thinking. And so as we're looking at how do I create the biology of safety coming from trauma biology, it's this clear idea of don't exceed your body's capacity. And your buddy does not have the capacity for more stress at this time in your life.

I remember you even talking about this earlier when you were, I think, focused on your adrenal fatigue. And I mean, remember, you doing a post about coffee and how hard it was to not drink coffee when he would become so dependent on and so used to it. But yet again, that's creating a stress for your body when your buddy doesn't have the capacity to up level itself and be like, oh, we want to operate at this level. OK, let me do that for you. It can't right now. it can only operate that this little and this is its best.

So when we're going to do the cold plunge, That's trying to get our body to operating up here. And it doesn' have The capacity on a cellular level, it Doesn't Have the Capacity. So this idea of figure out where your body is at right now. What is your current capacity? And that's where I start people. Where is Your current Capacity? What allows you to accomplish something without it feeling like it sends you into overwhelm and stay within your window of tolerance? Right? Like you and I have this background, so we know that we use the word homeostatic capacity.

But how do we take that terminology and apply it to everyday people? It's this idea of you can sense when, if you were to try to go clean your house right now, you would spend the rest of the day on your couch. tired, exhausted, because that was too much for you. You can, again, sometimes it's hard because we're disconnected from our bodies, but you can generally have that sense the more that you have lived with chronic symptoms to know like what will be too, much, for me and what feels like too.

much. For me, and being able to respect that and learn to stay within our window of tolerance as we then grow that window tolerance. So the first phase of this healing journey is to get yourself into your window I don't want you precipitating these trauma responses into overwhelm. That only reinforces that neuro pathway of this is just how we live life. We get stressed and we go into overwhelmed. Will do this every day for the rest of our life? No, like the more times we do that, the it's getting wired into our neuroplasticity that this just is how do life and the harder it will be to change that because it literally now become a habit, whether we need to or not.

So what we wanna do is find our window of tolerance and stay there even though that will mean temporarily making your life smaller. Making your diet something that's like what can you eat that your body will not react to? What can you do that you are staying within a window of safe enough? Safe enough. I feel safe, enough, not maybe completely safe but safe. And then once we've been there, then We can build and start building that window of tolerance so that we can expand our life back out and be able to do these other things that We want to but just our body's not there right now and if we tried to Do it we'd be pushing it rather than as you said supporting it it's the difference between are you running on fumes or Are you giving from the excess of what you feel that you have?

I feel like what you said is just so powerful, because if anybody listening to this, I hope this is your permission slip to actually tune into your body and to listen to your buddy. I know I've been there before. Dr. Amy has been here before a lot of our clients have been before where they're struggling with fatigue, they are struggling brain fog, perhaps they struggling their weight. other kinds of thyroid symptoms, autoimmune symptoms. And yet, they're pushing themselves, right? So they are like, well, I'm overweight, so I need to go run and I needs to do high-intensity exercise.

I am exhausted, but I have to be a good friend. So I needed to show up for all of these people. You know, am brain fogged but should really apply for another job or I should do X, Y and Z. We live in this world of shoulds and it's like if your capacity is so limited, Maybe this isn't the best time for you to start a new career, not the time to be like the super social butterfly and make new friends. This is the kind of time you can cocoon yourself and focus on your healing, be there for yourself, for your own body.

And I feel like, for me and on my healing journey, I used to be that person that I was like I'm tired and I am going to force myself to go to the gym. I m tired, and then I sign up to run a marathon. And it was sabotaging myself because I very disconnected from my own body. Um, for me personally, you know, like the, I love mantras every day and every way I'm feeling better and better. I loved positive affirmations. to really get out of that state. So right now, you can't tell behind me, but I'm seven months pregnant and I've got my pillows around me.

I got got feet up, I am not doing any cleaning today. Like I just not, just taking my time having a healing conversation with you. And the reason why I can do these things and be so connected within my body is because I have done all this work. probably hundreds of sessions at this point, and neurofeedback as well. That has really helped me to two of the things that have helped tremendously. And there's also you talk about somatic therapy. Can you talk about why that makes a big difference? Because one thing I did want to say is like, sometimes people go to therapy, and it's like they just talk and talk, talk.

And I've gone to grief therapy was very, very helpful. But at a certain point, I was like I'm just kind of rehashing the same thing over and over again. I feel like i'm not making a lot of progress. So I would love for you to Talk about how to actually get out of it, right? Absolutely. And my experience with this comes directly from my patient care. So I started in general surgery, but then as I transitioned and I decided to study trauma, I became an addiction medicine physician. So I was leading a medical detox, helping people detox off of their substances that they've been on for decades.

Some of these people were in their 50s and 60s, and they had started using as a teenager. So this was very similar to trauma. This is very familiar to having lived with our trauma for so long that it's all that I know. I don't even know how to do life without this. And to help them get off of their substances is not then just a simple detox and, okay, best of luck. We will see you later because they go out into the real world and they still have stress and triggers and busyness and confusion and loss.

And that's the only way that they've ever known to deal with those things. What I realized was that even though I could create that feeling of safety when they were with me and we were having a session, I can't go home with each of them. I cannot be at home to be like, oh, you just had a trigger? Okay, well, let's talk or let us do an exercise together. So I needed to teach them what they could do for themselves in the moment, because if I did not, they were going to relapse. So that is the angle from which I then started to use somatic work.

I needed them to be able to do something for themselves, not necessarily make an appointment with their therapist to go see their therapists in a week. We don't have a weak. Literally, we have about 30 seconds before they're going to decide, fuck this, I'm going use my substance because I need relief from this pain right now. So if 30 seconds is all I've got, what can I possibly teach them that they can do for themselves when I'm not even around? And that works so powerfully in 30 Seconds that They're like, Yeah, I don't need that heroin.

Yeah. I Don't Need that alcohol. So the pressure was on and that is then what I started using for the somatic self practices. So these are exercises that I learned as I was going through somatics therapy training. And yes, I did that training as a medical physician to help myself, had no intentions of ever teaching this, but I'm so glad that I learned it because it allowed me to then adapt and create self practices for people that they can do for themselves in the moment that work more powerfully than even an addictive substance.

And so these are very short exercises that involve a person moving in some way or connecting or touching their body in a very specific way that engages

Somatic Tools for Nervous System Healing 48:36

their anatomy and their physiology that will create an inner sense of safe enough right here right now. And so quickly that then they don't do that whole spiral thing that we can do of making up this whole story of what's going to happen if this and this, and within 30 seconds we find ourselves thinking about I'm going die alone on the streets. have no friends and no money. Our stories can go that far, that quickly. And so we've got to be able to redirect that so that we're not going into those responses anymore.

These are the somatic self-practices. In fact, what I'm happy to do is share five of my exercises. I've put together a nervous system reset, and they have five sommatic exercises that I teach people to for themselves. and I am happy share that with your audience. If they want to go to biologyoftrauma.com forward slash book, they will be able to get those exercises. And that's a very powerful way to start with something that you can do for yourself as part of anything else that they are already doing.

It's a very nice complement to the EMDR, to neurofeedback, the functional medicine. It is being able to have the skills, but also it's having that sense of confidence that I can stop the spiral. when it starts. I don't have to let that be a runaway train that takes me down a path that I didn't want to go. i now have agency over my own inner state and again we can sense it more in our emotions our emotional state but it's our physiology because this is our nervous system that we are shifting in the moment.

That's wonderful that you have these exercises and therapies people can do by themselves, right? Because neurofeedback and EMDR, that generally requires working with a practitioner, costs money. Sometimes you need to leave your house. You have to kind of get that set up and do all kinds of intakes. but you're able to utilize these somatic exercises that they're self guided and there's five different ones that people can choose from to see which ones, you know, work best for their bodies and they can be done in under five minutes to shift them away from the spirals and give them sort of like another coping strategy coping mechanism versus turning into like the, you know, potentially addictive substances.

And sometimes that might be like, cookies and cakes for some people. For other people, it might heroin or cigarettes or alcohol, right? And they're trying to sort of numb the pain or numb all of those thoughts. This is amazing that you've created something like this. I can't wait to take a look I'm going to get this for myself as well. Is it biologyoftrauma.com slash book? Forward slash Book. So that's where I will have the links for people to be able to order the book and then put their order information in and get that five-day nervous system reset.

And you actually have a book that's going to be shipping in about three weeks from now. I've actually got my hardcover copy already. You know as an author that you get the hard cover copies early before it's actually officially released, officially coming out September 23. And this is the whole biology of trauma. what does that mean? What does it mean for our healing journey and laying it out for how the body experiences trauma different from a stress, why it holds on and we can't just move on? And then what that means for these phases that I've talked about of the healing Journey, how to know where to start, How to Know if something that you're considering is the right place to Start or if that would actually be too much for your current capacity.

These are the things that we can know so that, we could just be more intentional and deliberate with our healing journey and not get stuck or lost. Yeah. Thank you so much for creating this resource. I know it's going to help a lot of people and thank you for the free guide for our community too. This is something that I think we could all use in our lives. Sometimes life can get overwhelming for whatever reason and we might not have the time and resources to connect with a therapist right away, which of course might be something we want to do in the long term.

but we also wanna figure out how we can help ourselves best. I feel like a lot of times we outsource our healing to other people where a lotta that healing can be self-directed, self guided and this is why I love educating people and I know you love educated people as an author or with our speaking or websites. We want people to like heal themselves and there are powerful, sometimes simple tools that you can utilize for that. Yes, and thank you for bringing it up because for me, it's like understanding the science then brings so much hope.

so that now trauma for me is not a conversation of darkness and heaviness. I love to talk about trauma because I know that there's so much that we can do. And as you say, engage our body's innate healing. It is designed to heal even from trauma. If it wasn't designed a hold on, it's designed the heal. it just hasn't had what it needs to be able to heal itself and so understanding the science just allows us that knowledge and the tools then for allowing the body to be at its best naturally. I see so many people walking around whether they're my clients or you know friends and family loved ones and a lot of them are walking has to do with attachment wounds.

So perhaps things that happened when they were young children with their families, and oftentimes I feel like it can be very heartbreaking because their relationships with her parents are not what they would want them to be, but also their relationship with significant others and friendships and with their children. And it's kind of like a whole big thing that impacts not just that parent-child relationship, but your entire life when you think about that. Can you talk about the connection with attachment wounds?

Maybe give us a little bit of a background information with all of your wonderful training as a physician and in mental health, I don't feel like a lot of us are as aware about what is attachment and what does that mean for for a person's like development, right? Absolutely. So again, Chapter 11 is where I really dive into the attachment piece. And it's huge connection with autoimmunity. In fact, those with auto-immunity have one of the attachment pains that I talk about. And these attachment pain happen at different stages of our development because we have different needs in our childhood based on whether we were just newborn or whether were five years old.

We have needs at that time, different emotional needs. The first attachment that we experience can be the hold me attachment. And that is because when we are first born, our biggest need is just to be held. And the reason for that, is our internal physiology is still so up and down that we need someone else to regulate our physiology. We often use the term regulation in terms of emotions. your emotional regulation, but we're talking about physiology. So a baby will die if they are not held because they don't have that regulation of their physiology and their heart starts beating too fast and there are physiology gets out of balance and they can die.

And my sense of I know I'm going to be okay, I can relax because I that I am going be to okay comes from being held. So if we are not held enough, well then we form the first attachment pain which is hold me. And what a person can feel is always then that they are afraid of being dropped. So even going into adulthood, they just have a hard time trusting other people. They have hard times relying on other because they're afraid that, ah, you're not going to hold me. I can't relax into this relationship because I don't trust that you are actually going follow through.

But then there's these other attachment pains and we can have hear me. So hear, me is the next attachment pain. And that's because as we develop from that initial stage of about the first month of our life, now we're trying to express our needs. Now we are trying express, I'm cold. I am wet. the response either doesn't come or it's unpredictable or comes with conflict or emotional disconnection. We start to experience that it is probably not a good idea to have needs. People don't like you when you have needs.

And so even as early as that, we can then start to disconnect from our own body and say, oh, no, I don''t feel cold. Oh, No,I don' have need because I can see the effect that it has on you. And when we are children, we so depend on that attachment relationship for our survival that we end up abandoning ourselves to preserve the attachment relationships.

Attachment Wounds, Parenting, and Repair 58:36

And that is a key part of autoimmunity. And every person with autoimmunity that I've talked with, we can trace back some element to feeling that way during their childhood. They felt like they needed to be someone for their parents. and whether that was the responsible one, the quiet one the perfect one. The funny one there's all these roles that we may have developed in order to be just who we thought that they wanted us to, be rather than be myself. Because at that age, the attachment relationship is the most critical thing for our survival, and we will abandon ourselves to maintain the relationship, even if it's an unhealthy or toxic one.

Yeah, I mean, that's incredible, and I definitely can relate to that. I grew up in Poland, And my dad left for the United States when I was around three. And so my mom was running a medical clinic and had a lot on her plate. So I always learned to be responsible and dependent. There were a lotta things that I just was supposed to do. That I could relate. One kind of controversial question, but growing up in Poland, if a baby cries at night, the common thing to do is to go get the baby and put the I live in the United States now.

I'm a soon to be mom of another baby and I have a seven year old. And I read all these books about getting the babies to sleep through the night. and i think that sounds wonderful in theory and God knows I love my sleep and waking up multiple times a night is difficult, especially when you have to work. But the cry it out method for babies I mean, how does that impact this attachment? And do you have thoughts on that or? I did a whole podcast episode on it myself on my biology trauma podcast that I have lots of thoughts.

And for me, it really comes down to again, just what is the inner physiology that's happening? And what we see happening is that a baby will first cry because that's how they communicate that they need something. Even if that need is for comfort, even if the need for, I feel all alone and I'm terrified and need someone right now, those are all needs. And so they're communicating a need. But if no one comes, they then go into a trauma physiology and they shut down and this is a common misconception that oh she's such a good baby she never cries that's a baby in a traumatic response that is the baby who is shut because she learned that she shouldn't cry.

No one is going to come for help. So again, going back to this idea of the trauma response is conserving energy. If no one's going come, why should I use the energy to cry? And so I get worried about those babies who no longer cry because their physiology is already forming this trauma biology and these pathways in their nervous system that say just shut down. You are not strong enough for any stress or any hard things and you should just automatically shutdown because that's the pattern that will continue for them into their adulthood.

Yeah, I think it's very devastating because there's many well-meaning parents. that sleep is, of course, valuable. And in America, we hardly get maternity leave. Maybe if we do, it's like three months. I took a lot of years off after having my son. One of the reasons was because he didn't sleep. So I just had him in bed with me and kept waking up because I was like, yeah, I can't. You know, was joking I would just going to go for maternities for three month and I ended up doing like 3 years. But I feel like that is a big disconnect these days in our society, because we're told like, we were supposed to be so independent in America, and we are supposed be tough.

And we even expect our infants to, you know, not express their needs. We're hearing this from pediatricians, like this is the best thing you can do for you and your baby. But, I know and perhaps for some babies, it's not an issue at all. women will feel their own intuition and that intuition can really guide them onto what is best for their individual families, right? Absolutely, and you know as I look back at my life and when I was a parent and I made so many mistakes, I Made so Many mistakes and i think that's been a big part of my healing journey is giving myself the grace that looking back I Was doing the best that I could at that time And I do think that that is true.

Like we are each doing the best that we can at that time in our life. And sometimes for parents, it's really tough. They have to go to work. So they have do things that they don't like to do that are even against their values. Maybe it is putting their child in daycare or other things. That they're like, oh, like I hate that I have this. I would rather them do those things with that inner understanding of I'm doing the best that I can, rather than adding shame onto that, because now they're in a trauma response as well, and I would rather have their nervous system be in good enough place, regulated enough, safe enough so that when they are with their children and they able to provide that connection and co-regulation, It is one of, I'm communicating safety to you, communicating love to, rather than what can be unconsciously and unintentionally communicated, which is, i'm ashamed of myself.

I don't feel like I am a good enough parent. And don t think that our children can t feel that. Their nervous systems feel those things. So, having grace for ourselves that we are doing the best we can with what we have at this time. And, you know, another kind of a point is like, there's no such thing as a perfect parent. There's not such a thing a the perfect spouse. You're not going to get a prize for being the crunchiest person in the world and doing everything perfectly and holistically and eating the best diet.

And I feel like for many of us, I think the stress of something can make things worse than the actual action of doing it. And I was talking to my brother, some of my parenting fears before I had my son, and he goes, you know, but you how to fix a lot of things, don't you? Right. And so when we figure out how we can fix our own trauma, we could also help to heal our families. We can help the heal. Our children. Hey, maybe, your child fell and you weren't there that one day and this was something that they held on to, or there was a storm and just slept through it and they were super, super scared.

You can actually, once you learn how to heal yourself, you can start really spreading that healing throughout your whole family. And not to say that we should on purpose go and do all the wrong things and make all of the mistakes on We're going to do things that we're gonna be like, yeah, that probably wasn't the best idea at the time, but knowing how to repair, I feel like this is so, so powerful because living in our modern world, we are constantly being broken down, whether it's toxins in food or inflammatory infections or just like the stress of living the modern-world.

I mean, you could have been the perfect parent, COVID hit, right? In 2020, like you could have been living the perfect life. Like you can't control any of that. And so just having that opportunity and understanding how trauma can show up in yourself, in your family members, this is such a powerful healing tool. You know, you use one of my favorite words, which is repair. And section three of my book is all on repair. It is like, this is how, these are our tools and how we use the tools to repair, so that word repair is actually really key for trauma healing on many levels.

And a child will actually be healthier going into their adulthood if they have had some rupture and repair so that the goal is actually not to be the perfect parent because our children will not actually be as healthy as if there has been some repair of disconnection, some repairs of ruptures because that's how they learn how to repair. That's they how learn to even handle stress and move through these different states and then be able to prepare things. But we also need to repair our relationship with ourselves.

And that's a big piece of the healing journey. Especially with autoimmunity, realizing that we've spent so long sometimes not liking ourselves, seeing ourselves as the problem. It's not just our relationships with other people that need repair. the primary relationship that we will need to repair is the one with ourselves and being able to shift from hating my body to befriending my, and that may sound easy it is not easy and yet that's some of the most important repair that, we can do and is always part of, the healing journey.

Absolutely. I would love for you to tell us again where we can get your book and the title of it. If you can hold it up for us to the biology of drama. Yes. The biology of trauma, for those who may know, Gobermante, he wrote the foreword to the book, and really it's being able to take the inner experience of the body to say, this is what's happening inside that creates a trauma experience for us.

Generational Trauma and Final Takeaways 1:09:36

How does the buddy actually experience the trauma? It is not the event outside of us, it is, what happens inside of so I lay that out what is actually happening and then the second section is on why does the body hold on and it's through this creation of a biology of trauma that creates the feedback loop that we talked about and in section three is given that this is where we're at What do we do about it? What are the phases? what are The tools for repair? How do We use the tools in the right way so that we don't get lost or we Don't retraumatize ourselves on the journey by trying to do too much trying To do the wrong things talking about It but not resolving it.

These are all the things that many people and unintentionally do wrong and find themselves taking a lot longer on the healing journey than what's actually needed if we know how to approach it with this understanding of this is my capacity, how do I find that window of tolerance, and then how I build that Window of Tolerance in a way that it's building my mental health, emotional health and physical health since they all play a role in my Thank you so much for creating this amazing, incredible resource.

I know that I'll be ordering a copy for myself and studying it myself. And I will be order a few copies for a friends of mine because I think this is going to be such a big game changer in their lives. If we have a minutes, I would love to ask you a rapid fire questions. Can trauma be passed down through generations and affect thyroid health? Trauma can be passed down through generations and it's not just in our patterns of communication and relationship. It's also in out sensations and our body associations and in biology.

So it actually does change our DNA and there are epigenetics of generational trauma. What's the most surprising way that trauma shows up in your body? One of the more surprising ways is that it gets connected with people, places, and things. And so we can be driving down the road and if it's at a location where we had a car accident or maybe we got a phone call at that location on the roads, our body will start to have this response. We may not even consciously understand why. We can go to family reunions and our body will have lots of things going on.

And yet we can mentally think, well, I'm not a child anymore. This stuff doesn't bother me anymore, but your body says, actually I am having a response. So that's one of the ways in which trauma can show up that surprises people of your is going to have a reaction to things that logically you may not understand. Can grief or heartbreak actually cause autoimmunity? Grief and heart break can cause a trauma response. And it's the trauma of response that creates the biology that can yield to auto-immunity.

Dr. Amy, thank you so much for being here with us. Thank you for the life-changing work that you're doing. Everybody listening, I hope this has been helpful on your healing journey. Until next time.