Essentials: Therapy, Treating Trauma & Other Life Challenges | Dr. Paul Conti

Dr. Conti defines trauma as an event that overwhelms an individual's coping skills, leading to persistent changes in brain function. These changes are evident in mood, anxiety, behavior, sleep, and physical health, often accompanied by reflexive feelings of guilt and shame that compel individuals to bury the experience.

Dr. Conti states, "We have to look at trauma as not anything negative that happens to us, but something that overwhelms our coping skills and then leaves us different as we move forward. So it changes the way that our brains function... If trauma rises to the level of changing the functioning of our brains, then there's almost always a reflex of guilt and shame around the trauma."

While guilt and shame were evolutionarily adaptive for survival and social cohesion in ancient times, they become maladaptive in the modern context of trauma. These powerful emotions, aroused without conscious choice, deter individuals from confronting their trauma, leading to avoidance rather than necessary processing and healing.

Dr. Conti explains, "The traumatic things that are sort of emblazed in our brain are built to last... shame is an aroused affect. So it can be raised in us without our choice and it's very powerful which if you think about that is an extremely strong deterrent... But it doesn't make sense in a world where we live much longer... these traumas that happen to us are often so bad for us because they they change how our brain is functioning."

The 'repetition compulsion' is the emotional brain's (limbic system) attempt to resolve past traumas by recreating similar situations in the present. This occurs because the limbic system disregards linear time, believing that 'making things right' now will also fix the past, leading to cycles of repeated, often abusive, relationships or situations.

Dr. Conti states, "The limbic system does not care about the clock or the calendar. So how I would relate that to the repetition compulsion is is when people are repeating what they're trying to do is to make things right... if I can solve something now I will also solve something in the past."

Healing from trauma involves externalizing the experience through speaking or writing, which brings new monitoring mechanisms online in the brain. This process allows individuals to gain distance, see the trauma from an outside perspective, and replace guilt and shame with self-compassion, thereby reducing the trauma's power.

Dr. Conti notes, "When the person starts looking at it, they can sort of see it from the outside and it starts to take the energy out of it. All the guilt and shame inside the person gets juxtaposed like what really happened there? And then they say right I was a terrified child right I didn't understand at all and they can come to a place of compassion."

Psychedelics facilitate trauma processing by reducing 'chatter' in the outer cortex, seating consciousness in deeper brain centers like the insular cortex, where 'humanness' and truth are found. This allows individuals to see their trauma with clarity and self-compassion. MDMA, by flooding the brain with positive neurotransmitters, creates a 'permissiveness' to approach difficult thoughts without fear, especially when guided clinically.

Dr. Conti explains, "The psychedelics make there be less chatter, communication in these other parts of the brain and then we become seated in the part of the brain that I believe is most about our experience of true humanness... MDMA is doing is sort of flooding with positive neurotransmitters... what that creates is a greater permissiveness inside to entertain or approach different things."