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The Peter Attia Drive

Paul Conti, M.D.: How to heal from trauma and break the cycle of shame

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Episode Description:

Paul Conti, a returning guest on The Drive, is a practicing psychiatrist and recent author of Trauma: The Invisible Epidemic: How Trauma Works and How We Can Heal From It, in which he offers valuable insights on healing from trauma. In this episode, Paul explains how his personal experience with trauma and his many years seeing patients have shaped his understanding of trauma’s impact on the brain, its common patterns and manifestations, and how often people don't recognize the implications of trauma in their own life. He discusses major challenges in recognizing trauma, including the lack of biomarkers in psychiatry and psychology, as well as the misguidance of the mental health system in targeting symptoms as opposed to root problems. He talks about shame as the biggest impediment to healing from trauma and offers solutions to how, as a society, we can start to change the stigma of mental health and allow more people to receive help. Finally, he concludes with a discussion about the potential role of psychedelics like psilocybin and MDMA in treating trauma.

We discuss:

  • Paul’s background and unique path to psychiatry [2:30];
  • A personal tragedy that shaped Paul’s understanding of trauma and resulting feelings of shame and guilt [5:30];
  • The current state of psychiatry training and need for improvement [20:15];
  • The over-reliance on outdated metrics and lack of attention to past trauma as impediments to patient care [28:30];
  • Defining trauma: various types, heterogeneity, and effects on the brain [34:30];
  • Importance of finding the roots of trauma and understanding the “why” [47:00];
  • The major challenge of recognizing trauma in patients [55:15];
  • How shame and guilt are barriers to treatment and healing [1:06:00];
  • How treating trauma compares to treating an abscess—a powerful analogy [1:11:30];
  • How evolutionary survival instincts create problems in modern society [1:15:15];
  • First step toward healing: overcoming the fear of talking about past trauma [1:19:00];
  • Shame: the biggest impediment to healing [1:25:15];
  • The antidote to shame and the need for discourse and understanding [1:34:15];
  • The emotional health component of healthspan [1:41:15];
  • How to reframe the conversation about mental health for a better future [1:52:00];
  • The growing impact of trauma on our society and the need for compassion [1:58:45];
  • Society’s antiquated way of treating manifestations of trauma rather than root issues [2:04:15];
  • Potential role of psychedelics like psilocybin and MDMA in treating trauma [2:11:15];
  • Parting thoughts and resources for getting help [2:16:30];
  • More.

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