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Restoring Joy and Treating PTSD, with Dr. Bessel van der Kolk
Dr. Bessel van der Kolk, one of the world's foremost psychiatrists specializing in PTSD, explains the disorder's many effects and symptoms.
Bessel van der Kolk is a psychiatrist noted for his research in the area of post-traumatic stress since the 1970s. His work focuses on the interaction of attachment, neurobiology, and developmental aspects of trauma’s effects on people. His major publication, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society, talks about how the role of trauma in psychiatric illness has changed over the past 20 years.
Dr. van der Kolk is past President of the International Society for Traumatic Stress Studies, Professor of Psychiatry at Boston University Medical School, and Medical Director of the Trauma Center at JRI in Brookline, Massachusetts. He has taught at universities and hospitals across the United States and around the world, including Europe, Africa, Russia, Australia, Israel, and China.
His most recent book is The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma.
Bessel van der Kolk: PTSD was a diagnosis that my generation first created in order to remind the VA to take care of veterans and to really say to the VA these guys are messed up because of Vietnam. And initially people said these guys were always messed up; it must be some other thing. And the way that we organized the diagnosis was around the issue of memory. About that you have flashbacks to witnessing people getting killed, to the horror stuff that they saw in the war. That is not really the primary issue that people came in with; the issue that people came in with was that they had a very hard time getting along with other people, not blowing up at people, becoming scared and frozen, having no feelings for their kids, feeling numb with their girlfriends and general problems with engagement with other human beings and getting triggered and becoming very angry and very upset and very out of sort.
And the memory issue was also an issue but it really is not what people suffer most from, it really is about having difficulty feeling alive in the present, feeling engaged, feeling a sense of pleasure, of joy, of even exuberance at the right moment of just feeling like boy it's good to be alive. And in the years since that time we have understood a lot about what happens in the brain that interferes with the capacity to feel alive in the present.
The primary symptoms are becoming upset, becoming triggered, they're particular sounds, smells, images, bring back states in which people act again as if they're being traumatized. What happens in kids is it's not so much memory issues but becoming upset, becoming angry, being assaultive, being oppositional, not trusting people, unable to concentrate, to pay attention, to engage in anything. And particularly when you're traumatized as a kid, kids are very egocentric and they think that the universe is all about them; that's what it's like to be a kid. And so if terrible things happen to you you feel like this is happening to you because you are a terrible person so this becomes part of your identity. I'm a person who makes bad things happen and I'm also a person who other people cannot possibly care for because people who were supposed to take care of me are not taking care of me.
And so kids develop something more like what we call developmental trauma disorder, in which it invades very many areas of functioning. It doesn't mean that adults who get traumatized may not also have those feelings. Often times traumatized adults often feel ashamed, blame themselves for what has happened to them. When they get raped they say I must have done something wrong to make this happen to me. So the issue of shame and blame is also a very big issue for adults.
Something like three quarters of the U.S. population experiences traumatic events and may actually be triggered by particular things. If you grew up with an alcoholic parent the likelihood that you will have certain traumatic triggers, have certain fears of intimacy, certain uptightness about getting out of control just like that parent went out of control is quite common. And in fact one out of five American women have been sexually molested at some point or another. One out of four Americans have been quite severely beaten by their caregivers. So these are common things. These are common things in the general population. And so most of us either have been painted by that brush ourselves or know people in our environments to whom that has happened and we are living with the consequences thereof. And the reason why I wrote this book actually is to not only draw people's attention to what we know, but also to really draw attention to the fact that we can do something about it and that we have learned a great deal about how to intervene and help people to come back to life.
After you get traumatized you feel defective, you feel there's something wrong with you and you hope that people won't notice. And you also don't believe that anybody can help you. And finding help in fact is not always that easy. How do you know when relationships keep failing? When you fall in love with somebody and on the third date you blow up or you become frightened or you find something with that person and it bugs the hell out of you. Your sense of compassion to yourself and other people goes out of the window. So you become very intolerant of other people, you become very intolerant of yourself and so you live in an intolerant environment. And your kids don't dare talk to you; you see them becoming frightened; you see them walk out of the room when they see you sit there. You turn on the television and you scream at people not to bother you. And this reactivity to people, this being bugged by people, this inability to tolerate other points of view, this inability to see that other people may look at the world differently than you do is a pretty good hallmark that you have something to work on and that you need to actually learn to notice yourself and to notice what goes on inside of you that makes you so chronically angry and irritated.
Anger and irritation is a very important piece. The other thing is those were the symptoms I talked about that we first saw in Vietnam veterans and that continues to be the big thing in child abuse survivors, car accident victims, soldiers, et cetera, et cetera, is the feeling of not being able to engage; that life doesn't mean very much; that my joy is gone. And then it's very easy to say I've always been like that. And then for me it becomes very important to help people to viscerally remember, to be a member of that football team in school or to play your French horn in the band or to make love for the first time or something that at one point gave you great joy now no longer means anything to you. And when those feelings have stopped that means that something is frozen inside of you. And then it's time to deal with that in order to unplug the river of life basically.
Directed/Produced by Jonathan Fowler, Elizabeth Rodd, and Dillon Fitton
One of the world's foremost psychiatrists specializing in PTSD, Dr. Bessel van der Kolk visits Big Think to discuss the history of the disorder, its varying effects on sufferers of all ages, and forms of treatment that can "help people to come back to life." To understand PTSD, says Dr. van der Kolk, you have to understand the nature of trauma and the ways in which traumatic triggers can vaporize anyone's joie de vivre. His latest book "The Body Keeps the Score" was written to draw attention to how traumatic disorders can be avoided.
Join multiple Tony and Emmy Award-winning actress Judith Light live on Big Think at 2 pm ET on Monday.
Frequent shopping for single items adds to our carbon footprint.
- A new study shows e-commerce sites like Amazon leave larger greenhouse gas footprints than retail stores.
- Ordering online from retail stores has an even smaller footprint than going to the store yourself.
- Greening efforts by major e-commerce sites won't curb wasteful consumer habits. Consolidating online orders can make a difference.
A pile of recycled cardboard sits on the ground at Recology's Recycle Central on January 4, 2018 in San Francisco, California.
Photo by Justin Sullivan/Getty Images<p>A large part of the reason is speed. In a competitive market, pure players use the equation, <em>speed + convenience</em>, to drive adoption. This is especially relevant to the "last mile" GHG footprint: the distance between the distribution center and the consumer.</p><p>Interestingly, the smallest GHG footprint occurs when you order directly from a physical store—even smaller than going there yourself. Pure players, such as Amazon, are the greatest offenders. Variables like geographic location matter; the team looked at shopping in the UK, the US, China, and the Netherlands. </p><p>Sadegh Shahmohammadi, a PhD student at the Netherlands' Radboud University and corresponding author of the paper, <a href="https://www.cnn.com/2020/02/26/tech/greenhouse-gas-emissions-retail/index.html" target="_blank">says</a> the above "pattern holds true in countries where people mostly drive. It really depends on the country and consumer behavior there."</p><p>The researchers write that this year-and-a-half long study pushes back on previous research that claims online shopping to be better in terms of GHG footprints.</p><p style="margin-left: 20px;">"They have, however, compared the GHG emissions per shopping event and did not consider the link between the retail channels and the basket size, which leads to a different conclusion than that of the current study."</p><p>Online retail is where convenience trumps environment: people tend to order one item at a time when shopping on pure player sites, whereas they stock up on multiple items when visiting a store. Consumers will sometimes order a number of separate items over the course of a week rather than making one trip to purchase everything they need. </p><p>While greening efforts by online retailers are important, until a shift in consumer attitude changes, the current carbon footprint will be a hard obstacle to overcome. Amazon is trying to have it both ways—carbon-free and convenience addicted—and the math isn't adding up. If you need to order things, do it online, but try to consolidate your purchases as much as possible.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Chronic irregular sleep in children was associated with psychotic experiences in adolescence, according to a recent study out of the University of Birmingham's School of Psychology.
A time for sleep<div class="rm-shortcode" data-media_id="Mt29uUqI" data-player_id="FvQKszTI" data-rm-shortcode-id="931343dee3c02121445e51e94ba22446"> <div id="botr_Mt29uUqI_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/Mt29uUqI-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/Mt29uUqI-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/Mt29uUqI-FvQKszTI.js"></script> </div> <p>Previous studies had already suggested a link between persistent nightmares in childhood and psychosis and borderline personality disorder (BPD) by adolescence, but researchers at the University of Birmingham's School of Psychology wanted to see if a similar connection existed between these mental disorders and other childhood behavioral sleep problems.</p><p>To do this, they scoured data from the Avon Longitudinal Study of Parents and Children, a longitudinal cohort study that followed approximately 14,000 children born in Avon, England, in the early 1990s. The study followed the children for more than 13 years. During that time, mothers filled out questionnaires asking about the children's lives. Factors looked at included housing, parenting, nutrition, physical health, mental wellbeing, environmental exposures, and so on. </p><p>The cohort study inquired about sleep routines, sleep duration, and awakening frequency when the children were 6, 18, and 30 months old, and then again at 3.5, 4.8, and 5.8 years. It also assessed mental health in adolescence using semi-structured interviews, such as the Psychosis-Like Symptom Interview.</p><p>"We know that adolescence is a key developmental period to study the onset of many mental disorders, including psychosis or BPD. This is because of particular brain and hormonal changes which occur at this stage," <a href="https://www.birmingham.ac.uk/staff/profiles/psychology/marwaha-steven.aspx" target="_blank">Steven Marwaha</a>, professor of psychiatry at Birmingham and senior author on the study, <a href="https://www.sciencedaily.com/releases/2020/07/200701125431.htm" target="_blank">said in a release</a>. "Sleep may be one of the most important underlying factors—and it's one that we can influence with effective, early interventions, so it's important that we understand these links."</p><p>After compiling the data, the researchers discovered an association between children with irregular sleeping patterns and teenagers with <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/about-psychosis/" target="_blank">psychotic experiences</a>—that is, episodes when the person perceives reality differently than those around them. Even when depression at 10 years old was considered as a mediating factor, their findings still suggested "a specific pathway between these childhood sleep problems and adolescent psychotic experiences." </p><p>Toddlers with shorter nighttime sleep duration and late bedtimes were likewise associated with a <a href="https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml" target="_blank">borderline personality disorder</a>—a disorder marked by a pattern of varying moods, self-images, and behaviors—in their teenage years. Depression at age 10 did not mediate this particular association, suggesting a separate and more specific pathway. </p>
A more restful tomorrow<p>While the sample size was large and mental health was assessed with a validated interview, there nevertheless remain limitations to this data. For starters, sleep habits were based on mothers' reports. Because they came from memory, versus a more direct observation method such as actigraphy, these data may be prone to imperfect recollection and reporting error. There are also many confounders that could be secretly nudging the results, such as family conditions, prenatal medicines, and a host of environmental factors. Finally, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024884/#:~:text=Sleep%20difficulties%20in%20youth%20with,fear%20of%20dark%20%5B13%5D." target="_blank">the relationship between sleep problems and mental disorders</a> is both complex and two-way.</p><p>As such, the study shows an association between poor childhood sleep later mental disorders but does not prove a causal link. Parents need not worry that a string of nightmares or the eternal struggle settle into bed will be the first ingredients in a witches' brew of debilitating mental disorders. The goal of the study, the researchers point out, is not to create undue worry but improve our ability to recognize the signs of at-risk children and deliver necessary interventions earlier.</p><p>"The results of this study could have important implications for helping practitioners identify children who might be at higher risk for psychotic experiences or BPD symptoms in adolescence, and potentially lead to the design of more effectively targeted sleep or psychological interventions to prevent the onset or attenuate these mental disorders," Isabel Morales-Muñoz, the study's lead researcher, <a href="https://www.healio.com/news/psychiatry/20200702/childhood-sleep-problems-linked-to-adolescent-psychosis-borderline-personality-disorder#:~:text=Sleep%20problems%20during%20early%20childhood,study%20published%20in%20JAMA%20Psychiatry." target="_blank">told Healio Psychiatry</a><u>.</u></p><p>If a parent reading this is worried that their child's sleep patterns are deleterious, the take away should not be despair over an unyielding fate. It should be to seek professional help as soon as possible to begin improving sleep duration and quality. Even if you aren't worried, it's worth remembering that childhood experiences lay the foundation for a lifetime of salubrious sleeping habits. It's so much more than beauty rest.</p>
Construction of the $500 billion dollar tech city-state of the future is moving ahead.
- The futuristic megacity Neom is being built in Saudi Arabia.
- The city will be fully automated, leading in health, education and quality of life.
- It will feature an artificial moon, cloud seeding, robotic gladiators and flying taxis.
The Red Sea area where Neom will be built:
Saudi Arabia Plans Futuristic City, "Neom" (Full Promotional Video)<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="c646d528d230c1bf66c75422bc4ccf6f"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/N53DzL3_BHA?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Are we genetically inclined for superstition or just fearful of the truth?
- From secret societies to faked moon landings, one thing that humanity seems to have an endless supply of is conspiracy theories. In this compilation, physicist Michio Kaku, science communicator Bill Nye, psychologist Sarah Rose Cavanagh, skeptic Michael Shermer, and actor and playwright John Cameron Mitchell consider the nature of truth and why some groups believe the things they do.
- "I think there's a gene for superstition, a gene for hearsay, a gene for magic, a gene for magical thinking," argues Kaku. The theoretical physicist says that science goes against "natural thinking," and that the superstition gene persists because, one out of ten times, it actually worked and saved us.
- Other theories shared include the idea of cognitive dissonance, the dangerous power of fear to inhibit critical thinking, and Hollywood's romanticization of conspiracies. Because conspiracy theories are so diverse and multifaceted, combating them has not been an easy task for science.