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.
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The COVID-19 pandemic is making health disparities in the United States crystal clear. It is a clarion call for health care systems to double their efforts in vulnerable communities.
- The COVID-19 pandemic has exacerbated America's health disparities, widening the divide between the haves and have nots.
- Studies show disparities in wealth, race, and online access have disproportionately harmed underserved U.S. communities during the pandemic.
- To begin curing this social aliment, health systems like Northwell Health are establishing relationships of trust in these communities so that the post-COVID world looks different than the pre-COVID one.
COVID-19 deepens U.S. health disparities<p>Communities on the pernicious side of America's health disparities have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.</p><p>"There is one common divide in American communities, and that is poverty," said <a href="https://www.northwell.edu/about/leadership/debbie-salas-lopez" target="_blank">Debbie Salas-Lopez, MD, MPH</a>, senior vice president of community and population health at Northwell Health. "That is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future wellbeing."</p><p>Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To pick one of many examples, <a href="https://www.npr.org/2020/09/27/913612554/a-crisis-within-a-crisis-food-insecurity-and-covid-19" target="_blank" rel="noopener noreferrer">food insecurity</a> reduces access to quality food, leading to poor health and communal endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and Type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.</p><p>The pandemic didn't create poverty or food insecurity, but it exacerbated both, and the results have been catastrophic. A study published this summer in the <em><a href="https://link.springer.com/article/10.1007/s11606-020-05971-3" target="_blank">Journal of General Internal Medicine</a></em> suggested that "social factors such as income inequality may explain why some parts of the USA are hit harder by the COVID-19 pandemic than others."</p><p>That's not to say better-off families in the U.S. weren't harmed. A <a href="https://voxeu.org/article/poverty-inequality-and-covid-19-us" target="_blank" rel="noopener noreferrer">paper from the Centre for Economic Policy Research</a> noted that families in counties with a higher median income experienced adjustment costs associated with the pandemic—for example, lowering income-earning interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for poorer families, who cannot easily alter their living circumstances, which often include more individuals living in one home and a reliance on mass transit to reach work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and health care, where maintaining physical distance can be all but impossible.</p><p>The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. "Our interpretation is that poorer people are less able to protect themselves, which leads them to different choices—they face a steeper trade-off between their health and their economic welfare in the context of the threats posed by COVID-19," the authors wrote.</p><p>"There are so many pandemics that this pandemic has exacerbated," Dr. Salas-Lopez noted.</p><p>One example is the health-wealth gap. The mental stressors of maintaining a low socioeconomic status, especially in the face of extreme affluence, can have a physically degrading impact on health. <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">Writing on this gap</a>, Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety, depression, and cognitive load. </p><p>"Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear," Sapolsky writes. "It is outrageous that if children are born into the wrong family, they will be predisposed toward poor health by the time they start to learn the alphabet."</p>Research on the economic and mental health fallout of COVID-19 is showing two things: That unemployment is hitting <a href="https://www.pewsocialtrends.org/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/" target="_blank" rel="noopener noreferrer">low-income and young Americans</a> most during the pandemic, potentially widening the health-wealth gap further; and that the pandemic not only exacerbates mental health stressors, but is doing so at clinically relevant levels. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/" target="_blank" rel="noopener noreferrer">the authors of one review</a> wrote, the pandemic's effects on mental health is itself an international public health priority.
Working to close the health gap<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc5MDk1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTYyMzQzMn0.KSFpXH7yHYrfVPtfgcxZqAHHYzCnC2bFxwSrJqBbH4I/img.jpg?width=980" id="b40e2" class="rm-shortcode" data-rm-shortcode-id="1b9035370ab7b02a0dc00758e494412b" data-rm-shortcode-name="rebelmouse-image" />
Northwell Health coronavirus testing center at Greater Springfield Community Church.
Credit: Northwell Health<p>Novel coronavirus may spread and infect indiscriminately, but pre-existing conditions, environmental stressors, and a lack of access to care and resources increase the risk of infection. These social determinants make the pandemic more dangerous, and erode communities' and families' abilities to heal from health crises that pre-date the pandemic.</p><p>How do we eliminate these divides? Dr. Salas-Lopez says the first step is recognition. "We have to open our eyes to see the suffering around us," she said. "Northwell has not shied away from that."</p><p>"We are steadfast in improving health outcomes for our vulnerable and underrepresented communities that have suffered because of the prevalence of chronic disease, a problem that led to the disproportionately higher death rate among African-Americans and Latinos during the COVID-19 pandemic," said Michael Dowling, Northwell's president and CEO. "We are committed to using every tool at our disposal—as a provider of health care, employer, purchaser and investor—to combat disparities and ensure the <a href="https://www.northwell.edu/education-and-resources/community-engagement/center-for-equity-of-care" target="_blank" rel="noopener noreferrer">equity of care</a> that everyone deserves." </p><p>With the need recognized, Dr. Salas-Lopez calls for health care systems to travel upstream and be proactive in those hard-hit communities. This requires health care systems to play a strong role, but not a unilateral one. They must build <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank" rel="noopener noreferrer">partnerships with leaders in those communities</a> and utilize those to ensure relationships last beyond the current crisis. </p><p>"We must meet with community leaders and talk to them to get their perspective on what they believe the community needs are and should be for the future. Together, we can co-create a plan to measurably improve [community] health and also to be ready for whatever comes next," she said.</p><p>Northwell has built relationships with local faith-based and community organizations in underserved communities of color. Those partnerships enabled Northwell to test more than 65,000 people across the metro New York region. The health system also offered education on coronavirus and precautions to curb its spread.</p><p>These initiatives began the process of building trust—trust that Northwell has counted on to return to these communities to administer flu vaccines to prepare for what experts fear may be a difficult flu season.</p><p>While Northwell has begun building bridges across the divides of the New York area, much will still need to be done to cure U.S. health care overall. There is hope that the COVID pandemic will awaken us to the deep disparities in the US.</p><p>"COVID has changed our world. We have to seize this opportunity, this pandemic, this crisis to do better," Dr. Salas-Lopez said. "Provide better care. Provide better health. Be better partners. Be better community citizens. And treat each other with respect and dignity.</p><p>"We need to find ways to unify this country because we're all human beings. We're all created equal, and we believe that health is one of those important rights."</p>
Shannon Lee shares lessons from her father in her new book, "Be Water, My Friend: The Teachings of Bruce Lee."
- Bruce Lee would have turned 80 years old on November 27, 2020. The legendary actor and martial artist's daughter, Shannon Lee, shares some of his wisdom and his philosophy on self help in a new book titled "Be Water, My Friend: The Teachings of Bruce Lee."
- In this video, Shannon shares a story of the fight that led to her father beginning a deeper philosophical journey, and how that informed his unique expression of martial arts called Jeet Kune Do.
- One lesson passed down from Bruce Lee was his use and placement of physical symbols as a way to help "cement for yourself this new way of being, or this new lesson you've learned." By working on ourselves (with the right tools), we can develop the skills necessary to rise and conquer new challenges.
How to deal with "epistemic exhaustion."
Melting ice is turning up bodies on Mt. Everest. This isn't as shocking as you'd think.
- Mt. Everest is the final resting place of about 200 climbers who never made it down.
- Recent glacial melting, caused by climate change, has made many of the bodies previously hidden by ice and snow visible again.
- While many bodies are quite visible and well known, others are renowned for being lost for decades.
Why leave the bodies there at all? Why not bring people down as soon as they die?<p>It costs a lot of money to go get a body on the highest mountain in the world, up to $80,000 to be <a href="https://people.com/human-interest/dead-bodies-mount-everest-glaciers-melt/" target="_blank">precise</a>. Then there is the problem of actually doing it, since some attempts to retrieve bodies are forced by difficult conditions to abandon their efforts.</p><p>Some people, such as mountaineer <a href="http://www.alanarnette.com/" target="_blank">Alan Arnette</a>, argue that the bodies should be left there. He told the BBC, "Most climbers like to be left on the mountains if they died. So it would be deemed disrespectful to just remove them unless they need to be moved from the climbing route or their families want them."</p> This doesn't stop people from wanting the bodies taken down or dealt with in other ways. <a href="https://en.wikipedia.org/wiki/David_Sharp_(mountaineer)" target="_blank">David Sharp</a>'s body was moved out of sight in 2007. <a href="https://en.wikipedia.org/wiki/George_Mallory" target="_blank">George Mallory'</a>s body took 75 years to find and was given an Anglican burial in 1999. Over time, the elements often move bodies away from the main routes up the mountain to more isolated areas where they remain undisturbed.
Everest’s chilling landmarks<div class="rm-shortcode" data-media_id="V4Kz3Zfc" data-player_id="FvQKszTI" data-rm-shortcode-id="9959d7e5b2866ad9f61ab823a5b60cbf"> <div id="botr_V4Kz3Zfc_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/V4Kz3Zfc-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/V4Kz3Zfc-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/V4Kz3Zfc-FvQKszTI.js"></script> </div> <p>The bodies that remain in view are often used as waypoints for the living. Some of them are well-known markers that have earned <a href="https://www.ranker.com/list/creepy-stories-about-deaths-and-dead-bodies-on-mount-everest/sabrina-ithal" target="_blank">nicknames</a>. </p><p> For instance, the image above is of "<a href="https://en.wikipedia.org/wiki/Green_Boots" target="_blank">Green Boots</a>," the unidentified corpse named for its neon footwear. Widely believed to be the body of Tsewang Paljor, the remains are well known as a guide point for passing mountaineers. Perhaps it is too well known, as the climber David Sharp died next to Green Boots while dozens of people walked past him — many presuming he was the famous corpse. </p><p>A large area below the summit has earned the discordant nickname "Rainbow Valley" for being filled with the bright and colorfully dressed corpses of maintainers who never made it back down. The sight of a frozen hand or foot sticking out of the snow is so common that Tshering Pandey Bhote, vice president of Nepal National Mountain Guides Association claimed: "Most climbers are mentally prepared to come across such a sight."</p><p>Other bodies are famous for not having been found yet. Andrew "Sandy" Irvine, the climbing partner of George Mallory, may have been one of the first two people to reach the summit of Everest a full 30 years before Edmund Hillary and Tenzing Norgay did it. Since they never made it back down, nobody knows just how close to the top they made it. </p><p>Mallory's frozen body was found by chance in the '90s without the Kodak cameras he brought up to record the climb with. It has been speculated that Irvine might have them and <a href="https://web.archive.org/web/20130303001517/http://www.velocitypress.com/Mallory__Irvine.html#A127_Film" target="_blank">Kodak </a>says they could still develop the film if the cameras turn up. Circumstantial evidence suggests that they died on the way back down from the summit, Mallory had his goggles off and a photo of his wife he said he'd put at the peak wasn't in his coat. If Irvine is found with that camera, history books might need rewriting. </p><p>As Everest's glaciers melt its morbid history comes into clearer view. Will the melting cause old bodies to become new landmarks? Will Sandy Irvine be found? Only time will tell. </p>
A strange object found in Utah desert has prompted worldwide speculation about its origins.
- A monolithic object found in a remote part of Utah caused worldwide speculation about its origins.
- The object is very similar to the famous monolith from Stanley Kubrick's "2001: Space Odyssey".
- The object could be work of an artist or even have extraterrestrial origins.
1. ART OBJECT<p>Chances are, this is an art object. The shiny "monolith" appears to be bolted to the ground and made of metal. It also seems to be fastened with rivets, rather being a uniform block of more unexplainable production origin. Deserts are great places for unusual art installations as has been evidenced by art projects you can discover wondering through the desert ghost towns and faraway canyons of Nevada, California, Utah and New Mexico. Certainly, an artist with a sense of humor and an appreciation of Kubrick's genius could have installed such "sculpture" in hopes of exactly what is happening right now – viral fame.</p><p>On the other hand, there is evidence, courtesy of eagle-eyed <a href="https://www.reddit.com/r/news/comments/jzkpad/helicopter_pilot_finds_strange_monolith_in_remote/gdg9qfi?utm_source=share&utm_medium=web2x&context=3" target="_blank">Google Earth sleuths</a>, that the object appeared in that location (somewhere near <a href="https://www.nps.gov/cany/index.htm" target="_blank" rel="noopener noreferrer">Canyonlands National Park</a>) in 2015-2016. So it's possibly been there for a few years. Would an artist have placed it there so long ago with the aim of having this type of success eventually?</p><p>A gallery owner <a href="https://www.9news.com.au/world/utah-monolith-desert-mystery-solved-john-mccracken-sculptor-artist-2001-a-space-odyssey/0bae1a27-5bd2-451e-90a6-393928d9ed02" target="_blank">claimed</a> the work may be a tribute to the art of the late artist John McCracken, who created similar-looking objects before he died in 2011. McCracken was part of the Light and Space movement with such artists as James Turrell, and was known to make his sculptures from plywood forms that were coated with fiberglass and polyester resin.</p><p>While the theory that the monolith was the work of a McCracken aficionado (or the artist himself) may hold some water due to the object's similarity, the fact that the artist died so long ago and the lack of clear incentive for anyone to have planted this years ago only to reveal it now work against this theory.</p>
John McCracken sculptures.