– I was raised in the mainstream culture
where if you feel bad,
you take something to make that feeling go away.
Around that time that I first started to work for the VA,
I looked at the treatments that we have.
I did the first study on Prozac for PTSD,
the first study for Zoloft for PTSD,
and a number of other conventional drugs.
What we found is they didn’t work very well.
Our conventional way of thinking about it is not working.
I thought, “Okay, if it doesn’t work,
我想 好的 如果它行不通的话
let’s see what else could work.”
My name is Bessel van der Kolk.
I am a physician, I’m a psychiatrist.
I have been studying trauma for about 50 years now.
The nature of trauma is that something happens to you,
your survival brain makes the first interpretation and says,
is this dangerous or is this safe?
So it’s very important to really be aware
that these reactions emanate for your body.
And so, the big challenge of treating trauma
is how do we help people to live in bodies
that feel fundamentally safe?
What was very clear
is that very good psychotherapy is actually quite helpful.
Not to fix people, but helping people to acknowledge,
oh my God, that was terrible what happened to me.
And I need to take care of the wounds that I’m carrying inside of myself.
This issue of self-compassion
and really knowing that your reactions are understandable
is a terribly important part
of beginning to recover from trauma.
Can I talk about something else before we talk about MDMA?
Because MDMA is so sexy.
For me, the opening to a new world
came when some people in my clinic
started to do something very strange, called EMDR.
Eye movement desensitization and reprocessing.
You ask people to call up the memory
of what you saw back then,
what you felt back then.
And then what you do
is that you ask people to follow your fingers
as you move your fingers from side to side.
And my first reaction was like,
“Man, stop this crazy nonsense, this is a crazy method.”
“兄弟 别乱搞了 这方法既疯狂又愚蠢”
And then I got to see some of the results,
I go like, “Wow, this is interesting.”
我就变成了这样 “哇 太有趣”
Wiggling your fingers and full of people’s eyes
as they think about the trauma
made the trauma go away.
This crazy eye movement desensitization
actually change the circuitry of the brain
to interpret your current reality from a different angle.
This had amazing effects
on people being able to let go of what happened.
They say, “Yes, that’s what’s happened to me.
他们会说 ”是的 我的确遭受过那些事儿
And it happened a long time ago.
It’s not happening right now.”
That was the first time
that I saw a non-conventional technique
have a very profound effect.
And then we studied yoga.
Maybe if you do yoga,
you can open up your relationship to your body.
You learn how to breathe calmly,
you learn to pay attention to yourself,
you get to see how different movements
and different postures affect you.
And so you form a deep relationship
with your internal sensory system.
Yoga, at the end,
was a more effective treatment for PTSD
than any of the drugs we had studied.
But I’ve yet to see a psychopharmacology clinic
being transformed to a yoga studio.
The next thing that we studied was theater and movement.
And it turns out that playing different roles in your body
helps you to feel that your body can feel differently,
depending on how you organize your relationship to yourself.
When my voice gets too gravelly,
let me know and I’ll drink some water.
– It’s feeling a little gravelly, so why don’t-
So, I live in the Berkshires
and we have a great program here,
called “Shakespeare in the Courts”
where if you’re a juvenile delinquent in this county,
you have a 50% chance that a judge will condemn you
to become a Shakespearian actor.
That’s civilization, huh?
The Shakespeare program is enormously helpful
because it helps people to feel their bodies
and to feel what it feels like to be a king,
what it feels like to be a warrior.
And you get to really have a deep experience of yourself
in different possibilities.
The next piece that I studied
is that you can actually put electrodes on your skull
so that when you make brainwaves
that help you to be calm and focused,
you get a little reward.
We did very well with neurofeedback.
So we can shape your brain
to actually have a different configuration
to be open to new experiences.
And then, about 15 years ago,
two guys came to talk to me and they said,
“Bessel, you know a lot about trauma.
But do you think about his idea?
We are thinking about psychedelics.
What do you think about psychedelics for trauma?”
And I go like, “Wow!
You’re speaking for my heart,”
because of course, I’m a child of the sixties
and we dabbled in LSD and psychedelic substances.
Wouldn’t it be great
if he could do psychedelic substances
to see if these substances can open up people’s minds?
To see that the reality that they live in
is just a small part of the reality that is.
But, I said, “Don’t do it.
但是 我说 不要那样做
It will destroy your career.
These drugs are illegal.”
And they said, “Thank you very much for your opinion.
We’ll try it anyway.”
They got permission to do a study of MDMA,
also known as ecstasy or molly, for trauma.
And it worked out pretty well.
Able to collect a large amount of money
to do a very large and extremely expensive study.
Lots of different sites around the US,
one in Israel, when in Canada.
So let me tell you how to study is set up.
After all the preparation,
you have a whole day of taking ecstasy
while you lie on a bed
with two therapists in your room for eight hours.
What we see in the people who get the drug is amazing.
People are able to go to places
they have never felt safe to go.
This is not a picnic.
They see the horrible things that’s happened to them.
But MDMA allows people to see themselves with compassion.
All these measures we have
about self-perception and self-awareness just shoot up.
And rather than blaming themselves, they’re able to say,
yes, this what happened to me, but it’s over.
是的 这就是发生在我身上的事 但已经结束了
Part of what has kept me so busy all these years
is how can we find a treatment
that allows the basic sense
of defectiveness and self-loathing to be controlled.
And now it looks like we have found something
that causes a very substantial drop in PTSD.
Probably more than just about anything else we have studied.
But what’s important here is that one size doesn’t fit all.
Different people need very different things.
What worked for my last patient very well
may not work for you.
Everything is an experiment in life.
And healing from trauma is an experiment.
– I was raised in the mainstream culture