Episode Transcript
Hi, this is Rachel on Recovery. We were back with Doctor Stacy Shor and she's going to tell the rest of her story,
most definitely
tell us a little bit about new neurons in adults.
Well, that's the cells I was talking about. I mean we we have lots of neurogenesis when we're developing in the fetus. Obviously, because the cells are just exploding really in terms of their production. But in the adult, like I said, there's not that many. They do tend to be in the hippocampus, olfactory bulb, maybe a few other places. You know, it's kind of hard to study them in, in humans. There have been some studies, for example, showing though that people who are
depressed. Severely depressed over a long period of time, actually have many fewer of these cells. They're also really sensitive to alcohol. So drinking alcohol produces fewer of these cells. And if you look at the brains of people who are addicted to alcohol, been drinking a lot of alcohol, there's fewer of these new neurons. So most things that we think of as bad for us. Are actually bad for these cells including stress and trauma. So for whatever reason that the, the mechanisms that are engaged when we're suffering with through a lot of stress and trauma impacts the production of these neurons. I can see that,
yeah. Interesting. And it's, it's also.
You know not to be too negative because there's also things we can do to to enhance the production. For example, exercise like aerobic exercise is great for making more of these cells. Like I said, learning learning is really good for keeping the cells a lot. So it's not hope, it's not hopeless. We can make more and this probably cool if you think about it, that you could make more neurons in your brain just by most definitely. All right. Tell us about the hippocamus and how it relates to PTSD and CPTSD.
Yeah. So
most of the studies in humans on this, you know, years ago were had to be done postmortem, meaning someone would die and then they would donate their brain. To science. And then, you know, they would look at the brain and see if there are any changes. And so those studies were few and far between. And you can imagine just lots of things happen between when someone dies and when their brain makes it to some laboratory. So we don't really know that much about how complex trauma or even just trauma itself. Could affect the human brain until brain imaging came on the scene. And you know that
technology has really, really developed a lot in the last 10 or 20 years, much more than I would have even imagined. And so as a consequence we do know quite a bit more about it. I don't I don't think there's like one thing we can know because again it's super dynamic the brain and. We do know that there's certain networks that are really engaged when people are traumatized, have been traumatized. You know, kind of talking a little bit about rumination, even. Like we know that people who have experienced a lot of trauma ruminate. And there are certain networks in our brain that become engaged as we're ruminating and engaging in those networks prevents us from using other networks that we might. Rather used to learn something or to propel ourselves forward. So it's a it's kind of a dynamic thing. I can't say though that there are quite a few studies now suggesting that people with particularly with depression and some with with PTSD, that that the hippocampus for example, might even be smaller so. You know, there's some controversy about it. It's not, it's not like you could measure someone's hippocampus and tell whether or not they have PTSD. I don't want to apply that at all. But you can imagine that, you know, longterm suffering with symptoms of PTSD and depression definitely has an impact on on the structure, the actual anatomical structure and size of our brain, and in particular the hippocampus. Most definitely,
yeah. What are some of the more most accepted forms of therapy for trauma?
Yeah. So the people have been seeking help for trauma forever, at least as long as we have recorded history and as you. I'm sure no, there's just many different types of therapy that have been tried. And so in in academic science, you know we we usually talk about evidence based therapies. That means you know, therapies that have been really tested out in the world usually through randomized clinical trials, meaning that nobody kind of knows what they're in, what groups are in therapy. To be a little more objective and the two types of therapy that have emerged to be really useful for trauma are prolonged exposure therapy. It's often referred to as PET and cognitive processing therapy, CPT
and both of these therapies emerged. From CBT which is means cognitive behavioral therapy and you know those therapies focus on thoughts. How do we change our thoughts. And again you know because our thoughts are attached to our memories and our feelings. If we could just change those thoughts especially if they're irrational or causing us lots of suffering, then maybe we can also change the feelings and. So both of those therapies kind of focus on that exposure therapy, prolonged exposure therapy has someone, the person that the client is exposed to the memory over and over and over again until the memory kind of loses its attachment to the feeling in our body, you know so for example if someone was
exposed to.
A violent attack on a street by, you know, a strange man. Then they might be exposed first to the memory. Just talk about it, write about it. They would tell the story over and over again until it kind of loses some of its emotional content. And even in some circumstances, they might even start to like, visit it or maybe some pictures of the street or. And what the brain is doing during these exposures is it's learning. Oh wait, this bad thing happened to me in the past, caused lots of suffering, lots of horrible feelings in my body. But your brain is learning. It isn't happening now. You know that that experiences in the past, this new memory is being made that says, oh, I can walk down a street and not be afraid, even if it's dark and even if it's, you know, the same street where I was attacked. So it's a form of learning. It's learning something new on top of what you learned, you know, during the trauma. And it's very effective. The only problem is it's, you know, it's kind of hard, like people don't want to necessarily revisit all these memories, much less actually revisit them. And so a lot of people don't stick it out. You know, it's called prolonged because we need to do it a lot of times. And unfortunately it's hard and people don't necessarily want to or can't afford to.
Or can't afford to. Good point. You know, it's all these things are expensive too. And that's another problem kind of with our, our approach,
cognitive processing therapy is kind of similar. Like if you look at the protocol for it, it's not that different, but it focuses a little bit more or quite a bit more on the beliefs, you know, the beliefs and that accompany trauma. Because it's not necessarily just the trauma that's traumatizing the experience itself. It's the belief you have about it. Like maybe regret or shame or, Yeah, like a lot of those beliefs, like, oh, if I hadn't been going down that street, then this would have never happened. And if I could just re go back and relive it, I could be totally different. And those are. You know, not necessarily. Not true, but they need to be. The beliefs need to be paid attention to because that's oftentimes what keeps people in the past. Well, and there's all kinds of therapy that can be helpful. I know the newest ones that are out are relationship and like emotional therapy.
Yeah. And they're all a little bit different. And I know even for BPD, they usually use DPT, so. Yeah. DBT is also like dialectical behavioral therapy. You know, it has a little bit of meditation mindfulness in it, which is kind of was one of the first really kind of cognitive therapies that incorporated mindfulness into the into the process. Now a lot of them do, but back in, you know, know, years ago that was kind of unique and I think it really opened up a lot of doors for people. You know, my my feeling about therapy, and I'm not a therapist, but I'm, I am a psychologist and I know a lot about these therapies, is that people need to find what what helps them or what they feel comfortable doing. Maybe not comfortable might not be the right word because they're all going to be, you know, could be traumatizing just having to think about what happened. But. You know kind of what suits your person. And so some people gravitate more towards exposure therapy, others might more to kind of body centered therapies. And yeah, there's a lot out there, even just talk therapy is and and talking to a counselor, a social worker, those are really helpful for group therapy. You know some yes, group therapy can be great. I don't find it super helpful when dealing with PTSD. And I feel like you almost trigger each other and
and you it's just it can be it can be good but it has to be very small group and it has to be have really good
people managing the group group leaders. Yeah yeah a really good point. I mean it's used. I, I, I did some work at a residential treatment Center for homeless women. These women
were homeless out on the streets of New Jersey. They were mothers. So they have young babies and children who were traumatized as well or often taken away from them and and they had addiction issues a lot, lots of different types of trauma. You can imagine that the trauma that happened while they were out on the streets and. So then they were in this residential treatment center where I worked for a while and they had a lot of group therapy, you know partly because it's it's more accessible and it's cheaper to deliver. You know so a lot of places really can't afford to have like one-on-one therapy for each person. So they they that's where kind of group therapy comes in. But but you're right, it's. It can be definitely difficult to hear everyone. Yeah, I think, I think it's good in some situations, but I feel like
you have to have a good, good leadership leading the group and it can be very, very, yeah, it can be very triggering and that's. And that's good for any kind of therapy or anything really in life, but it's kind of depends on the person who's doing it. So even if you, you know, we're able to afford and go through like some of these therapies, it's mostly like the person who's helping you, you do and you know are they really well filled to do that and sensitive and all those things compassionate well and experience. I think there's, you know, I went on a retreat for. Sexual assault survivors. And it was so triggering, and it was just such a terrible experience. I felt awful the entire time I was there. Oh,
that's so wonderful. But I also had gone to a, you know, the Unique foundation has a retreat for survivors of childhood sexual abuse. And it was well organized, small groups. And so everything went really well.
So you feel like it's the size of the group is, well, a big size. And you know, I, the, the other one was ran by, you know, a survivor, you know, I don't think had worked through all her trauma. And the other one was ran by. You know, this family that, you know, is like we need to reach out to, you know, these victims of childhood sexual abuse. And this is how they do it because, I mean, it's a it's a free week. All you have to do is pay for your transportation and you spend a whole like 4 days at this retreat
and they wow, that's the one that helped, that we thought was good and helped you. Was it kind of immediate, like you knew during the process that it was helpful or was it like maybe like also, I mean, I think both they were. It was very well done. It was very professional. And the other one, I felt like they had some good things, but they had a long way to go
and I feel like there was just so much more they could have done. But they just didn't have the experience and they were not healed enough to help. And I I talked to a couple of people who've done recovery and they're like, yeah, you have to be in a certain place after recovery to help others because otherwise you're just a mess and it it'll end badly.
Yeah.
Yeah, I've definitely been hearing that, you know, even.
Therapists, you know, they have, they become, can also become kind of traumatized just from being, Oh yeah, you're in so much trauma, secondary trauma is incredibly real.
Yeah. One of my colleagues, we did this study on sexual violence. We've done several, but one of them was at the university with college women and, you know, so she was doing the interviews. For the PTSD diagnosis and you know, if you know about structured interviews, they go into a lot of detail and ask lots of questions about what happened and exactly what happened and where and how did it make you feel, etcetera, etcetera. And I felt like for her, you know, listening to those stories day after day started to really, yeah, it started to really affect her ability to even Oh yeah. I mean, you can ask any expert, Dan Allen or Diane Lamberg. You know, they specialize in childhood sexual abuse and they'll tell you straight up, this stuff will kill you, you know, if you don't take care of yourself. Yeah, because you are taking on somebody else's trauma. And Diane Lamberg even talks about waking up with nightmares, you know, just hearing about these stories. No, I was kind of curious like just to ask you a question. And I just wrote this book about trauma. And one of the things I tried to do or tried not to do was put too many stories. You know, I felt there were a lot of books out there about, Oh yes, most definitely.
I think kind of most of them focus on on that and that's fine, you know, But I just, but I was wondering like how? And I've so I've been reading some people's responses to some books and they're like, yeah, I don't, I don't really want to hear everyone's story. It's too, you know, it's triggering sometimes, even though it might be relevant or interesting, but it's well, especially for impacts, because we soak all that up
as somebody who is a recovering impact and still in progress.
We soak up all that emotion and it wears us out.
Yeah. I think somebody was doing like a Ted Talk on it and they talked about like they had all these Gen. Xers. I'm not Gen. Xers,
not Millennials. It was, yeah, I guess.
Yes. Anyways, this particular generation that was struggling because they're like I'm working, you know, they're working hours and they're like, I'm exhausted, I can't do this. And they were all in paths. And so when you're in this type of work and you're an empath, you've got to distance yourself and you've got to not, you know, you've got to set boundaries whether it, you know, depending on how you're working with it. I mean, even I have to, I mean. I think I had three interviews in one day and I was just exhausted. I just want, you know, I I think I ended up with a migraine at the end of the bit and I was just like, I can't do this.
And so I can imagine, you know, I try to, you know, two a week and try not to schedule them on the same day and that's kind of my Max. If I do 2 interviews in one day, that's all I can handle.
Yeah. So just knowing your limits on that because, I mean, unfortunately it it's very difficult to separate yourself sometimes from that.
Yeah, I noticed like even with the me Too movement, which was, you know, amazing and I'm glad it happened that people became more aware of the prevalence of sexual trauma and people were able to, you know, talk about it more freely and and and get help. But I did also hear from a lot of primarily women who I work with that, you know, they don't necessarily want to talk about it or have to. Yeah, they didn't want to relive it over and over again. And they thought to some extent not necessarily obligated to do that. But, you know, there was just more
emphasis on it than they. Wanted. Well, yeah, go ahead. Good to. It's just kind of good to recognize it because I'm not sure people who haven't been traumatized appreciate how it feels to relive that kind of experience. Well, and I know, like a lot of yeah, because I mean, I was just reading the courage to heal and I was just like, you know, student in a group. And it's just like, I don't want to read this section because it's just, we can just skip this. I don't need to know what happened. It's too triggering. Yeah. Yeah. Yeah. I mean, I even feel that. And I haven't been sexually, you know, traumatized necessarily. But I have had some, you know, frightening experiences in my life and I sometimes. Find myself going there. Or here's a kind of a similar story, and I'm like, Nope, don't need to hear that story again. Don't need to relive that memory. OK, tell us about mapping map training, the brain.
Yeah. OK, so now that I've described some of the. Problems that can arise in the brain in response to stress and trauma. Let me tell you a little bit about what I've been trying to do to help people, primarily women, but it's anyone can really do it. I've just been mostly focused on on women and who had trauma. So as I mentioned, I. I had done these studies, you know, really now a couple of decades ago, showing that the brain makes these new neurons. And one of the things that we discovered was that these neurons could be rescued from death. They could be, you know, induced to survive longer if there was some kind of mental training going on.
And then another lab had determined that you could make more of these neurons with with exercise, primarily aerobic exercise, meaning exercise that requires oxygen. That gets exercise. It gets the heart rate up and delivers lots of oxygen to the brain. You know, when your heart is beating fast you. Provide more oxygen to your brain from the heart. And then that in turn makes a lot of changes in the brain, one of which is generating more of these neurons. So I had this idea, maybe I could kind of combine these two responses together in some kind of. It's not a therapy per se. I mean, I call it a brain fitness program because. It's not therapy. It it is really something that anyone can do even without a therapist
and it's called MAP training. So MAP stands for mental and physical. So it combines mental training with physical training. So
when I was trying to make up this program thinking about how to do it, I. Came upon meditation, and I really hadn't meditated before in my life. I didn't even really know that much about it. But I knew it was hard. You know, I had read enough and knew enough to know like meditation sounds really challenging to do. And before I started doing it and I realized, yeah, it's really hard, but it's also really interesting I find. To listen to your own thoughts, as disturbing as they can be at times. And it was definitely a learning experience. You know, I wanted whatever I chose to be something that you could always be learning from. And I do feel like meditation is one of those practices, you know? That's why they call it a practice, because every single time you do it, you're like, wow, I think I learned something new about myself. Good and bad, but you just kind of learn to like, wow, I have all these thoughts and I keep thinking that thought and why am I thinking that I'm thought again And why am I worrying so much about the future when it you know, I can't possibly know everything about it. So anyway, I think of it as a form of mental training and so, So map training is 30 minutes of meditation. We do sitting meditation, the first part, so just sitting in silence. I don't use guided meditation because I I feel like guided meditation sometimes is more about the person who's guiding you than about yourself. And I feel like sitting in silence with your own thoughts is, you know, are you really good way to to know your own brain, to get to know your own brain.
Then there's 10 minutes of slow walking meditation. So slow walking meditation is similar in concept to sitting meditation, focusing on your breath, but we focus on our feet. So we walk really slowly in a circle and kind of keep your attention in your feet. When your mind starts to wander off, you bring it back to your feet
and then. After the slow walking meditation which is just 10 minutes, then we engage in 30 minutes of aerobic exercise and that's that can be done anyway. I mean I have a dance exercise. I don't like to call it dance necessarily but like aerobic movements to music it's more like it
that I like to do and that I have used in a lot of my studies and. And we have some videos now using that. But you could do any kind of aerobic exercise. You could run, you could spin on a spinning machine, swim anything as long as it gets your heart rate up above about 100 beats.
So probably enough to be soon enough,
Yeah, and that's. That's the program. It's, you know, it's one hour. So the meditation, the mental training is followed immediately by this physical training. And then we have done numerous studies out in the world to show that it actually helps people.
I did a study with people who are clinically depressed. I did a study with people who women who had sexual violence in their life. I did a study with. Medical students who are very stressed out. I did a study with women who have HIV living in Newark and have lots of trauma because of that experience.
Anyway, I've just done quite a few studies. I did, oh, I did a study during COVID with teachers who obviously were very. Traumatized and stressed out by the pandemic. And in all these cases, all these studies, we found that people are just doing it like once or twice a week for six weeks. They're less depressed, they're less, they ruminate less. They have less traumatic thoughts. They're more optimistic. They feel better about who they are. The brains obviously change. So we've documented changes in brain activity and. Yeah. So that's that's a map. Train my brain. OK. And tell us how that too. All right. I think that's it. Thanks for listening, Rachel. And recovery. We'll be back next week at 10:00 AM. Follow us on your favorite social media platform and on your favorite podcast platform. If you have any questions, reach out to Rachel and recovery. Thanks for listening. And TuneIn next Thursday at 10:00 AM. Thanks.
