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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:
00:00:00 - Intro
00:00:10 - Paul’s background and unique path to psychiatry
00:03:29 - A personal tragedy that shaped Paul’s understanding of trauma and resulting feelings of shame and guilt
00:19:42 - The current state of psychiatry training and need for improvement
00:28:27 - The over-reliance on outdated metrics and lack of attention to past trauma as an impediment to patient care
00:34:48 - Defining trauma: various types, heterogeneity, and effects on the brain
00:47:55 - Importance of finding the roots of trauma and understanding the “why”
00:56:49 - The major challenge of recognizing trauma in patients
01:08:13 - How shame and guilt are barriers to treatment and healing
01:14:18 - How treating trauma compares to treating an abscess—a powerful analogy
01:18:08 - How evolutionary survival instincts create problems in modern society
01:22:00 - First step toward healing: overcoming the fear of talking about past trauma
01:28:35 - Shame: the biggest impediment to healing
01:37:57 - The antidote to shame and the need for discourse and understanding
01:45:30 - The emotional health component of healthspan
01:57:06 - How to reframe the conversation about mental health for a better future
02:04:08 - The growing impact of trauma on our society and the need for compassion
02:10:06 - Society’s antiquated way of treating manifestations of trauma rather than root issues
02:17:29 - Potential role of psychedelics like psilocybin and MDMA in treating trauma
02:22:50 - Parting thoughts and resources for getting help

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About:

The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 35 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).

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