Essentials: Erasing Fears & Traumas Using Modern Neuroscience

0:00:02 – Welcome to Huberman Lab Essentials,
0:00:04 where we revisit past episodes
0:00:07 for the most potent and actionable science-based tools
0:00:10 for mental health, physical health, and performance.
0:00:12 I’m Andrew Huberman,
0:00:15 and I’m a professor of neurobiology and ophthalmology
0:00:17 at Stanford School of Medicine.
0:00:20 Today, we’re going to talk about the neuroscience of fear.
0:00:22 We are also going to talk about trauma
0:00:25 and post-traumatic stress disorders.
0:00:28 I think it’s fair to say that in the last 10 years,
0:00:30 the field of neuroscience has shed light
0:00:32 on not just the neural circuits,
0:00:36 meaning the areas of the brain that control the fear response
0:00:38 and the ways that it does it,
0:00:41 but some important ways to extinguish fears
0:00:43 using behavioral therapies, drug therapies,
0:00:46 and what we call brain-machine interfaces.
0:00:48 Today, we are going to talk about all of those,
0:00:51 and you’re going to come away with both an understanding
0:00:54 of the biology of fear and trauma,
0:00:58 as well as many practical tools to confront fear and trauma.
0:01:00 To give you a sense of where we are going,
0:01:03 I’ll just lay out the framework for today’s podcast.
0:01:04 First, I’m going to teach you
0:01:07 about the biology of fear and trauma,
0:01:09 literally the cells and circuits
0:01:12 and connections in the body and chemicals in the body
0:01:15 that give rise to the so-called fear response,
0:01:19 and why sometimes, but not always, fear can turn into trauma.
0:01:23 I will also describe the biology of how fear is unlearned,
0:01:25 or what we call extinguished.
0:01:26 You’re going to learn, for instance,
0:01:28 that we can’t just eliminate fears,
0:01:32 we actually have to replace fears with a new positive event.
0:01:34 So what is fear?
0:01:38 Well, fear falls into a category of nervous system phenomenon
0:01:42 that we can reliably call an emotion.
0:01:46 I think it’s fair to say that emotions include responses
0:01:48 within our body, quickening of heart rate,
0:01:52 changes in blood flow, things that we experience as a warming,
0:01:53 or a cooling of our skin,
0:01:56 but that there’s also a cognitive component.
0:01:58 There are thoughts, there are memories.
0:02:00 There’s all sorts of stuff that goes on in our mind
0:02:05 and in our body that together we call an emotion.
0:02:09 So let’s talk first about what fear isn’t.
0:02:11 Most people are familiar with stress,
0:02:15 both as a concept and as an experience.
0:02:17 Stress is a physiological response,
0:02:21 and it is fair to say that we cannot have fear
0:02:23 without having several,
0:02:26 if not all of the elements of the stress response.
0:02:29 However, we can have stress without having fear.
0:02:33 Likewise, people are familiar with the phrase,
0:02:35 or the word rather, anxiety.
0:02:40 Anxiety tends to be stress about some future event,
0:02:41 although it can mean other things as well.
0:02:46 We can’t really have fear without seeing or observing
0:02:49 or experiencing some of the elements of anxiety,
0:02:52 but we can have anxiety without having fear.
0:02:56 So what you’re starting to realize is that fear is built up
0:03:00 from certain basic elements that include stress and anxiety.
0:03:03 And then there is trauma.
0:03:08 The operational definition of trauma is that some fear
0:03:12 took place, which of course includes stress and anxiety,
0:03:17 and that fear somehow gets embedded or activated
0:03:20 in our nervous system such that it shows up at times
0:03:24 when it’s maladaptive, meaning that fear doesn’t serve us well,
0:03:27 and it gets reactivated at various times.
0:03:30 The reason I’m putting all this word soup around fear
0:03:33 out onto the table is not to complicate the issue.
0:03:35 Rather, it is to simplify the issue,
0:03:37 because now that we acknowledge
0:03:38 that there are many different phrases
0:03:40 to describe this thing that we call fear
0:03:42 and then related phenomenon,
0:03:45 we can start to just focus on two of these issues,
0:03:47 fear and trauma,
0:03:50 as it relates to specific biological processes,
0:03:52 specific cognitive processes,
0:03:55 and we can start to dissect how fears are formed,
0:03:57 how fears are unformed,
0:04:01 and how new memories can come to replace
0:04:03 previously fearful experiences.
0:04:05 We’ve known for a long time that there are things
0:04:07 that we can do to improve our sleep,
0:04:09 and that includes things that we can take,
0:04:11 things like magnesium threonate, theanine,
0:04:13 chamomile extract, and glycine,
0:04:17 along with lesser known things like saffron and valerian root.
0:04:19 These are all clinically supported ingredients
0:04:21 that can help you fall asleep, stay asleep,
0:04:23 and wake up feeling more refreshed.
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0:05:05 I know that both from my subjective experience of my sleep
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0:05:34 So in this effort to establish a common language
0:05:36 around fear and trauma,
0:05:39 I want to point out autonomic arousal.
0:05:43 Autonomic arousal relates to this aspect of our nervous system
0:05:45 that we call the autonomic nervous system.
0:05:48 It basically has two branches to it.
0:05:51 Two branches meaning two different systems.
0:05:54 One is the so-called sympathetic autonomic nervous system.
0:05:55 It has nothing to do with sympathy.
0:05:58 It has everything to do with increasing alertness.
0:06:00 The other branch of the autonomic nervous system
0:06:03 is the so-called parasympathetic branch
0:06:04 of the autonomic nervous system.
0:06:06 I know that’s a mouthful.
0:06:09 The parasympathetic branch of the autonomic nervous system
0:06:12 are the cells and neurons and chemicals
0:06:14 and other aspects of your brain and body
0:06:16 that are involved in the calming nervous system.
0:06:19 So sympathetic is alerting, parasympathetic is calming,
0:06:21 and it acts as sort of a seesaw
0:06:23 to adjust your overall level of alertness.
0:06:25 There are many different aspects
0:06:26 to the autonomic nervous system,
0:06:28 but one of the main aspects is an aspect
0:06:30 that’s going to come up again and again and again today.
0:06:33 It’s called the HPA axis.
0:06:38 The HPA axis stands for hypothalamic pituitary adrenal axis.
0:06:41 The hypothalamus is a collection of neurons.
0:06:44 It’s an area of your brain, real estate,
0:06:46 that’s deep in the brain, at the base of the brain,
0:06:48 that contains many, many different areas
0:06:50 that control things like temperature
0:06:55 and desire to have sex, desire to eat, thirst.
0:06:59 It also controls the desire to not mate, have sex,
0:07:04 not eat, not drink more water or any other type of fluid.
0:07:07 So it has accelerators and brakes in there as well.
0:07:10 The hypothalamus connects to the so-called pituitary.
0:07:13 The pituitary lives close to the roof of your mouth.
0:07:16 It releases hormones into your bloodstream.
0:07:18 And so the hypothalamus has this ability
0:07:21 to trigger the release or prevent the release
0:07:24 of particular hormones like cortisol
0:07:27 or the hormones that go stimulate adrenals
0:07:29 to produce adrenaline.
0:07:31 And speaking of the adrenals,
0:07:34 that A and the HPA are the adrenals.
0:07:36 You have two glands that sit above your kidneys
0:07:37 and your lower back.
0:07:39 They release different hormones
0:07:42 and other types of chemicals into the body.
0:07:44 And the two main ones that you need to know about today
0:07:48 are adrenaline, also called epinephrine and cortisol.
0:07:50 Both of those are so-called stress hormones,
0:07:52 but they’re not always involved in stress.
0:07:55 They’re also involved in waking up in the morning
0:07:59 when you arise, excuse me, when you rise from sleep.
0:08:03 And so this HPA axis should be thought of in the following way.
0:08:06 The HPA axis includes a piece of the brain,
0:08:10 the hypothalamus, the pituitary and the adrenal.
0:08:12 So it’s a beautiful three-part system
0:08:16 that can use your brain to alert or wake up your body
0:08:18 and prepare it for action.
0:08:20 And it can do that in the short term
0:08:23 by triggering the release of hormones and chemicals
0:08:26 that make you alert and ready to go right away.
0:08:29 And by triggering the release of neurotransmitters
0:08:30 and hormones and other chemicals
0:08:34 that give that alertness a very long tail,
0:08:37 a very long latency before it shuts off.
0:08:41 And that’s important because one of the hallmarks of fear
0:08:43 and one of the hallmarks of trauma
0:08:48 is that they involve fear responses that are long lasting.
0:08:50 Even if those fearful events,
0:08:53 the events in the world that trigger the HPA axis
0:08:54 can be very brief.
0:08:58 The fear response can reverberate through your system
0:09:00 because the chemicals that are involved
0:09:04 in this HPA axis have a fast component
0:09:06 and a longer lasting component.
0:09:08 And the longer lasting component
0:09:10 can actually feed back to the brain
0:09:12 and literally control gene expression,
0:09:16 which can take many days and build out new circuits
0:09:19 and new chemicals that can embed fear
0:09:20 in our brain and body.
0:09:22 We can’t really have a discussion about fear
0:09:25 without discussing the famous amygdala.
0:09:28 Famous because I think most people by now
0:09:29 have heard of the amygdala.
0:09:31 Amygdala means almond.
0:09:33 It’s an almond shaped structure
0:09:35 on both sides of the brain.
0:09:37 The amygdala is part of what we can call
0:09:38 the threat reflex.
0:09:41 And this is very important to conceptualize fear
0:09:43 as including a reflex.
0:09:46 And that reflex involves things like quickening
0:09:48 of your heart rate, hypervigilance,
0:09:50 your attentional systems pop on,
0:09:55 increased ability to access energy stores
0:09:58 for movement and thought and so forth.
0:10:01 And the amygdala is part of the threat reflex
0:10:02 so much so that we can really say
0:10:05 that it’s the final common pathway
0:10:07 through which the threat reflex flows.
0:10:08 In other words,
0:10:12 the amygdala is essential for the threat response.
0:10:15 So while the amygdala might look like an almond,
0:10:17 it’s actually part of a much bigger complex
0:10:19 or collection of neurons
0:10:21 called the amygdaloid complex.
0:10:26 That complex has anywhere from 12 to 14 areas,
0:10:27 depending on which neuroanatomist
0:10:29 is naming things and carving it up.
0:10:30 Why is that important to us?
0:10:33 Well, it turns out that the amygdala
0:10:35 is not just a area for threat.
0:10:38 It’s an area for generating threat reflexes
0:10:41 that integrates lots of different types of information.
0:10:44 information from our memory systems,
0:10:45 like the hippocampus,
0:10:47 and from our sensory systems,
0:10:47 our eyes,
0:10:48 our ears,
0:10:48 our nose,
0:10:50 our mouth,
0:10:50 et cetera.
0:10:51 So taste information,
0:10:52 vision,
0:10:53 auditory information,
0:10:54 touch,
0:10:54 et cetera,
0:10:57 flow into the so-called lateral portion
0:10:58 of the amygdala
0:10:59 or the amygdaloid complex.
0:11:01 And then there are multiple outputs
0:11:02 from the amygdala.
0:11:04 And this is where things get particularly interesting
0:11:06 because the outputs of the amygdala
0:11:07 have a lot of different areas,
0:11:09 but there are two main pathways.
0:11:12 One involves the hypothalamus
0:11:16 and it also feeds out to our adrenals
0:11:18 to create a sense of alertness and action.
0:11:21 The other pathway out of the amygdala
0:11:22 is to a very interesting area
0:11:24 that typically is associated with reward
0:11:25 and even addiction.
0:11:28 The amygdaloid complex actually projects
0:11:30 to areas of the dopamine system,
0:11:32 the so-called nucleus accumbens,
0:11:33 the mesolimbic reward pathway.
0:11:36 For those of you that want to look that up
0:11:38 or that remember from the dopamine episodes,
0:11:40 we have pathways in our brain
0:11:42 that are associated with pursuit,
0:11:42 motivation,
0:11:43 and reward.
0:11:44 And the neuromodulator dopamine
0:11:45 is largely responsible
0:11:47 for that feeling of craving,
0:11:47 pursuit,
0:11:47 and reward.
0:11:49 And this threat center
0:11:52 is actually able to communicate with
0:11:54 and activate the dopamine system.
0:11:55 And later you will realize
0:11:57 why that is very important
0:11:59 and why you can leverage the dopamine system
0:12:02 in order to wire in new memories
0:12:03 to replace fearful ones.
0:12:05 There’s a fourth component,
0:12:07 and I promise this is the last component
0:12:08 that we need to put into this picture
0:12:10 of the neural circuits for fear.
0:12:11 And this is a circuit
0:12:13 that involves an area of the brain
0:12:14 called the prefrontal cortex
0:12:16 and some of it subdivisions,
0:12:17 so literally in the front.
0:12:20 And it’s involved in what we call
0:12:21 top-down processing.
0:12:23 Top-down processing
0:12:26 is the way that
0:12:27 your prefrontal cortex
0:12:29 and other areas of the brain
0:12:30 can control
0:12:32 or suppress a reflex.
0:12:33 You tell yourself,
0:12:34 I want to do this
0:12:36 or I should do this
0:12:37 or even though I don’t want to,
0:12:39 I’m going to do it anyway.
0:12:41 So this fourth component
0:12:42 of fear
0:12:43 is really our ability
0:12:45 to attach narrative,
0:12:46 to attach meaning,
0:12:48 and to attach purpose
0:12:51 to what is by all accounts
0:12:51 and purposes
0:12:53 a generic response.
0:12:54 There’s no negotiating
0:12:56 what fear feels like.
0:12:57 There’s only negotiating
0:12:58 what it means.
0:12:59 There’s only negotiating
0:13:01 whether or not you persist,
0:13:02 whether or not you pause,
0:13:03 or whether or not you retreat.
0:13:05 So this is usually the point
0:13:05 in the podcast
0:13:07 where I think people start asking,
0:13:08 okay, well, there’s the biology,
0:13:08 there’s the mechanism,
0:13:09 there’s the logic.
0:13:11 How do I eliminate fear?
0:13:14 Well, it’s not quite that simple,
0:13:15 although by understanding
0:13:16 the logic and the mechanisms
0:13:18 by which these circuits are built,
0:13:20 we can eventually get to that place.
0:13:22 I do want to plant a flag
0:13:25 around a particular type of tool
0:13:26 or a logical framework
0:13:28 around a particular set of tools,
0:13:29 rather,
0:13:31 that we are going to build out
0:13:31 through this episode.
0:13:35 And based on what you now know,
0:13:37 that the threat reflex
0:13:38 gets input
0:13:40 and it has outputs
0:13:41 and it’s subject
0:13:43 to these top-down
0:13:44 processing events,
0:13:45 these narratives,
0:13:48 you should be asking yourself,
0:13:50 what sort of narrative
0:13:51 should I apply
0:13:52 to eliminate fear?
0:13:53 Well, first,
0:13:54 let’s take a step back
0:13:56 and just acknowledge the reality,
0:13:57 which is that fear
0:13:59 is in some cases
0:14:01 an adaptive response.
0:14:02 We don’t want people
0:14:04 eliminating fears
0:14:05 that can get them injured
0:14:06 or killed, right?
0:14:08 The reason that the fear
0:14:09 threat response
0:14:11 and reflex exists at all
0:14:12 is to help us
0:14:14 from dying,
0:14:14 to help us
0:14:16 from making really bad decisions.
0:14:17 So it’s not just about
0:14:18 a readiness
0:14:19 for things
0:14:20 that might injure us
0:14:21 or kill us
0:14:23 in the immediate circumstance,
0:14:25 but also protecting us
0:14:26 for the future
0:14:27 because of our important need
0:14:28 and ability
0:14:28 to anticipate.
0:14:30 Some memories,
0:14:31 even if they evoke
0:14:32 a sense of fear
0:14:32 in us,
0:14:33 are protective.
0:14:34 They protect us
0:14:35 from making bad mistakes
0:14:36 that could get us injured
0:14:37 or killed
0:14:38 or put us
0:14:39 into really horrible circumstances.
0:14:41 Other memories
0:14:42 are dangerous
0:14:43 because they create
0:14:44 a sense in us
0:14:46 of discomfort
0:14:47 and they tend
0:14:48 to limit our behavior
0:14:49 in ways that are
0:14:50 maladaptive,
0:14:51 that prevent us
0:14:52 from having healthy
0:14:53 relationships to others,
0:14:55 healthy job relationships,
0:14:56 healthy relationship
0:14:57 to ourselves,
0:14:57 frankly.
0:14:58 So this language
0:14:59 of memories
0:15:00 as protective
0:15:00 or memories
0:15:01 as dangerous,
0:15:02 it’s an important
0:15:03 aspect of fear
0:15:04 because much
0:15:05 of the fear system
0:15:07 is a memory system.
0:15:08 It’s designed
0:15:09 to embed
0:15:10 a memory
0:15:10 of certain
0:15:11 previous experiences
0:15:13 in us
0:15:14 such that
0:15:15 the threat reflex
0:15:15 is activated
0:15:17 in anticipation
0:15:19 of what might happen.
0:15:19 Okay?
0:15:20 So let’s talk
0:15:21 for a second
0:15:21 about how certain
0:15:22 memories get attached
0:15:23 to this fear system.
0:15:24 And this brings us
0:15:25 to a beautiful
0:15:26 and indeed
0:15:27 Nobel Prize winning
0:15:27 aspect
0:15:29 of biology
0:15:29 and physiology
0:15:30 which is
0:15:31 Pavlovian conditioning.
0:15:32 many of you
0:15:32 are probably
0:15:33 familiar
0:15:34 with Pavlov’s dogs
0:15:35 and the famous
0:15:35 Pavlovian
0:15:37 conditioning experiments.
0:15:38 They go something
0:15:39 like this,
0:15:39 ring a bell.
0:15:41 A dog doesn’t
0:15:41 do much
0:15:42 in response
0:15:42 to a bell.
0:15:43 It might attend to it
0:15:44 but it doesn’t salivate
0:15:45 typically in response
0:15:45 to the bell.
0:15:46 However,
0:15:46 if you pair
0:15:47 the ringing
0:15:47 of a bell
0:15:48 with a presentation
0:15:49 of food
0:15:50 enough times
0:15:51 the dog
0:15:51 will salivate
0:15:51 in response
0:15:52 to the food.
0:15:53 Eventually
0:15:53 you take away
0:15:54 the food,
0:15:54 you just ring
0:15:55 the bell
0:15:55 and the dog
0:15:56 will salivate
0:15:56 in response
0:15:57 to the bell.
0:15:57 Okay?
0:15:59 So in the context
0:15:59 of so-called
0:16:00 Pavlovian conditioning,
0:16:01 these things
0:16:01 have names
0:16:02 like conditioned
0:16:02 stimulus
0:16:03 and unconditioned
0:16:04 stimulus
0:16:04 and responses.
0:16:06 The unconditioned
0:16:06 stimulus
0:16:07 is the thing
0:16:08 that evokes
0:16:10 a response
0:16:11 unconditionally.
0:16:12 So food
0:16:13 is the unconditioned
0:16:13 stimulus
0:16:14 in the example
0:16:15 I just gave.
0:16:15 The bell
0:16:16 in the previous
0:16:17 example
0:16:19 is what we call
0:16:20 the conditioned
0:16:21 stimulus
0:16:22 or the conditioning
0:16:22 stimulus.
0:16:23 The conditioned
0:16:24 stimulus
0:16:25 is paired
0:16:26 with the
0:16:27 thing
0:16:27 that naturally
0:16:28 creates
0:16:28 a response
0:16:29 and then
0:16:29 eventually
0:16:30 the conditioned
0:16:30 stimulus
0:16:31 creates
0:16:31 the response
0:16:32 itself.
0:16:33 You might
0:16:33 think,
0:16:33 well,
0:16:34 that just
0:16:34 seems,
0:16:34 you know,
0:16:35 endlessly
0:16:36 boring
0:16:36 and simple,
0:16:38 but this
0:16:38 is actually
0:16:38 the way
0:16:38 that our
0:16:39 fear systems
0:16:39 work.
0:16:41 Except unlike
0:16:42 Pavlov’s
0:16:42 dogs,
0:16:43 you don’t
0:16:44 need many,
0:16:46 many pairings
0:16:48 of a bell
0:16:48 with some
0:16:49 unconditioned
0:16:50 stimulus
0:16:50 in order to
0:16:51 get a response.
0:16:52 You can get
0:16:52 what’s called
0:16:53 one trial
0:16:53 learning.
0:16:54 And in
0:16:54 this circuit
0:16:55 that involves
0:16:55 the amygdala,
0:16:56 the threat
0:16:56 reflex,
0:16:57 and all this
0:16:57 other,
0:16:58 you know,
0:16:59 stuff that I
0:16:59 was talking
0:17:00 about earlier,
0:17:02 the system
0:17:03 is set up
0:17:03 for learning.
0:17:04 It’s set up
0:17:05 to create
0:17:05 memories
0:17:06 and to
0:17:07 anticipate
0:17:07 problems.
0:17:08 It’s a very
0:17:09 good system
0:17:09 because it
0:17:10 was designed
0:17:10 to keep
0:17:11 us safe.
0:17:12 So now you
0:17:12 should understand
0:17:14 how classical
0:17:15 conditioning,
0:17:15 as it’s called,
0:17:16 occurs.
0:17:18 You go to
0:17:19 give a piano
0:17:20 recital as a
0:17:20 kid,
0:17:21 you sit down
0:17:22 and you freeze
0:17:22 up,
0:17:23 and it’s
0:17:23 horribly
0:17:24 embarrassing.
0:17:26 And even
0:17:26 if you just
0:17:26 freeze up
0:17:27 for a few
0:17:27 seconds,
0:17:28 the heart
0:17:29 rate increase
0:17:29 and the
0:17:30 perspiring,
0:17:30 the sweating,
0:17:32 and the shame
0:17:33 that you feel
0:17:34 leads you to
0:17:35 want to avoid
0:17:36 playing instruments
0:17:37 or public
0:17:38 displays of,
0:17:39 you know,
0:17:39 performances
0:17:41 for a long
0:17:42 period of time
0:17:42 unless you do
0:17:43 something to
0:17:43 overcome it.
0:17:45 Some people,
0:17:46 it tends to
0:17:47 be more an
0:17:47 accumulation of
0:17:48 experiences.
0:17:49 There’s a
0:17:50 key,
0:17:50 what we call
0:17:51 temporal component.
0:17:51 There’s a
0:17:52 component of
0:17:53 the fear
0:17:54 system being
0:17:54 able to
0:17:56 batch many
0:17:56 events in
0:17:57 time and
0:17:58 create one
0:17:59 specific fear
0:18:01 or take one
0:18:01 very specific
0:18:02 isolated incident
0:18:03 that happened
0:18:04 very briefly
0:18:05 and create one
0:18:05 very large
0:18:06 general sense
0:18:07 of fears.
0:18:07 And I’ll give
0:18:08 an example
0:18:09 of the latter
0:18:10 just to kind
0:18:11 of flesh this
0:18:11 out a little
0:18:11 bit.
0:18:13 I had a
0:18:13 friend come
0:18:15 visit me
0:18:15 in San
0:18:15 Francisco
0:18:16 some years
0:18:17 ago and
0:18:17 their car
0:18:18 got broken
0:18:18 into,
0:18:19 unfortunately,
0:18:19 a frequent
0:18:20 occurrence in
0:18:20 San Francisco
0:18:21 and be in
0:18:21 the middle
0:18:21 of the
0:18:21 day.
0:18:21 Never
0:18:21 leave
0:18:22 anything
0:18:22 in your
0:18:22 car in
0:18:22 San
0:18:23 Francisco.
0:18:23 They’ll
0:18:24 break in
0:18:24 in the
0:18:24 middle
0:18:24 of the
0:18:25 day.
0:18:25 Doesn’t
0:18:25 matter.
0:18:26 Police
0:18:26 can be
0:18:26 having coffee
0:18:27 right there
0:18:27 in front
0:18:27 of them.
0:18:28 They’ll still
0:18:28 do it.
0:18:29 They got
0:18:30 their belongings
0:18:30 taken and
0:18:31 they decided
0:18:31 they were
0:18:32 never coming
0:18:32 back to
0:18:33 San
0:18:33 Francisco.
0:18:34 This was
0:18:34 an isolated
0:18:35 incident
0:18:35 that
0:18:37 forever
0:18:37 colored
0:18:38 their
0:18:39 view
0:18:39 of
0:18:39 the
0:18:40 city
0:18:40 which
0:18:40 I
0:18:41 you
0:18:41 know
0:18:41 frankly
0:18:42 understanding
0:18:42 the fear
0:18:42 system
0:18:43 I can
0:18:43 understand.
0:18:44 We can
0:18:45 have
0:18:45 isolated
0:18:46 incidents
0:18:46 that
0:18:46 wick out
0:18:47 to broad
0:18:48 decisions
0:18:48 about
0:18:48 entire
0:18:49 places
0:18:50 or we
0:18:50 can have
0:18:51 many
0:18:51 experiences
0:18:52 that
0:18:52 funnel
0:18:53 into
0:18:53 very
0:18:54 specific
0:18:55 isolated
0:18:55 fears
0:18:55 about
0:18:56 particular
0:18:56 circumstances
0:18:57 places
0:18:57 and
0:18:57 things.
0:18:58 I’d like
0:18:58 to take
0:18:59 a quick
0:18:59 break
0:18:59 and
0:18:59 acknowledge
0:19:00 one of
0:19:00 our
0:19:00 sponsors
0:19:01 Element.
0:19:02 Element is
0:19:02 an electrolyte
0:19:03 drink that
0:19:03 has everything
0:19:04 you need
0:19:04 and nothing
0:19:05 you don’t.
0:19:06 That means
0:19:06 the electrolytes
0:19:07 sodium
0:19:07 magnesium
0:19:08 and potassium
0:19:08 in the
0:19:09 correct
0:19:09 amounts
0:19:10 but no
0:19:10 sugar.
0:19:10 Proper
0:19:11 hydration
0:19:11 is
0:19:11 critical
0:19:12 for
0:19:12 optimal
0:19:12 brain
0:19:13 and
0:19:13 body
0:19:13 function.
0:19:14 Even
0:19:14 a slight
0:19:15 degree
0:19:15 of
0:19:15 dehydration
0:19:16 can
0:19:16 diminish
0:19:16 cognitive
0:19:17 and
0:19:17 physical
0:19:18 performance.
0:19:18 It’s
0:19:19 also
0:19:19 important
0:19:19 that
0:19:19 you get
0:19:20 adequate
0:19:20 electrolytes.
0:19:21 The
0:19:21 electrolytes
0:19:22 sodium
0:19:22 magnesium
0:19:22 and
0:19:23 potassium
0:19:24 are
0:19:24 vital
0:19:24 for
0:19:24 functioning
0:19:25 of
0:19:25 all
0:19:25 the
0:19:25 cells
0:19:25 in
0:19:25 your
0:19:26 body
0:19:26 especially
0:19:27 your
0:19:27 neurons
0:19:27 or
0:19:27 your
0:19:28 nerve
0:19:28 cells.
0:19:29 Drinking
0:19:29 Element
0:19:30 dissolved
0:19:30 in
0:19:30 water
0:19:30 makes
0:19:30 it
0:19:31 very
0:19:31 easy
0:19:31 to
0:19:31 ensure
0:19:31 that
0:19:31 you’re
0:19:32 getting
0:19:32 adequate
0:19:33 hydration
0:19:33 and
0:19:34 adequate
0:19:34 electrolytes.
0:19:35 To make
0:19:35 sure
0:19:35 that
0:19:35 I’m
0:19:36 getting
0:19:36 proper
0:19:36 amounts
0:19:36 of
0:19:37 hydration
0:19:37 and
0:19:38 electrolytes
0:19:38 I
0:19:38 dissolve
0:19:39 one
0:19:39 packet
0:19:39 of
0:19:39 element
0:19:40 in
0:19:40 about
0:19:40 16
0:19:40 to
0:19:41 32
0:19:41 ounces
0:19:41 of
0:19:41 water
0:19:42 when
0:19:42 I
0:19:42 first
0:19:42 wake
0:19:42 up
0:19:42 in
0:19:42 the
0:19:43 morning
0:19:43 and
0:19:43 I
0:19:43 drink
0:19:44 that
0:19:44 basically
0:19:45 first
0:19:45 thing
0:19:45 in
0:19:45 the
0:19:45 morning
0:19:46 I’ll
0:19:46 also
0:19:46 drink
0:19:46 element
0:19:47 dissolved
0:19:47 in
0:19:47 water
0:19:47 during
0:19:48 any
0:19:48 kind
0:19:48 of
0:19:48 physical
0:19:49 exercise
0:19:49 that
0:19:49 I’m
0:19:49 doing
0:19:50 especially
0:19:50 on
0:19:51 hot
0:19:51 days
0:19:51 when
0:19:51 I’m
0:19:51 sweating
0:19:52 a lot
0:19:52 and
0:19:52 losing
0:19:52 water
0:19:53 and
0:19:53 electrolytes
0:19:54 element
0:19:54 has
0:19:55 a bunch
0:19:55 of
0:19:55 great
0:19:55 tasting
0:19:56 flavors
0:19:56 I love
0:19:57 the
0:19:57 raspberry
0:19:57 I love
0:19:58 the
0:19:58 citrus
0:19:58 flavor
0:19:59 right
0:19:59 now
0:19:59 element
0:19:59 has
0:19:59 a
0:20:00 limited
0:20:00 edition
0:20:01 lemonade
0:20:01 flavor
0:20:02 that is
0:20:02 absolutely
0:20:03 delicious
0:20:03 I hate
0:20:03 to say
0:20:04 that I
0:20:04 love
0:20:04 one
0:20:04 more
0:20:05 than
0:20:05 all
0:20:05 the
0:20:05 others
0:20:06 but
0:20:06 this
0:20:06 lemonade
0:20:07 flavor
0:20:07 is
0:20:07 right
0:20:07 up
0:20:07 there
0:20:07 with
0:20:08 my
0:20:08 favorite
0:20:08 other
0:20:08 one
0:20:09 which
0:20:09 is
0:20:09 raspberry
0:20:10 or
0:20:10 watermelon
0:20:10 again
0:20:11 I
0:20:11 can’t
0:20:11 pick
0:20:11 just
0:20:11 one
0:20:12 flavor
0:20:12 I love
0:20:12 them
0:20:13 all
0:20:13 if
0:20:13 you’d
0:20:13 like
0:20:14 to
0:20:14 try
0:20:14 element
0:20:14 you
0:20:15 can
0:20:15 go
0:20:15 to
0:20:15 drink
0:20:16 element
0:20:16 dot com
0:20:17 slash
0:20:17 Huberman
0:20:18 spelled
0:20:18 drink
0:20:19 L-M-N-T
0:20:19 dot com
0:20:20 slash
0:20:21 Huberman
0:20:21 to claim
0:20:21 a free
0:20:22 element
0:20:22 sample
0:20:22 pack
0:20:23 with
0:20:23 a
0:20:23 purchase
0:20:23 of
0:20:23 any
0:20:24 element
0:20:24 drink
0:20:24 mix
0:20:25 again
0:20:25 that’s
0:20:26 drink
0:20:26 element
0:20:27 dot com
0:20:27 slash
0:20:28 Huberman
0:20:28 to claim
0:20:28 a free
0:20:29 sample
0:20:29 pack
0:20:30 so
0:20:30 I
0:20:30 like
0:20:30 to
0:20:30 think
0:20:30 that
0:20:31 by
0:20:31 now
0:20:31 you
0:20:31 have
0:20:31 a
0:20:32 pretty
0:20:32 good
0:20:33 understanding
0:20:33 of
0:20:33 the
0:20:34 circuits
0:20:34 that
0:20:35 underlie
0:20:35 the
0:20:35 threat
0:20:36 reflex
0:20:36 the
0:20:37 fear
0:20:37 response
0:20:38 and
0:20:38 how
0:20:38 we
0:20:38 have
0:20:39 top
0:20:39 down
0:20:40 control
0:20:40 meaning
0:20:40 we
0:20:41 can
0:20:41 attach
0:20:41 a
0:20:42 narrative
0:20:42 to
0:20:43 the
0:20:43 fear
0:20:43 response
0:20:44 and
0:20:45 that
0:20:45 the
0:20:45 fear
0:20:45 response
0:20:45 can
0:20:46 be
0:20:46 learned
0:20:47 in
0:20:48 association
0:20:48 with
0:20:48 particular
0:20:49 events
0:20:50 okay
0:20:50 so
0:20:51 now
0:20:51 I’d
0:20:51 like
0:20:51 to
0:20:51 talk
0:20:52 about
0:20:53 therapies
0:20:53 that
0:20:53 are
0:20:53 carried
0:20:54 out
0:20:54 in
0:20:55 humans
0:20:55 that
0:20:56 allow
0:20:56 fears
0:20:57 to be
0:20:57 undone
0:20:58 that
0:20:58 allow
0:20:59 traumas
0:20:59 to be
0:21:00 reversed
0:21:00 contrary
0:21:01 to popular
0:21:02 belief
0:21:03 it is
0:21:04 not
0:21:04 going
0:21:05 to work
0:21:05 to simply
0:21:06 extinguish
0:21:07 a fear
0:21:08 one
0:21:08 needs
0:21:09 to
0:21:09 extinguish
0:21:10 a fear
0:21:11 and or
0:21:11 trauma
0:21:12 and
0:21:13 replace
0:21:14 that
0:21:14 fearful
0:21:15 or
0:21:15 traumatic
0:21:16 memory
0:21:16 or idea
0:21:17 or response
0:21:18 with a
0:21:19 positive
0:21:19 response
0:21:20 and this
0:21:20 is
0:21:20 something
0:21:21 that’s
0:21:21 rarely
0:21:22 discussed
0:21:23 both
0:21:23 in the
0:21:23 scientific
0:21:24 literature
0:21:24 but
0:21:25 certainly
0:21:25 in the
0:21:25 general
0:21:26 discussion
0:21:27 around
0:21:27 fear
0:21:27 and
0:21:27 trauma
0:21:28 and
0:21:28 so
0:21:28 that
0:21:29 brings
0:21:29 us
0:21:29 to
0:21:30 which
0:21:31 treatments
0:21:31 are
0:21:32 directly
0:21:32 related
0:21:33 to
0:21:33 the
0:21:33 fear
0:21:34 circuitry
0:21:34 and the
0:21:35 circuitry
0:21:35 related
0:21:35 to
0:21:36 trauma
0:21:37 and
0:21:37 the
0:21:37 primary
0:21:38 one
0:21:38 to
0:21:38 begin
0:21:38 with
0:21:39 is
0:21:40 the
0:21:40 so-called
0:21:41 behavioral
0:21:41 therapies
0:21:42 there
0:21:42 are
0:21:42 three
0:21:42 forms
0:21:42 of
0:21:43 therapy
0:21:44 that
0:21:45 purely
0:21:45 through
0:21:45 the
0:21:45 use
0:21:45 of
0:21:46 language
0:21:46 have
0:21:46 been
0:21:46 shown
0:21:47 to
0:21:47 have
0:21:47 very
0:21:48 strong
0:21:49 positive
0:21:49 impact
0:21:49 meaning
0:21:50 reduce
0:21:51 fears
0:21:51 and
0:21:51 traumas
0:21:52 and
0:21:52 those
0:21:53 three
0:21:53 are
0:21:54 prolonged
0:21:54 exposure
0:21:55 therapy
0:21:56 cognitive
0:21:56 processing
0:21:57 or CPT
0:21:58 and cognitive
0:21:59 behavioral
0:21:59 therapy
0:22:01 it’s
0:22:01 very
0:22:01 clear
0:22:02 because
0:22:02 it’s
0:22:02 been
0:22:03 measured
0:22:04 that
0:22:05 if
0:22:05 you
0:22:05 look
0:22:06 at
0:22:06 the
0:22:06 amount
0:22:06 of
0:22:07 anxiety
0:22:07 the
0:22:08 pure
0:22:08 physiological
0:22:10 anxiety
0:22:10 response
0:22:11 of
0:22:11 quickening
0:22:12 of heart
0:22:12 rate
0:22:14 flushing
0:22:14 of the
0:22:14 skin
0:22:15 sometimes
0:22:16 quaking
0:22:17 of the
0:22:17 hands
0:22:17 that
0:22:17 the
0:22:18 experience
0:22:18 of
0:22:18 fear
0:22:19 over
0:22:20 time
0:22:21 when
0:22:21 people
0:22:22 recount
0:22:22 or
0:22:23 retell
0:22:23 their
0:22:23 trauma
0:22:24 that
0:22:25 the
0:22:25 first
0:22:25 time
0:22:25 they
0:22:25 do
0:22:26 that
0:22:27 especially
0:22:27 when
0:22:27 it’s
0:22:28 recounted
0:22:28 in
0:22:29 a lot
0:22:29 of
0:22:29 detail
0:22:31 there’s
0:22:31 a
0:22:32 tremendous
0:22:32 anxiety
0:22:33 response
0:22:33 sometimes
0:22:34 even
0:22:35 as
0:22:35 great
0:22:35 or
0:22:35 greater
0:22:36 than
0:22:36 the
0:22:36 actual
0:22:37 exposure
0:22:37 to
0:22:37 the
0:22:37 fearful
0:22:38 event
0:22:38 or
0:22:38 trauma
0:22:39 and
0:22:40 obviously
0:22:40 this
0:22:40 is
0:22:40 something
0:22:41 that
0:22:41 is
0:22:41 done
0:22:42 with
0:22:42 a
0:22:43 clinician
0:22:43 present
0:22:44 because
0:22:44 it
0:22:44 is
0:22:45 very
0:22:45 traumatic
0:22:46 to
0:22:46 the
0:22:46 person
0:22:46 they’re
0:22:47 literally
0:22:47 reliving
0:22:48 the
0:22:48 trauma
0:22:48 in
0:22:49 full
0:22:49 rich
0:22:49 detail
0:22:50 and
0:22:50 they
0:22:50 are
0:22:50 encouraged
0:22:51 to
0:22:51 provide
0:22:52 full
0:22:52 rich
0:22:53 detail
0:22:53 they’re
0:22:53 often
0:22:54 encouraged
0:22:54 to
0:22:54 speak
0:22:55 in
0:22:55 complete
0:22:55 sentences
0:22:56 to
0:22:57 flesh
0:22:57 out
0:22:57 details
0:22:58 about
0:22:58 how
0:22:58 they
0:22:59 felt
0:23:00 inside
0:23:00 to
0:23:01 flesh
0:23:01 out
0:23:01 details
0:23:02 about
0:23:02 their
0:23:03 memories
0:23:03 going
0:23:04 into
0:23:04 this
0:23:04 traumatic
0:23:05 or
0:23:05 fearful
0:23:05 event
0:23:06 going
0:23:07 through
0:23:07 it
0:23:07 and
0:23:08 after
0:23:09 really
0:23:10 digging
0:23:10 into
0:23:11 all the
0:23:11 nuance
0:23:12 and contours
0:23:13 of these
0:23:13 horrible
0:23:14 experiences
0:23:16 but what’s
0:23:16 remarkable
0:23:17 is that
0:23:18 in the
0:23:18 second
0:23:19 and the
0:23:20 third
0:23:20 and the
0:23:21 fourth
0:23:22 retelling
0:23:22 of these
0:23:23 traumatic
0:23:24 or fearful
0:23:24 events
0:23:25 that
0:23:26 anxiety
0:23:26 response
0:23:27 and the
0:23:27 amount
0:23:28 of the
0:23:28 physiological
0:23:29 response
0:23:29 I should
0:23:30 say that
0:23:30 the
0:23:30 amplitude
0:23:31 of the
0:23:31 physiological
0:23:32 response
0:23:33 becomes
0:23:33 progressively
0:23:34 diminished
0:23:34 with each
0:23:35 retelling
0:23:36 every
0:23:37 clinician
0:23:37 I spoke
0:23:38 to in
0:23:38 anticipation
0:23:39 of this
0:23:39 episode
0:23:39 said the
0:23:40 exact same
0:23:40 thing
0:23:41 which is
0:23:41 that a
0:23:42 detailed
0:23:44 recounting
0:23:44 of the
0:23:45 traumatic
0:23:45 and fearful
0:23:46 events
0:23:47 is absolutely
0:23:47 essential
0:23:49 in order
0:23:49 to get
0:23:50 the
0:23:50 positive
0:23:51 effects
0:23:51 of
0:23:51 prolonged
0:23:52 exposure
0:23:52 cognitive
0:23:53 processing
0:23:53 and cognitive
0:23:54 behavioral
0:23:54 therapy
0:23:55 so the
0:23:55 thing
0:23:55 to embed
0:23:56 in your
0:23:56 mind
0:23:57 is that
0:23:58 recognition
0:23:59 of the
0:23:59 early
0:24:00 traumatic
0:24:01 or fearful
0:24:01 event
0:24:02 in detail
0:24:03 over and
0:24:03 over
0:24:04 is key
0:24:05 to forming
0:24:06 a new
0:24:07 non-traumatic
0:24:09 association
0:24:10 with that
0:24:10 event
0:24:12 or person
0:24:13 so that’s
0:24:13 part one
0:24:14 you need
0:24:15 to diminish
0:24:16 the old
0:24:17 experience
0:24:17 and when I
0:24:18 say diminish
0:24:18 I mean
0:24:19 reduce
0:24:20 the amplitude
0:24:20 of the
0:24:21 physiological
0:24:22 response
0:24:23 but
0:24:24 even
0:24:25 after
0:24:25 that’s
0:24:25 occurred
0:24:27 there’s
0:24:27 an
0:24:27 essential
0:24:27 need
0:24:28 to
0:24:28 relearn
0:24:29 a new
0:24:30 narrative
0:24:31 why is
0:24:31 there
0:24:31 essential
0:24:32 need
0:24:32 to
0:24:32 relearn
0:24:33 a new
0:24:33 narrative
0:24:34 or create
0:24:34 a new
0:24:35 association
0:24:36 well that
0:24:37 has to do
0:24:38 with that
0:24:38 fear reflex
0:24:39 circuitry
0:24:39 as you
0:24:40 recall there
0:24:41 are outputs
0:24:42 to areas
0:24:42 of the
0:24:43 brain that
0:24:43 are associated
0:24:44 with dopamine
0:24:44 release
0:24:45 and reinforcement
0:24:47 and that
0:24:47 we now know
0:24:48 offers the
0:24:49 capacity for
0:24:49 these fear
0:24:50 circuits and
0:24:50 these circuits
0:24:51 that underlie
0:24:52 trauma to
0:24:52 be mapped
0:24:53 onto new
0:24:54 experiences
0:24:56 that are
0:24:57 of positive
0:24:57 association
0:24:59 that is all
0:24:59 through narrative
0:25:00 it’s all
0:25:01 through cognition
0:25:01 and I think
0:25:02 this is a
0:25:02 very important
0:25:03 point
0:25:04 oftentimes I
0:25:04 think we
0:25:05 tend to
0:25:06 undervalue
0:25:08 the importance
0:25:09 of rationalization
0:25:10 and of story
0:25:11 and of narrative
0:25:12 but the
0:25:13 prefrontal
0:25:13 cortex is this
0:25:15 amazing capacity
0:25:15 of our
0:25:16 brain real
0:25:16 estate
0:25:17 to create
0:25:18 meaning
0:25:18 to attach
0:25:19 meaning
0:25:19 and purpose
0:25:20 to things
0:25:21 that otherwise
0:25:21 are just
0:25:22 reflexive
0:25:23 now I
0:25:23 mentioned
0:25:24 prolonged
0:25:24 exposure
0:25:25 therapy
0:25:25 cognitive
0:25:26 processing
0:25:26 and cognitive
0:25:27 behavioral
0:25:27 therapy
0:25:28 for those
0:25:28 of you
0:25:29 that are
0:25:29 seeking
0:25:29 relief
0:25:30 from
0:25:31 fear
0:25:31 and traumatic
0:25:32 events
0:25:33 you can
0:25:33 look up
0:25:34 licensed
0:25:34 clinicians
0:25:35 that can
0:25:35 carry out
0:25:36 those
0:25:37 one or
0:25:37 several of
0:25:38 those types
0:25:38 of therapies
0:25:41 there are
0:25:41 many people
0:25:42 however
0:25:42 that don’t
0:25:42 have access
0:25:43 to that
0:25:44 or who
0:25:45 are working
0:25:46 through stuff
0:25:46 they have
0:25:47 things in their
0:25:48 past that are
0:25:49 very uncomfortable
0:25:49 to them
0:25:51 and I’m aware
0:25:51 that many people
0:25:52 are working
0:25:52 through those
0:25:53 things through
0:25:54 journaling
0:25:54 through talking
0:25:55 to a friend
0:25:57 through any
0:25:57 number of
0:25:58 different sort
0:25:59 of non-traditional
0:26:00 approaches
0:26:01 one thing that
0:26:02 really pertains
0:26:03 to everybody
0:26:04 who’s working
0:26:04 through fear
0:26:05 and trauma
0:26:07 of any kind
0:26:08 is the importance
0:26:09 of social
0:26:09 connection
0:26:10 as it relates
0:26:11 to the chemical
0:26:11 systems
0:26:13 and the neural
0:26:14 circuits associated
0:26:14 with fear
0:26:15 and trauma
0:26:16 and it’s
0:26:17 really important
0:26:17 to understand
0:26:18 that regular
0:26:19 social connection
0:26:21 trusting social
0:26:22 connection
0:26:23 of any kind
0:26:24 is going to be
0:26:24 very beneficial
0:26:25 for that process
0:26:26 in a few minutes
0:26:26 we are going
0:26:27 to discuss
0:26:28 some of the
0:26:29 behavioral treatments
0:26:30 including some
0:26:30 really new
0:26:31 exciting protocols
0:26:33 for dealing
0:26:33 with fear
0:26:34 and trauma
0:26:36 but for a few
0:26:36 minutes
0:26:36 I’d like to
0:26:37 discuss some
0:26:38 of the drug
0:26:38 treatments
0:26:39 that are starting
0:26:39 to emerge
0:26:40 as potential
0:26:41 therapeutics
0:26:42 in particular
0:26:42 for PTSD
0:26:44 the two drug
0:26:44 treatments I’d
0:26:45 like to focus
0:26:46 on are ketamine
0:26:48 assisted psychotherapy
0:26:50 and MDMA
0:26:51 assisted psychotherapy
0:26:53 ketamine is a
0:26:54 dissociative
0:26:55 anesthetic
0:26:56 you know
0:26:57 dissociation
0:26:58 in its essence
0:27:00 is really about
0:27:01 viewing what’s
0:27:01 happening from
0:27:02 a different
0:27:03 perspective than
0:27:03 what normally
0:27:04 one would view
0:27:05 that experience
0:27:06 from
0:27:07 what seems
0:27:07 to be the
0:27:08 case is that
0:27:09 it somehow
0:27:10 allows the
0:27:11 patient the
0:27:12 individual to
0:27:13 recount their
0:27:14 trauma while
0:27:16 feeling either
0:27:17 none or a
0:27:18 very different
0:27:20 set of emotional
0:27:21 experiences that
0:27:22 they experienced
0:27:23 in the actual
0:27:24 trauma or fearful
0:27:25 experience so
0:27:26 it’s a remapping
0:27:27 of new
0:27:28 onto old
0:27:29 new meaning
0:27:30 new feelings
0:27:30 onto old
0:27:31 feelings while
0:27:32 staying in the
0:27:32 exact same
0:27:33 narrative and
0:27:34 so in that
0:27:34 way we can
0:27:35 sort of view
0:27:36 or we can
0:27:37 try and view
0:27:38 ketamine assisted
0:27:39 psychotherapy for
0:27:40 the treatment of
0:27:41 trauma as bringing
0:27:42 together the
0:27:43 three elements that
0:27:43 we talked about
0:27:44 before you want to
0:27:45 diminish the
0:27:46 intensity the
0:27:47 potency of the
0:27:48 old original
0:27:50 trauma experience
0:27:51 or fear experience
0:27:52 so that seems to
0:27:52 be accomplished
0:27:53 through this
0:27:54 dissociation that
0:27:55 leads to the
0:27:57 extinction of the
0:27:57 trauma and the
0:27:58 fear but then
0:27:59 there also seems
0:28:00 to be an
0:28:01 automatic or kind
0:28:02 of built-in
0:28:02 re-learning
0:28:03 of a new
0:28:04 narrative and
0:28:05 new set of
0:28:06 experiences which
0:28:06 is the next
0:28:07 step that we
0:28:08 described earlier
0:28:10 so it’s an
0:28:11 intriguing therapy
0:28:12 it’s one that’s
0:28:13 really catching
0:28:13 on and there
0:28:14 are many many
0:28:15 clinics around the
0:28:15 U.S. that are
0:28:16 now doing it
0:28:17 whether or not it
0:28:18 turns out to be
0:28:19 the ultimate
0:28:20 treatment for
0:28:21 trauma and for
0:28:23 fear isn’t clear
0:28:25 my colleagues in
0:28:26 psychiatry tell me
0:28:27 that that’s unlikely
0:28:28 although it does
0:28:28 seem to be
0:28:29 beneficial for
0:28:30 a number of
0:28:30 people especially
0:28:31 people that are
0:28:33 experiencing trauma
0:28:34 or have existing
0:28:35 traumas and fear
0:28:35 that are coupled
0:28:36 with depressive
0:28:37 symptoms because the
0:28:38 data on ketamine and
0:28:39 depression seems to
0:28:40 be quite strong
0:28:42 I’d like to take a
0:28:42 quick break and
0:28:43 acknowledge one of our
0:28:44 sponsors Function
0:28:46 last year I became a
0:28:47 Function member after
0:28:48 searching for the most
0:28:49 comprehensive approach to
0:28:50 lab testing
0:28:51 Function provides over
0:28:52 100 advanced lab
0:28:53 tests that give you a
0:28:55 key snapshot of your
0:28:56 entire bodily health
0:28:57 this snapshot offers you
0:28:58 with insights on your
0:28:59 heart health
0:29:00 hormone health
0:29:01 immune functioning
0:29:02 nutrient levels and
0:29:02 much more
0:29:03 Function not only
0:29:04 provides testing of
0:29:05 over a hundred
0:29:06 biomarkers key to
0:29:07 your physical and
0:29:08 mental health but it
0:29:09 also analyzes these
0:29:10 results and provides
0:29:11 insights from top
0:29:12 doctors who are expert
0:29:13 in the relevant areas
0:29:15 for example in one of
0:29:16 my first tests with
0:29:17 Function I learned
0:29:17 that I had elevated
0:29:18 levels of mercury in
0:29:19 my blood
0:29:20 Function not only
0:29:21 helped me detect that
0:29:22 but offered insights
0:29:23 into how best to
0:29:24 reduce my mercury
0:29:25 levels which included
0:29:26 limiting my tuna
0:29:27 consumption I’ve been
0:29:28 eating a lot of tuna
0:29:29 while also making an
0:29:30 effort to eat more
0:29:31 leafy greens and
0:29:31 supplementing with
0:29:32 NAC and acetyl
0:29:33 cysteine both of which
0:29:34 can support glutathione
0:29:35 production and
0:29:36 detoxification and I
0:29:37 should say by taking
0:29:38 a second function
0:29:39 test that approach
0:29:40 worked comprehensive
0:29:41 blood testing is
0:29:42 vitally important
0:29:43 there’s so many things
0:29:44 related to your mental
0:29:45 and physical health
0:29:46 that can only be
0:29:47 detected in a blood
0:29:48 test the problem is
0:29:49 blood testing has
0:29:50 always been very
0:29:50 expensive and
0:29:51 complicated in
0:29:52 contrast I’ve been
0:29:53 super impressed by
0:29:55 function simplicity and
0:29:56 at the level of cost it
0:29:58 is very affordable as
0:29:58 a consequence I
0:29:59 decided to join their
0:30:00 scientific advisory
0:30:01 board and I’m thrilled
0:30:02 that they’re sponsoring
0:30:04 the podcast if you’d like
0:30:05 to try function you
0:30:05 can go to
0:30:06 functionhealth.com
0:30:07 slash Huberman
0:30:08 function currently has
0:30:09 a wait list of over
0:30:11 250,000 people but
0:30:12 they’re offering early
0:30:13 access to Huberman
0:30:15 podcast listeners again
0:30:17 that’s functionhealth.com
0:30:18 slash Huberman to get
0:30:19 early access to
0:30:21 function so now let’s
0:30:23 talk about MDMA MDMA
0:30:25 also sometimes called
0:30:27 ecstasy or molly in
0:30:29 its recreational form is
0:30:31 a powerful synthetic
0:30:34 drug that at least as
0:30:34 far as we know
0:30:37 creates a state in the
0:30:38 brain and body that is
0:30:39 unlike any other
0:30:40 chemical state in the
0:30:41 brain and body that’s
0:30:42 normally experienced
0:30:43 what do I mean by that
0:30:45 well we have several
0:30:46 neuromodulator systems in
0:30:47 our body good examples of
0:30:48 neuromodulators are
0:30:50 dopamine serotonin
0:30:52 acetylcholine norepinephrine
0:30:53 and there is a little bit
0:30:55 of a seesaw type
0:30:56 phenomenon with dopamine
0:30:57 and serotonin dopamine
0:30:59 most commonly associated
0:31:01 with activating neural
0:31:02 circuits related to
0:31:03 motivation craving and
0:31:05 reward and serotonin
0:31:07 more typically activated
0:31:08 in response to
0:31:10 situations or conditions
0:31:11 in which we are very
0:31:12 happy and content with
0:31:13 what we have so dopamine
0:31:14 is more about pursuing
0:31:16 and seeking serotonin is
0:31:18 more about kind of
0:31:20 pleasure and satisfaction
0:31:21 with resources that we
0:31:22 have in our immediate
0:31:26 sphere MDMA is a unique
0:31:28 compound in that it leads
0:31:30 to very large increases in
0:31:31 the amount of both
0:31:33 dopamine and serotonin in
0:31:34 the brain and body
0:31:36 simultaneously and that’s a
0:31:37 unique circumstance that
0:31:40 is just simply not seen
0:31:41 under normal conditions
0:31:42 from a subjective
0:31:44 standpoint people under the
0:31:46 influence of MDMA in the
0:31:48 therapeutic setting tend to
0:31:49 report immense feelings of
0:31:52 connection or resonance with
0:31:54 people or even things with
0:31:56 music with objects why would
0:31:57 this state of mind and
0:32:00 body be potentially useful for
0:32:01 the treatment of trauma what
0:32:04 it seems to allow is a very
0:32:08 fast relearning or new
0:32:11 associations to be tacked on to
0:32:12 the previously traumatic
0:32:13 experience so again it brings
0:32:16 us back to the same model of how
0:32:17 people extinguish fears and
0:32:19 traumas and replace them with new
0:32:22 experiences when there is no drug
0:32:24 treatment involved there needs to
0:32:26 be a diminishing of the old
0:32:27 experience meaning an extinction
0:32:28 and then a relearning of a new
0:32:30 narrative this whole business of
0:32:33 fear and trauma relates to taking
0:32:36 external experiences and funneling
0:32:39 those experiences into this thing
0:32:41 that I’m calling a threat reflex or
0:32:43 the fear circuitry we have a
0:32:45 system that can generate threat
0:32:47 responses and in the case of
0:32:49 trauma PTSD and extreme stress
0:32:51 chronic stress that system gets
0:32:52 ramped up so that it takes very
0:32:54 little maybe even just a memory or
0:32:56 maybe even a an association that
0:32:57 we’re not even aware of how do we
0:33:00 recalibrate the system well most of
0:33:01 the approaches that are out there
0:33:03 involving drug treatments typical
0:33:05 drug treatments would involve
0:33:08 suppressing the level of internal
0:33:10 arousal just trying to bring that
0:33:12 down so what we’ve been doing in
0:33:15 human subjects is having them do
0:33:16 breathing protocols called cyclic
0:33:18 hyperventilation which is somewhat
0:33:20 stressful it’s five minutes a day of
0:33:23 stress and involves basically doing
0:33:27 this what I’ll do in a moment for five
0:33:29 minutes which is hyperventilating which
0:33:29 is
0:33:36 but not continuously for the five
0:33:38 minutes because many people would pass
0:33:40 out or feel extremely uncomfortable it
0:33:42 involves inhale exhale inhale exhale very
0:33:44 deep inhale through the nose exhale through
0:33:47 the mouth and then every 25 or 30 breaths
0:33:49 or so doing a full exhale and holding
0:33:52 one’s breath lungs empty for about 25 maybe
0:33:54 30 maybe even 60 seconds and then
0:33:57 continuing until five minutes is up
0:34:00 subjects report and our data indicate
0:34:02 that people feel a heightened level of
0:34:05 autonomic arousal in fact I can feel it
0:34:07 right now even from that very brief
0:34:09 cyclic hyperventilation bout I just did you
0:34:13 you feel a heating up you feel a some people
0:34:14 will perspire some people get wide-eyed
0:34:16 some people feel agitated that’s adrenaline
0:34:18 being released into your system it’s
0:34:21 stressful in air quotes you can imagine a
0:34:25 very brief five minutes a day two weeks
0:34:28 intervention in which people with the
0:34:30 support of a clinician we would hope would
0:34:33 deliberately induce a physiological state
0:34:36 that’s very stressful right not shying away from the stress
0:34:40 response but increasing their own stress response deliberately
0:34:45 and maybe in conjunction with recounting the traumatic or fearful
0:34:49 circumstance this is far and away different than the kind of state of
0:34:53 mind and body that would come about in a ketamine assisted
0:34:57 trauma induced psychotherapy session or a mdma assisted
0:35:02 trauma psychotherapy session or in a narrow purely narrative based
0:35:07 psychotherapy session aimed at alleviating fear or trauma the reason I like these
0:35:11 sorts of interventions is that a they are very low cost or even zero cost
0:35:18 right one could you could imagine doing this while journaling or while recounting a
0:35:23 particular experience I do think that deliberate self-directed entry into these
0:35:28 short bouts of stress is a very promising approach and it’s one that if people are going to
0:35:32 experiment I just again want to caution people with anxiety or panic disorders be very cautious
0:35:38 probably don’t do it ideally you would do this in conjunction with support from a clinician
0:35:42 but I’m also aware that there are a lot of people out there that are dealing with trauma and dealing
0:35:49 with post-traumatic stress of various kinds and that they’re desperate for various self-directed
0:35:54 intervention approaches so just very briefly I want to touch on some of the lifestyle and
0:36:00 supplementation factors that can impact things like fear and trauma and getting over fear and trauma
0:36:08 to make a long story short there are many things that we all can and should do to support our overall
0:36:13 mental and physical health and these are the foundational elements of quality nutrition what
0:36:20 that means to you quality sleep on a regular basis ample sleep on a regular basis I just want to briefly
0:36:26 let me mention a few of the things that some people find great benefit from in the supplementation realm
0:36:35 as it relates to anxiety stress fear and PTSD but I want to point out that again these are somewhat indirect in
0:36:43 their support and most of them focus on reducing anxiety overall the two that I want to focus on are two
0:36:48 that I’ve never talked about on this podcast before because I’ve done podcasts before on stress and
0:36:55 managing stress in the kind of shorter term the first one is saffron of all things but it there are 12
0:37:02 studies believe it or not that orally ingested saffron at 30 milligrams seems to be a reliable dose
0:37:08 for reducing anxiety on the standard inventories the Hamilton anxiety rating scale for those of you that want to
0:37:13 know and these are significant effects and these were carried out in both male and female subjects always
0:37:18 here I’m only referring to human studies uh several of these were double blind studies there’s um a
0:37:26 meta-analysis of the uh positive effects meaning uh anxiotic effects anxiety reducing effects that is
0:37:34 of things like saffron the other one is inositol um inositol has been shown to create a very notable
0:37:41 decrease in anxiety symptoms um it’s a fairly high dose that’s used but believe it or not uh the potency
0:37:47 of this effect is on par with many of the prescription antidepressants 18 grams of of inositol taken for a
0:37:54 full month and it does take some time for these uh symptoms of anxiety to uh to be improved now the
0:38:00 question is when would you take it well by the logic of what we spelled out today you probably would not
0:38:06 want to take it during a session or prior to a session where you were trying to amplify the intensity of
0:38:12 an experience and the recounting of an experience in efforts to eventually extinguish that experience
0:38:17 right so you can imagine doing this outside of that session as a way to kind of bring your system back to
0:38:23 baseline perhaps so today we’ve reviewed a large amount of information about the biology of pathways in the
0:38:30 brain and body that underlie the fear response and that give rise to chronic fear and in some cases to
0:38:39 trauma and ptsd we also touched on a large variety of approaches to dealing with fear trauma and ptsd that
0:38:46 currently exist in the clinical landscape out there most important i believe is to understand and really
0:38:52 think about the logical structure of the circuits that underlie fear and ptsd because in doing that
0:38:58 each of us all of us can think about what sorts of treatments and approaches make the most sense for
0:39:06 them i also hope that it will help people lean into certain practices involving re-exposure provided
0:39:12 that’s done in a supportive environment re-exposure to a given traumatic event in an attempt to extinguish
0:39:17 that obviously you want to do that safely meaning psychologically safely and physically safely there
0:39:23 are great practitioners out there that can help you with that work there are also a number of people out
0:39:29 there i am certain that are carrying certain traumas or certain fears that they would like to alleviate
0:39:34 that are not in the extreme clinical realm and that’s the reason why i touched on a number of things
0:39:40 including some self-directed practices that might be useful and reasonable for them to explore
0:39:42 you