Hi, I'm Rachel Yehuda and I study post-traumatic stress disorder and the effects of trauma, including intergenerational trauma. Chapter one, why trauma sticks? In graduate school, I studied the neuroscience of stress. Post-traumatic stress disorder was a relatively new disorder. It was a very provocative and challenging concept because the concept of post-traumatic stress disorder wanted you to understand that the effects of stress were enduring. Stress theory at that time basically suggested that stress effects were temporary. But the natural way that the body had of dealing with stress was to recalibrate and achieve a kind of a homeostasis. The idea that there was still something to see weeks, months, years, and even decades later was really interesting.

The way that I like to think about a traumatic experience is an event that really divides your life. It's a watershed. About 70% of people have experienced at least one of these potentially traumatic experiences in their lives. When you look at the prevalence of PTSD compared to the prevalence of trauma exposure, what you begin to understand is that most people don't develop post-traumatic stress disorder. What's important about that is that trauma itself doesn't have the power to transform people. It's our responses to the trauma.

When we talk about using psychedelic assisted psychotherapy, what we're really trying to do is use the power of psychedelics to help people do the work of trauma-focused therapy that is often very hard to do when you're in an ordinary state of consciousness. Many times they give up on the therapy because these therapies are just too emotionally draining. MDMA has shown remarkable efficacy. About two thirds of people that are treated report no longer having PTSD. MDMA is not a classic psychedelic. You can be coherent because you are not having an ego dissolution experience.

Being in a state where you're not so worried about getting agitated can be very helpful for processing traumatic memories. Instead of just understanding this intellectually, she feels it as a truth. She sees it in a way that is also infused with compassion for herself. Psychedelic is to the brain what the telescope is to astronomy. It allows you to get past this initial layer and go to that next layer.

People with post-traumatic stress disorder have lower cortisol levels. Cortisol is designed to help you cope with the fight or flight challenge. We think that lower levels of cortisol are part of why the stress response doesn't fully shut off. Epigenetics refers to the study of how genes are regulated. The epigenetic mark is robust and it can survive cell division.

When people talk about intergenerational transmission of trauma, I'd really like to correct: it's not intergenerational transmission of trauma, it's the idea that people in a subsequent generation may feel the effects of a trauma in a first generation. Maybe that is a way of transmitting a lesson to the next generation about how to cope. It's a type of wisdom. If you use fear extinction on that male mouse, that offspring doesn't have the epigenetic changes. The real beneficiaries of successful PTSD treatment are the next generation.

Responding to mass casualty and mass trauma in our society may not be only a mental health problem, but it might be a problem of creating resilient and healing societies. The legacy that we have most often from our parents is that whatever they went through, they survived, and that's why we exist. The question is what's the next step beyond survival? It's restoring, repairing, achieving resilience, achieving growth.

Successful healing is really about going deep and correcting this narrative that you got stuck in that is some version of how bad you are. Now you're having a different narrative about how you actually survived. We're not just looking to neutralize something negative. We're trying to learn from a traumatic experience. I hope viewers take away from this is that there's hope.