คำบรรยาย (166)
0:00- I was raised in the mainstream culture
0:03where if you feel bad,
0:05you take something to
make that feeling go away.
0:09Around that time that I first
started to work for the VA,
0:12I looked at the treatments that we have.
0:16I did the first study on Prozac for PTSD,
0:19the first study for Zoloft for PTSD,
0:21and a number of other conventional drugs.
0:25What we found is they
didn't work very well.
0:29Our conventional way of thinking
about it is not working.
0:34I thought, "Okay, if it doesn't work,
0:36let's see what else could work."
0:39My name is Bessel van der Kolk.
0:41I am a physician, I'm a psychiatrist.
0:44I have been studying trauma
for about 50 years now.
0:54The nature of trauma is that
something happens to you,
0:58your survival brain makes the
first interpretation and says,
1:02is this dangerous or is this safe?
1:06So it's very important to really be aware
1:09that these reactions
emanate for your body.
1:12And so, the big challenge
of treating trauma
1:16is how do we help people to live in bodies
1:20that feel fundamentally safe?
1:24is that very good psychotherapy
is actually quite helpful.
1:30Not to fix people, but
helping people to acknowledge,
1:34oh my God, that was terrible
what happened to me.
1:38And I need to take care of
the wounds that I'm carrying
1:45This issue of self-compassion
1:47and really knowing that your
reactions are understandable
1:51is a terribly important part
1:53of beginning to recover from trauma.
1:57Can I talk about something
else before we talk about MDMA?
2:01Because MDMA is so sexy.
2:05For me, the opening to a new world
2:08came when some people in my clinic
2:10started to do something
very strange, called EMDR.
2:15Eye movement desensitization
and reprocessing.
2:19You ask people to call up the memory
2:23of what you saw back then,
2:26what you felt back then.
2:29is that you ask people
to follow your fingers
2:33as you move your fingers
from side to side.
2:37And my first reaction was like,
2:39"Man, stop this crazy nonsense,
this is a crazy method."
2:44And then I got to see some of the results,
2:46I go like, "Wow, this is interesting."
2:51Wiggling your fingers
and full of people's eyes
2:53as they think about the trauma
made the trauma go away.
2:58This crazy eye movement desensitization
3:00actually change the circuitry of the brain
3:03to interpret your current
reality from a different angle.
3:08This had amazing effects
3:10on people being able to
let go of what happened.
3:13They say, "Yes, that's
what's happened to me.
3:16And it happened a long time ago.
3:18It's not happening right now."
3:21That was the first time
3:22that I saw a non-conventional technique
3:25have a very profound effect.
3:29And then we studied yoga.
3:31Maybe if you do yoga,
3:33you can open up your
relationship to your body.
3:36You learn how to breathe calmly,
3:38you learn to pay attention to yourself,
3:40you get to see how different movements
3:42and different postures affect you.
3:45And so you form a deep relationship
3:47with your internal sensory system.
3:53was a more effective treatment for PTSD
3:56than any of the drugs we had studied.
3:59But I've yet to see a
psychopharmacology clinic
4:02being transformed to a yoga studio.
4:05The next thing that we studied
was theater and movement.
4:11And it turns out that playing
different roles in your body
4:15helps you to feel that your
body can feel differently,
4:19depending on how you organize
your relationship to yourself.
4:23When my voice gets too gravelly,
4:25let me know and I'll drink some water.
4:28- It's feeling a little
gravelly, so why don't-
4:41So, I live in the Berkshires
4:43and we have a great program here,
4:45called "Shakespeare in the Courts"
4:48where if you're a juvenile
delinquent in this county,
4:51you have a 50% chance that
a judge will condemn you
4:55to become a Shakespearian actor.
4:57That's civilization, huh?
5:00The Shakespeare program
is enormously helpful
5:02because it helps people
to feel their bodies
5:06and to feel what it
feels like to be a king,
5:09what it feels like to be a warrior.
5:11And you get to really have a
deep experience of yourself
5:15in different possibilities.
5:18The next piece that I studied
5:20is that you can actually
put electrodes on your skull
5:24so that when you make brainwaves
5:26that help you to be calm and focused,
5:29you get a little reward.
5:31We did very well with neurofeedback.
5:33So we can shape your brain
5:36to actually have a different configuration
5:39to be open to new experiences.
5:43And then, about 15 years ago,
5:46two guys came to talk to me and they said,
5:49"Bessel, you know a lot about trauma.
5:51But do you think about his idea?
5:52We are thinking about psychedelics.
5:55What do you think about
psychedelics for trauma?"
6:01You're speaking for my heart,"
6:04because of course, I'm
a child of the sixties
6:07and we dabbled in LSD and
psychedelic substances.
6:12if he could do psychedelic substances
6:14to see if these substances
can open up people's minds?
6:18To see that the reality that they live in
6:21is just a small part
of the reality that is.
6:26But, I said, "Don't do it.
6:29It will destroy your career.
6:32These drugs are illegal."
6:35And they said, "Thank you
very much for your opinion.
6:39We'll try it anyway."
6:41They got permission to do a study of MDMA,
6:44also known as ecstasy
or molly, for trauma.
6:49And it worked out pretty well.
6:51Able to collect a large amount of money
6:54to do a very large and
extremely expensive study.
6:57Lots of different sites around the US,
6:59one in Israel, when in Canada.
7:02So let me tell you how to study is set up.
7:06After all the preparation,
7:07you have a whole day of taking ecstasy
7:11while you lie on a bed
7:13with two therapists in
your room for eight hours.
7:17What we see in the people
who get the drug is amazing.
7:22People are able to go to places
7:25they have never felt safe to go.
7:28This is not a picnic.
7:31They see the horrible things
that's happened to them.
7:35But MDMA allows people to see
themselves with compassion.
7:40All these measures we have
7:41about self-perception and
self-awareness just shoot up.
7:47And rather than blaming
themselves, they're able to say,
7:51yes, this what happened
to me, but it's over.
7:56Part of what has kept me
so busy all these years
7:59is how can we find a treatment
8:01that allows the basic sense
8:03of defectiveness and
self-loathing to be controlled.
8:09And now it looks like
we have found something
8:11that causes a very
substantial drop in PTSD.
8:16Probably more than just about
anything else we have studied.
8:22But what's important here is
that one size doesn't fit all.
8:27Different people need
very different things.
8:30What worked for my last patient very well
8:33may not work for you.
8:35Everything is an experiment in life.
8:38And healing from trauma is an experiment.
