In the third and final episode of a series with Dr. Wayne Jonas, Dr. Daniel Amen and Tana Amen discuss how childhood trauma factors in to chronic conditions. As Dr. Jonas outlines in his new book, “How Healing Works,” taking an integrative approach and a patient in the driver’s seat mentality, you can find ways to heal yourself to enjoy the things that matter most.
Dr Daniel Amen: Welcome to "The Brain Warrior's Way Podcast". I'm Dr. Daniel Amen.
Tana Amen: I'm Tana Amen. Here, we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions.
Dr Daniel Amen: "The Brain Warrior's Way Podcast" is brought to you by Amen Clinics where we've transformed lives for three decades using brain spec imaging to better target treatment and natural ways to heal the brain. For more information, visit amenclinics.com.
Tana Amen: "The Brain Warrior's Way Podcast" is also brought to you by Brain M.D. where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit brainmdhealth.com. Welcome to "The Brain Warrior's Way Podcast".
So we are back with Dr. Jonas and I am so excited because in the last episode, we touched on doing things that make you happy and how that might be able to help your healing. So when you're happy, obviously happiness is going to help your healing. When you're doing things that make you sad, that's not going to help healing. We talked a little bit about that at the end.
Dr. Wayne Jonas: Well[inaudible 00:01:14] aren't good for you. Right? 'Cause cupcakes make me happy, but they're not good for me. That's feel better now.
Tana Amen: But not what-
Dr. Wayne Jonas: A month later.
Tana Amen: That's now quite what we were talking about. We were talking about the physical component of doing things that are empowering to you and making you happy. I brought the example of doing karate even though I was told not to do karate, and I agreed, maybe I needed to modify karate because of my back, my chronic back pain. But for me, doing karate, the worst day in karate is better than the best day in yoga, because for my brain and how I function that makes me happy. When I don't do it, I start to feel lethargic and old and I don't feel good. Then my back pain is worse.
So I brought that up to Dr. Jonas, and he said something so interesting I want him to touch on it in this episode.
Dr Daniel Amen: Alright.
Tana Amen: 'Cause it's interesting for healing.
Dr Daniel Amen: So, welcome back Dr. Wayne Jonas, the author of "How Healing Works". Pick it up. It's a very important book. If you are struggling with a chronic health condition or you don't want to get a chronic health condition, this book can help you. It also makes a great gift for anybody you know that is struggling with a healthcare issue.
Dr. Wayne Jonas: Yeah. It also makes a great gift for your doctor, by the way, because doctors want to try to do this. I actually have a section in the appendix where I teach doctors how to actually do these kinds of integrative health visits and ask the right questions to really get at the components of help and healing that we know determine health. On my website, drwaynejonas.com, we're populating it with all kinds of tools that can help patients and doctors actually do this together right now. They don't have to be specialists in anything. They need to learn about it, they need to get educated about it. But we're trying to give them tools that they can already start to get at these areas.
Now, the question of happiness came up. I actually wrote an entire chapter in the book on that. It's chapter eight. I call it a little something being different. I call it the mental and the spiritual components. I talk about what matters to a patient and what I call the "meaning response", the response that occurs from your body when you do something that truly is meaningful for yourself.
The study that we were talking about at the break was a National Academy of Medicine Institute of Medicine study that came out in 2001. It was a landmark study, had a huge impact, called "Crossing the Quality Chasm." It is what put the movement of patient centered care on the map. You've heard of patient centered care. You've heard of things like the patient centered medical home, and this type of thing is a framework for managing chronic disease. One of their primary recommendations was: The patient should be in the driver's seat, which means the patient actually is telling you what they need and what matters to them. Then you bring in the evidence, you bring in the support to help them achieve that type of thing and their help, because that's what brings the motivation back.
You know, when they look at compliance even with regular medications, only about 50% of people will comply with the medications as their doctors prescribe it. They're not even taking it the way it is. If you look at behavioral changes it's worse, it's only about 5% of people actually engage in the behavioral changes. So, the only way to solve that problem is to connect it to what's meaningful for them. They have to say, "Yes, I like this." And in your words, "This makes me happy." "This brings me joy", perhaps is another way to do it. Then bring the evidence and the behavior support into that, so that they can be successful at accomplishing.
Tana Amen: Right.
Dr. Wayne Jonas: Once they're successful at accomplishing it, they it's a partnership, and it is patient centered. The patient is in the driver's seat. The physician and the healthcare system is an assistant. They are facilitators, educators of that process. No longer are they throwing agents at them, but the patient has found their own agency with whatever they do.
Tana Amen: Right. Well, and we know when people do things that make them happy, or are meaningful to them, it releases chemicals in your body that reduce the cortisol, that reduce those bad chemicals that increase inflammation and pain and things like that. When you're doing things that are stressful, it does the opposite. It increases your pain. So, I like that. But I remember stopping the thing that makes me happy because several doctors told me I had to. Within a short time I started to feel old and lethargic and I didn't feel good, like I was getting older or something. I did have one doctor who told me, "Do what you love, just modify it, just do it so that you don't get hurt." That gave me this green light, and I'm like, "Oh, that makes sense. Just modify it." Okay, so I started to do that, and immediately I started to feel better. So just be smart about how you do it, right?
Dr. Wayne Jonas: Yes. I think that-
Dr Daniel Amen: So, we only have about nine minutes, and we want to talk about the impact of childhood trauma and chronic pain. One of the things we've talked about on this show before is that when you experience childhood trauma, it actually changes the microbiome and increases the risk of inflammation in your body, also increases the risk of anxiety and depression. So, talk to us, Dr. Jonas, on your experience between chronic pain and childhood trauma.
Dr. Wayne Jonas: You know, this is a major area, and I ask all of my patients, not just with chronic pain but with any chronic major disease, about how their childhood was. In chronic pain it is huge. In PTSD, it is huge. But we now know, and the data is very strong on this, that having had "adverse childhood experiences", that's the term that's used, ACEs, in childhood ... it can be physical abuse, it can be emotional abuse, it can be neglect, it can be a variety of forms ... increases the risk for not only chronic pain but even physical conditions such as asthma, cardiovascular disease, obesity, diabetes, PTSD, et cetera.
So, it is a major factor, and the earlier you have the trauma the more it formulates pathways in the brain and in the body that make it difficult actually to heal. Now, you can heal afterwards, and there ware ways to do it, but it actually becomes more difficult in those areas. It hampers the ability to actually engage in this.
I actually write about this in chapter seven of my book on the social and emotional components of health and healing. You know, there are some wonderful ... I'll give you an example. I had a woman in chronic pain, who had been through all kinds of treatments, alternative and conventional treatments. I asked her how her childhood was. Nobody had asked her that before believe it or not. She had a very traumatic, difficult childhood that she had walled off on one side and completely ignored and separated from the rest of her self. So, she was no longer whole. Now, when you're undergoing trauma that's an important survival method. You'd better learn how to do that. But later on, if you continue to do that, you're not a whole person because that's part of you, it's part of your life, and you need to be able to reconcile that.
I write about the research in my book that shows when you do reconcile that, when you open up to those areas, a huge impact on your biology, your immune system, your function, your healthcare utilization, and chronic pain. So, this woman, I asked her about that. She said, "You know, I had a very difficult childhood." She wasn't ready to go there on her first visit. I said, "That's fine. We know it's there. Let's put it in the parking lot, and let's look at techniques to do that."
Now, to get at this issue there is some great work on this. Daniel, you have been one of the pioneers in mapping out what happens in the brain when these kinds of traumas occur, psychological and physical traumas in the brain, and how that then formulates pathways in the brain that then modify what people can do and can't do later on. I think your work with the PET scanning, the brain imaging, match so nicely with a man by the name of Bruce Perry from the Childhood Trauma Institute in Texas, who has actually now mapped out pathways that you can capture to complement brain imaging in those areas specifically to deal with childhood trauma.
There are growing centers like the Center for Help and Equity in Trauma, run by Audrey Stillerman. I just talked there yesterday, actually at the University of Illinois in Chicago. They have an entire center for healing trauma. They bring in modalities of whole person care to do that. What they find is that people can reconstruct those pathways, as you know, and you've seen it on your images. They can actually ... the neuro plasticity can actually grow different parts of the brain that were damaged in those early times. They can do it through the same things we've been talking about for other chronic illnesses, through movement, through nutrition, through appropriate supplements, and also by opening up and reintegrating it into your life.
One of the things I recommend on my website, for example, and I recommended for this woman who had the childhood trauma, cause she was so very hesitant to go there, was journaling. There's now work showing that simply writing about or talking about old traumatic issues in a safe environment has huge therapeutic effect. It helps you become more whole, and it changes your entire physiology in your brain in those areas.
Dr Daniel Amen: Especially if you do it from the adult perspective, sort of supervising the child. Or how would a good mother help this child. I love the whole ... we just did a podcast on it, post traumatic growth. So, if you look at a bell shaped curve, about 10% of people exposed to serious trauma will develop PTSD, but 80% won't. What's the difference between them and, as you mentioned, it's sort of the brain you bring into trauma or the life you bring into the trauma will determine the life that comes out of it.
But about 10% of people on the other end of the spectrum will get this thing Dr. Martin Slugman calls "post traumatic growth", where they have really developed better relationships, spiritual purpose, they feel more confident about themselves, "If I can survive that I can survive anything." So, I loved what you said. Journaling is really important. I would just add put your adult self in there and how can you make sense out of it.
My early research, the earliest research I engaged in was on adult children of alcoholics. It was an issue near and dear to my heart 'cause someone I really cared about grew up in a very violent alcoholic home. That has generational impact, just I think you were saying, but it was so important to go back through some of the traumas, but from an adult perspective.
Dr. Wayne Jonas: I think you're absolutely right. I see this all the time with service members who have had a past history of trauma, now they get deployed, and they're in war, so they get exposed to trauma again. Many of them, especially those who have had a past history of trauma, will have post traumatic stress problems in those areas. A proportion of them will have post traumatic growth, as you describe. You can enhance that process by putting them into a safe, nurturing, loving environment and then working with them to reintegrate those traumatic experiences, including the past experiences into their life.
There's a wonderful book about how to do this. It's written by a good friend of mine, Joe Bobrow. It's called "Waking Up from War". It is about ... He's a psychologist and actually a minister, and he sets up four and five day retreats for veterans that have psychological depression, PTSD, a variety of traumatic struggles. He shows that in this loving environment when they reintegrate in a safe environment under supervision in these areas, they can launch into this post traumatic growth area and flourish afterwards. It is literally waking up from war, that's the title of his book. I love it. I write about it in my book and describe how it happens. The evidence is there that you can address these things even in adult life.
Dr Daniel Amen: So, if you have chronic pain, one of the questions to ask yourself is, did I have a difficult childhood? Are there issues that I haven't dealt with or I need to deal with in order to settle down very important areas of my brain that were over firing since childhood? We published a study, goodness two years ago now, on 21,000 people, looking at the difference between PTSD and TBI, traumatic brain industry. With PTSD, we saw the emotional brain working too hard, where with traumatic brain injury we saw a deficit, so decreases in activity. Of course, a number of people have both. But calming down those circuits, 'cause when they work too hard, if you hurt you can't stop thinking about the hurt, which will just devastate you.
Tana Amen: As somebody who experienced childhood trauma and has had chronic pain, I know I'm ... People ask me on my page all the time, "What's the one thing I can do to get started?" You know, we've both often said, you know, do it all. Here's the thing: I don't want to sound flippant when I say that. I must not be very special, or maybe I'm extra special because I can't do one thing. I'm one of those people who has to do it all. I do the supplements, I work really hard on my sleep, I work hard on my nutrition, I meditate, I've done therapy. I'm not kidding about trying to get better and get out of that pain, and it works when you do it all. Okay? It really helps.
But how do I answer that question for people who are trying to get started, and they feel overwhelmed. What would you recommend? What would you recommend for just getting started? It doesn't mean you don't need to do it all and incorporate it as a lifestyle. How do you get started? What's the one thing?
Dr Daniel Amen: We only have a minute left. So, in a nutshell, Wayne, what would you say?
Dr. Wayne Jonas: So, you're an example of an empowered patient. Many people aren't' quite ready for that. So, you find one thing. What I do is I find one thing, and then I support them. Often I bring in a health coach that will help them accomplish that one thing, the one thing that matters to them, that brings them joy. Okay?
Dr Daniel Amen: I like that.
Dr. Wayne Jonas: If they then experience that change, and they can do that, it almost doesn't matter what it is they're doing.
Tana Amen: Right, okay. [crosstalk 00:17:14]
Dr. Wayne Jonas: They experience that change, they move to that. They have to pick it.
Tana Amen: So once they master that, then you-
Dr. Wayne Jonas: Then you experience the empowerment.
Dr Daniel Amen: Remember the story of Nancy. She did one thing, and then she did another thing. So, people don't have to feel like they have to do it all, 'cause there are not very many people like you. And when we first met, one of the first gifts I gave you was 10 sessions of AFDR.
Tana Amen: I'm like, "You think I'm screwed up."
Dr Daniel Amen: It just made a huge difference. Well, we have to stop. "How Healing Works". Dr. Wayne Jonas, we'll have you back. What a joy to spend time with you.
Tana Amen: That was awesome.
Dr. Wayne Jonas: Thank you.
Dr Daniel Amen: I know our community [crosstalk 00:17:54]
Tana Amen: And you gave me permission to do karate. I like it.
Dr Daniel Amen: Alright, my friend, take care.
Dr. Wayne Jonas: It was a pleasure. Thank you very much.
Dr Daniel Amen: Thank you for listening to the Brain Warrior's Way Podcast. Go to I tunes and leave a review, and you'll automatically be entered into a drawing to get a free signed copy of "The Brain Warrior's Way" and "The Brain Warrior's Way Cookbook" we give away every month.
