Can understanding Trauma help you to be a better leader?
On the back of spending 4 days at Europe’s leading Trauma Conference, I’ve compiled some thoughts and ideas which I’ve put into two sections.
The first is a challenge I set to everyone, and the medical profession is no exception, to think differently about how it best serves its customers (patients in this case) when thinking about how it operates.
In my work speaking to senior teams as a keynote leadership speaker, what I see and hear is that disruption is everywhere. How we face this disruption and the levels of curiosity, skepticism and willingness to experiment I think are some of the most crucial factors in how that organisation will respond to the change that is all around us.
The second area is a canter through some of the potential alternative solutions to trauma which were discussed during the conference. I’m sharing these as I find these absolutely fascinating in terms of being able to better understand us as human beings.
The Challenge
How do you convince a professional who has spent a lifetime training in one way of doing things that perhaps the approach they’ve learnt might not be the best thing? That a different lens, a different way of thinking might be radically impactful for the people they serve.
That’s a big ask right?
Add on to that the profession has generations of layered on experience reinforcing the same beliefs that might perhaps need changing.
An even taller order.
That’s exactly what I’ve been immersed in for the last 4 days at a Conference where I attended the medical track sharing latest breakthrough thinking and innovations.
Who am I to reflect on anything medical?
I have close to zero medical training (I did train as a Ships Doctor but I would openly say this gives me zero medical standing).
I’ve not practiced anything medical or mental health-related, psychology or otherwise.
I am widely read in the field of psychology and trauma but I have no formal qualifications in this space.
I do work with a team of Consultant Psychiatrists at MOAI Health where we are building a technology platform to help tackle mental health at scale. Just being there though doesn’t confer medical expertise on me.
What I do have though is a lifetime of experience of trying to get people to think differently, to think differently about teamwork, about leadership, and about their mindset.
That’s something that I think is relevant to all of us.
We live in a fast moving changing world and I don’t believe that doing what we did yesterday will solve the problems of tomorrow.
I think we all face this challenge.
How to think differently for the future.
So, I’d like to use this opportunity to share an example from one profession where the status quo is being firmly challenged.
It’s the medical profession, and more specifically medicine approached through the lens of trauma and how unresolved trauma has a profound effect on us,
I will share some of the key insights and who they were from - these I find to be fascinating in themselves irrespective of any wider point about changing mindsets. At the end, I will bring it back to the wider issue of the mindset I think is most helpful to operating in a changing world.
What was the Conference and what was shared?
It was Europe’s largest trauma, mental health, and wellbeing conference, held at Oxford University with speakers who are the leaders in their profession including Bessel van Der Kolk (author of The Body Keeps the Score), Gabor Mate, Dr Steven Porges, Dr Rangan Chatterjee and many more.
There were many tracks that you could follow. The ones that most interest me are the medical tracks where latest research into trauma is overlaid into the medical profession and it is these threads I will follow here.
Some assorted insights from Bessel van Der Kolk (I highly recommend his book The Body Keeps the Score as a more detailed primer):
We know almost nothing. He shared this picture of Pluto and how we were able to see it in 1994 (the very blurry picture) compared to how we could then see it in 2018. In terms of understanding trauma we are at the equivalent of 1994.
In his work, he has done more research into the different evidence based treatments than anyone else alive. These are empirical based questions where much more research is needed.
I’ll share some of the general insights and themes from his book and work before diving into the most recent findings and work.
Trauma is assumed to be an exceptional and an unusual thing. It’s not. It’s something the vast majority of people experience and can be described as:
“An illness of not being alive in the present”
Trauma isn’t what happens to us - it is what happens inside us as a result of an experience. And what is really crucial is what is called “attachment” - how we relate to others after that experience.
He shared the story of research by Oliver Sacks after World War 2 where kids were shipped out of London to rural parts of the UK to avoid the bombing. Kids who stayed with their parents did much better that kids who were sent away.
Der Kolk believes that attachment sits at the heart of this “who was there for you and who protected you”
When 9/11 happened, there was virtually no PTSD because people were there for each other.
An interesting comment he made was that it is virtually impossible to become drug addicted without having had childhood trauma, and that trauma and alcoholism are very highly correlated.
What happens when you have an experience that is intense is that your body as an adaptive mechanism cuts you off from the pain. The term is dissociation. It means you try not to feel something.
This is the most cursory highlighting of the issue here to set the scene before diving into ideas and solutions these thought leaders shared. There is a wealth of literature and research on this area and I highly recommend any of the books by Bessel van Der Kolk, Gabor Mate, Dr Steven Porges to dive deeper into this area.
One final data point shared by Der Kolk is that traumatised people die on average 15-20 years earlier because their body keeps responding to trauma as though it is still happening.
Whether it’s what Gabor Mate calls Big T trauma (war, sexual assault, an accident) or Small T Trauma (bullying, divorce, or emotional neglect), if unresolved, it has a meaningful impact.
I think that this means this is relevant to all of us:
Relevant because it means we can understand ourselves better.
Relevant because it means we can understand others better.
What I want to turn to is to the NEW approaches that were shared.
Some I found to be challenging. All of them had a theme that it’s only through clinical trials and research can we only really prove the case.
The Second Area: Solutions and Innovations
(In sharing these, to be clear I’m not advocating for them, just sharing the ideas that challenge orthodox thinking)
Der Kolk is less than enthusiastic about traditional talking therapies. These have been the mainstay for treating trauma for a long time. He’s mindful not to dismiss them acknowledging that they have a place, but highlights their limitations:
“Telling the whole story does not abolish the trauma”, or
“Knowing why you are screwed up doesn’t make you less screwed up”.
“In our culture, we know how to yak yak, and to take pills”
“Traumatised people don’t use the left side of their brain, the cognitive side, so why do people still use CBT?”
“CBT (Cognitive Behavioural Therapy) is used to correct people’s thinking - the challenge is not in terms of people thinking, but it resides in nervous system, in different places to where cognitive functioning happens”
So what should be used instead?
Der Kolk asked a room of some 400-500 medical professionals and therapists how many people were familiar with EMDR? I scanned the room and estimate around 25% of the room had hands in the air.
In his own words: “When it was first explained to me I was very skeptical - this is one bizarre treatment - what could waggling a finger in front of my face do?”
He shared a before and after video of a lady who had made a significant shift in processing her trauma after a car crash.
He realised at this point that this treatment unleashed something very mysterious and powerful.
He described it as the first exposure to a treatment that does not rely on a narrative (in contrast to CBT).
His subsequent research studies and clinical trials have shown how spectacularly effective this treatment option is.
In his own words “this therapy gives you the most bang for your buck if you want to become a therapist”.
Warning Note:
At the end of this full day workshop with Der Kolk, an Irish gentleman shared the story from over a decade earlier of how one EMDR practitioner had left him on the brink of suicide - he subsequently found a second practitioner who helped him then to a place of mental safety and to work through his challenges. Responding to this, Der Kolk highlighted the need to find trusted practitioners - it’s about who is using these powerful tools and recommended finding people via the trusted word of mouth. It’s a good note of reminder to approach all new things with both a sense of caution as well as a sense of experimentation.
What else
Yoga: it’s incredibly effective for calming your nervous system and handling trauma. (Yoga practitioners I know need no convincing!)
Here’s a surprising one.
MDMA assisted Psychotherapy
In all his career, Der Kolk has not seen anything so spectacularly effective at overcoming trauma as MDMA assisted Psychotherapy (see screen shot)
Images at Instagram here.
“This enabled patients to go much deeper into trauma and to find things that had been repressed:
“I had the courage to face all the stuff inside me”
Important Caveat: this is all work that needs to be done in a safe setting.
The research he led on this (peer reviewed paper in the image below) won a prize for one of the 10 most important scientific breakthroughs in the world that year.
This research cost $163m to develop, run and present their findings.
It was rejected by the FDA this year. Der Kolk believes this was for political reasons.
Much more on this can be found in David Nutts fascinating book on Psychedelics.
I find it fascinating that even evidence based science-led breakthroughs have such a hard time to get accepted.
This to me is one of the things that anyone looking to innovate and bring a Big Bold Mindset needs to have in mind. That it takes time for thinking to shift. Quite right and naturally there should be scepticism about anything new, and that it should be held up to the light and challenged hard.
In one of the other ventures I’m involved in at Pathogen Reduction Solutions we face resistance making the case for better Indoor Air Quality. Another story for another time!
Neuro Feedback
Search Neurofeedback peer reviewed papers” in Google Scholar
In this deceptively simple treatment, patients have sensors to monitor their brainwaves (takes about 1 min to set up).
Patients then basically play a computer game where their brainwaves are represented as different coloured rockets.
Patients learn to regulate their own responses based on the feedback they see on the screen.
Despite there being hundreds of research papers showing how effective this is, there is still a relatively unknown treatment approach.
This exact question was raised in a panel debate and why this is the case. It was shared that globally there are some 25,000 to 30,000 practitioners of this worldwide and that it has gained some traction but still has a long way to go. One suggestion was that perhaps the word “neuro” puts people off!
Der Kolk’s view of this is that it is so powerful that he would like to see this available in every school across America (where he’s based).
Music for the Nervous System
Dr Steven Porges and Anthony Gorry (a music producer) have spent the last 18 months creating what they describe as a new technology.
https://polyvagalmusic.com/
It’s music specifically designed to get in tune with the rhythm of the body, of the ANS (Autonomic Nervous System) to help people to regulate their nervous systems simply by listening to music.
As an audience in a 90 minute session they spent an hour explaining the science and research behind this and then let us experience the music.
My own personal experience was that it felt very relaxing.
Is it what you might call clinical grade?
I don’t know but these are serious people developing new approaches. Clinical trials are underway, so watch this space.
This is the link if you want to follow what they are doing - https://www.sonocea.com/
If it works, just how powerful would that be? Amazing to think that seemingly simple things could have profound effects.
A Thought on Being Change Resistant?
I watched an hour-long discussion on stage between Dr Rangan Chatterjee (RC) and Bessel van Der Kolk (BvDK)
For me, this highlighted a really interesting point about resistance to change and holding onto old ideas.
For Reference, Dr Rangan Chatterjee runs a very popular podcast with over 2m views/ listens per week.
Link - https://drchatterjee.com/blog/category/podcast/
RC asked BvDK a fascinating question:
“Can you think your way out of trauma?”
RC explained that he believes you can citing holocaust survivor Edith Eger who he interviewed on his podcast and shared that the conversation they had changed how he thought about things. His conclusion was that the thinking alone had caused the change in him”
BvDK’s response was fascinating:
“In an age of trauma, I’d be very sceptical about the power of reason”
“With Edith, you connected with her limbic system - it was more than just a cognitive experience, it was more like “Will you be my Mum” and this is what a good parent is like.
As I watched the interview, I thought I observed a shift in RC’s posture and his reaction indicated me something had landed.
I sought him out afterwards to speak 1:1 with him and asked him how compelling the answer was?
His response surprised me.
“It didn’t change my mind - I still believe you can think your way out of trauma”. He paused. And then said maybe I believe that 85%. And added maybe I should do a podcast on this and dive deeper.
My response, yes please: I’d love to see that.
In this one interaction, I saw the challenge of an innovator (BvDK) challenging the foundations of received wisdom. Wisdom that an incredibly enlightened person (RC) was holding onto (more on him later).
It’s an indication of how hard it can be to change embedded beliefs.
100% to 85% in a conversation, and an intention to dive deeper into it
That’s a good result I think for anyone trying to change someone’s mind, and it is right we should be sceptical and challenge. That is part of the process.
This is a ringside seat on what it takes to create mindset shifts.
The Wider Issue of Mindset
It will be evident to readers who have got this far that I’m fascinated by this particular subject area. I really do believe that being trauma informed and having a deep understanding of this is crucial to how we perform effectively as individuals and within teams.
That though is the not the key point I want to end on.
I want to come back to the wider issue of mindset and how we think about change. Whether we embrace it, how open-minded we are, how curious we are, the levels of skepticism we have and whether we are willing to challenge orthodox thinking. In this, I have to confess a bias towards wanting to challenge orthodox thinking in this in search of better ways to doing things!
Here’s the position I think is healthy. Please do challenge me on this and give me your thoughts.
I think it is 100% right we should be sceptical about new innovations and ideas.
Just because something is new doesn’t make it right. There is of course some level of certainty about old ideas.
Science, research, thinking and the world we operate in changes continuously though and we should be 100% open to new ideas.
I advocate what I call a healthy curiosity.
Look at whats new and changing. Get interested in it. Get curious about it. Seek out what research backs up those new ideas. Who is advocating for those ideas?
Form a view on what you think about and find a way to test that view.
Ray Dalio famously said “everything changed when I went from saying I’m right to How do I know I’m right?”
Learn, reflect and experiment. Take notes about what you try and what you notice about.
I believe adapting requires us to continually challenge what we know and to find better ways forward.
With that in mind, I have 3 experiments for you to consider. In all of these experiments I’m going to encourage you to consider something that outside the normal field you operate in, and in a field or an area where you have an interest or curiosity. (for example I have dived into the field of trauma)
The Quick One
5-Minute Reflection:
Think about that field or area that you are interested in and reflect what has been changing in the world over the past few years. How has technology, for example AI changed how things have been done in that field. What new innovations have been brought to bear. Just notice how a different sector are adapting to change. Is it a lot or is it not at all.
The Medium One (20-30 Minutes) - Have A Discussion
Find someone else who is interested in that field and debate/ explore the changes that are coming in and notice where the levels of scepticism/ curiosity land. Get interested in the differences that bringing new innovations could bring.
Reflect back on your own profession and how open minded it is to change.
The Longer One (1 hour) - Create some experiments
Consider what’s an experiment you could try. In the ideas I’ve shared above, very openly I’ve run experiments with a series of EMDR sessions, I now regularly do Yoga and I’ve found a practitioner to try Neuro Feedback with.
What experiments could you try?
Final Note
I can’t think of a more exciting to be alive with so many incredible changes. See if you can deliberately and consciously create some time and space in your diary to explore new ideas that you can experiment with. Have fun experimenting!
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