150: The Trauma You Carried for Decades Could Be the Root of Your Disease with Dr. Aimie Apigian

"Hey, Breastee, welcome to keeping your breast on your host, Dr. Jen Simmons." I walked away from breast cancer surgery because I couldn't stay inside a system that promotes fear, dismisses root causes and calls itself healthcare. This show is dedicated to you, your education, your clarity, your confidence and your power. Here we have transparent conversations about real health, the kind that actually changes outcomes. We're talking prevention, hormones healing, longevity, and the truth behind the choices you're being offered. So you can stop outsourcing your decisions and start leading your life. Here you're going to hear from the disruptors, the innovators, the shiny examples, and the unsung heroes who are proving that there's a better way. So give me the next hour of your life, and I'll make sure you leave with something that makes you healthier. Because as I always say, breast health is health. So stay tuned for this week's episode of Keeping a Breast. (upbeat music) So I think so many people find it hard to believe that trauma from 10 years ago and 20 years ago and 30 years ago could be haunting them today. And when I speak to women about a breast cancer diagnosis, I always get into their trauma. And most women don't want to get into their trauma because they put it in the past for a reason. So I thought it was so important to bring someone onto the podcast that could really speak to this. And there is no better person than I could think of than Dr. Amy Epighen. So Amy, Dr. Amy, welcome. - Thank you. It's a very important conversation to have, especially around breast cancer and stored trauma in the body. - Yeah. - Yeah, it is. So first, just give us like a high level about your background, about how you came to be in this space. Because as we all know, the story of why we arrive where we are is usually very purposeful. For me, it definitely was. I never thought that I was going to study trauma, let alone leave a thriving medical practice just to make this my life's work. But for me, it really started in medical school. And I had just finished a Master's in Biochemistry. Yes, I am that nerd. And had a few months free before jumping back into the third year of medical school where it's all the clinical work. And I was thinking, what can I do with this time? And I decided to become a foster parent. I thought I was going to be a foster parent. You decided to become a foster parent in medical school. - In those months that I had free, that was what I was thinking. - What? - Now, life, you thought you could contain it to your free month? - I did think that. And then life had other plans for me. - Yeah, for sure. And I did not know at that time how much of my reasons for wanting to do this really stemmed from my experience in childhood being raised by a father who had been adopted at birth and becoming his emotional stability. And it affected me so much. And I didn't realize that I hadn't processed any of that. And so this was almost a way of trying to complete something that had never been completed in myself. - Can you say more about what that looks like in that? - What was that dynamic like? How were you as the child his emotional stability? - I will speak just to my father's experience and my experience with him. Even though I know that this is going to resonate with a lot of people, some who have been adopted, and others who don't have that history and want to necessarily know why that resonates with them. But for my father, it was devastating for him to feel like he was not good enough, devastating. He could not separate the idea that he had done something bad from the fact that he was bad. And when your childhood experience, you mean he was not good enough for his parents to keep? Is that what you mean? Is that what was that? - That is often a unconscious belief and stealing that people who are adopted have. - Wow. - Is that if I had been enough? They wouldn't have given me away. - Wow, that is quite the burden to bear. - It is. - I mean, I've heard a lot of that. - People say, you know, you're unwanted or something along those lines. So I guess, I guess it's another way of saying that. - It is. And the feeling that's created when you're a newborn and you have this separation from the only nervous system that you've ever known in your entire nine months of Inuterro, you come to believe that it was because of you. You have no concept yet of the world, other factors. And so the feeling, and we start to even separate what we think logically versus what our body feels. Our body has a mind of its own. And the body has this feeling of being unlovable. And we then look at what does a person do to feel lovable? Many of them go into achievements. If I work hard enough, I will deserve love. If I, and you fill in the blank and that becomes their driving force, often for their life, in order to continue to feel like, okay, I'll be okay. I'll be okay. They won't leave me because I am this for them. A lot of this also turns into if they need me, if I am the one who's responsible, if I am the one who is the provider, and so they depend on me, then they won't leave me. And so again, many people who have this kind of was dynamic with you and your father. Yes. And I tuned in very young and very early to the fact that I needed to not have him feel like he ever did anything wrong in his parenting. And so it was a very tight rope to walk where I couldn't mess up not because it was for me, but because it was for him. 'Cause it would reflect on him. Yes. That is a very intense way to have to go through childhood. It was and I know that I'm not alone. And I never would have looked at that and would have said that was trauma. I had trauma in my childhood. I never thought that that was my history. And so then when I developed chronic illness in 2014, I was very confused because like breast cancer, the conditions that I developed are strongly associated with high adversity in childhood. Your parent went to jail. Your parent was on a substance. There was divorced. And I'm like, none of that is in my family. So I did not understand why I had the body and the diseases of those who did have a lot of trauma in their childhood when I did not see that. I was looking for something big and bad. I wasn't looking at the burden that I carried as a little girl trying to keep her father feeling like he was good enough. Okay. So you're gonna have to back up and start to make the connection for people because for most people, it is just too hard. Even what you're talking about, connecting the chronic disease that you dealt with to a history of trauma. Paint the picture because I think it's very hard for the average person to imagine, to connect the two things, to make it make sense. I feel very lucky because this was part of my medical training. In my medical training, we were taught about the adverse childhood experiences. And there wasn't anything at that time that I remember that there was to do about it other than know that there is this connection and be able to refer your patients to therapy when you see that they've had traumatic experiences. For instance, like what? For instance, you were in foster care. And so as an adult, I'm seeing you now, you have diabetes and I'm saying, you know, you really should go talk to someone about your past and about your childhood because we know that somehow these experiences do affect your health and are associated with many conditions. And so we have the research now. I knew the research. And so when I developed these conditions, knowing the research, it was easy for me to make that connection. For others, I look at them and I think, wait, if as a physician, I didn't think that I had had trauma. If as a physician, I didn't recognize that I was using all of these survival coping mechanisms, what chance do other people have who didn't have the education that I had to make those connections, connect those dots and actually see how much trauma burden their body is carrying? But I will say it, Dr. Gendra, at this point, every chronic health condition, every chronic health condition, has been associated with adverse childhood experiences, including cancer, including breast cancer. I mean, I completely believe that you were introduced to this concept when you were in medical school. If I was introduced to this concept, I don't remember. Right? Like, it might have been one day, one class. Maybe I missed it. I'm not sure. I don't know. But even throughout all my training, and I had a lot, right? Like, I have 11 years of higher education to do what I do. In the years of surgery, in the years of fellowship, even in the years of practice, it wasn't until I got to the functional integrative space that anyone was even talking about this. And now it completely makes sense to me because now I understand the connection between the trauma and your nervous system and your immune system. But most people, providers included, don't think about that. And so, as they put people into cancer treatment programs, you can't chemo away this wound. Now, and in fact, the most helpful thing you can do for yourself is to learn how to regulate your nervous system while you're going through your chemotherapy or radiation or surgical treatments. It is the one thing that will make the most difference because otherwise, our nervous system puts our body in a physiological state where there is no growth, there is no health, there is no safety, and fear will only feed cancer. Now, to be fair, some of this research is newer. And so for those people who have not kept up with the research around the average child experiences, they wouldn't know this, but actually in 2022, a large review, it was a systematic review of nine studies covering almost 3,000 participants. And from that study, it became very clear that those who were exposed to more adversity in their childhood were an increased risk of breast cancer. And it was a dose-dependent relationship. And what does that mean? That means that the more stress, or I'm going to use the word trauma, the more overwhelmed you experienced as a child, it directly increased your risk of breast cancer. And so now you have this reality as an adult, even though this is decades, I mean, think of it Dr. Jen, right? Like decades ago, we were children decades ago. So this has been building underneath the surface. And if it's now just the downstream effect, then what if we could address that inner pain, fear, and overwhelm that created this biology while we're going through treatment and even start to reverse that fear that drives our inner state? What if I could even on the radiation table, or receiving the chemotherapy treatment? What if in that very moment I could learn some body-based skills that created a felt sense of safety? Otherwise, I'm laying on the radiation table, and I'm in fear. I'm receiving the chemotherapy, and I'm in fear. That fear is going to affect the efficacy of treatment. So first, I want to try to understand on a basic level, what is physiologically happening in the body? Why does trauma from decades ago set the stage for breast cancer today? There are five steps that our body takes when it experiences a trauma response. It is what makes it different than a stress response. And these five steps are physiological changes that happen. And so if these five steps do not happen, it was not a trauma response, and it does not have the degree of damage to our biology as something like a stress. And so these five steps happen, and they happen because we have an experience where we feel so shocked that this is our reality, that this is really happening, and that it feels unbearable, overwhelming, and all alone. It is a moment when we feel trapped, powerless in the face of an inescapable life threat. And without knowing how to reset that kind of a response, meaning how do I reset my body, my physiology back to a sense of safety? What happens is that the body now loops between those steps of the trauma response, seeking resolution, and tell it gets it. It often never does because we're not taught how to resolve even an overwhelming traumatic experience. And that loop is what then creates this damage in our biology. If it only happened once, we would be fine. But it doesn't happen once. That loop, looping through those steps starts to happen once a week, once a day, twice a day, and that is accumulating the damage to our DNA, damage to our mitochondria, imbalances in our immune system, imbalances in our hormones, all leading to this imbalanced state that then has no chance against cancer cells. And I would imagine that regardless of what you carried with you to your diagnosis, the diagnosis of breast cancer is a trauma in and of itself, right? There's just compounding, right? Yes, exactly. The diagnosis and often the way in which a person is treated by their medical providers leaves them feeling trapped, powerless, and all alone. So scary. Because what are the trauma numbers? I mean, how many children are affected by trauma, adolescents, or affected by trauma? How much how much is out there that is setting the stage for disease in adulthood? How many people are affected? That was what was shocking about the adverse childhood experiences. And that's why it wasn't, I want to say, welcomed in the medical community because it showed that in a area of San Diego, California, where it was middle class to wealthy people, at least 50 to 60 percent of them reported having had some major form of trauma, often in the form of sexual abuse because it was a clinic for women who were obese. This was so shocking that people who were wealthy could be walking around, having had and holding on to trauma from their childhood. We have seen it as no, no, no, that's just for those who are lower income. That's for the lower socioeconomic. Those are for those who are less fortunate. Let's try to develop programs for them. And this literally threw all of that in the wind and said, no, this is a universal problem of being a human being on this earth. Trauma. And that, I mean, that adverse childhood experiences became a questionnaire that you can take and see what your score is. But if you had asked me to fill out that survey and get my score, it would have been zero. Other people, it may have been one. And so I'm looking at that was helpful at that time to really break through some myths that were holding us back in our understanding of trauma. But we've now even upgraded to a new level our understanding of trauma, which is in that for any reason overwhelmed our ability to respond to feel and to be present at that. So just out of curiosity, if you were making the quiz, right? If you were making the questionnaire, what questions would you ask? I mean, what should people be asking themselves to know if they're vulnerable? This is one of the most important shifts that I've made in my career is I stopped asking people about their past. People think it's being trauma-informed to include a questionnaire in their medical practice. I say, don't ask about their past. I want to know about what's going on in your life today. Because you may have had trauma, but you also may have healed it. You may have actually done the work. to resolve it and it's no longer driving your physical health. It's the unresolved trauma that drives disease. Not the resolved. I want to know the unresolved. And to know the unresolved, I don't have to look at your past. I'm going to look at what do you do today? How do you survive your day today? Where are the signs? I call these five patterns. They're in chapter 9 of my book. Five patterns to recognize that your body is still holding on to trauma today. Do you have evidence in your life that you use things, people, places to escape? Escape is a survival response. It is a trauma survival response. And this can look like I escape into a glass of wine in the evenings. It can look like I escape into movies and binge watch TV series. It can look like I escape into comfort foods and emotional eating. It can also look like I escape into work. And I'm a workaholic. I mean, there's there's so many ways, which is why don't make a list, find the principles, find the pattern and see where do I see this pattern of escaping in my life? The next pattern that I'd like to look at is the pattern of being stuck. Before you move on, I do want to ask you about social media because social media is specifically designed to addict people. So I would think that there are many people who probably spend hours and hours on social media and they're not intentionally doing it to escape, but they get sucked up in the void. I was not planning on covering this on a podcast about breast cancer, but since we're going here, let's go here. Those who do not have trauma do not have as big of a risk for addiction. Interesting. They don't have a void to feel. They don't have inter pain that they're trying to escape. And so they would keep all the probably don't get caught up. Exactly. It doesn't even call to them. They just have this innate sense of balance in their life that anything that starts to imbalance them and they're like, no, no, that doesn't feel good. Let me realign my life with what does feel good, healthy, wholesome. Yeah. Okay. That makes sense. All right. Sorry to interrupt you. No. So this is again, another way to escape another way to see that we may have stored trauma is what do I seem to have an addictive personality? Do I worry about me becoming addicted to something, whether that's caffeine, social media, or exercise? If I worry about myself becoming addicted to something, that's a sign that I still have some stored trauma. The next pattern refers to the survival strategy in the trauma response of immobilizing or freezing. We've all heard that in response to a stress, we can fight, fight or freeze. That freeze is the trauma response. It's actually the first step of the trauma response. And that freeze is a paralysis. If our trauma doesn't get resolved, that paralysis lingers and it becomes stuckness in our life. And so I can look at where do I see myself getting stuck in my life? Do I start a project but not finish it? Do I not even start it and just procrastinate? Do I let perfectionism paralyze me? Can I get to a certain point in my career and then hold myself back in self-sabotage because I get stuck with being seen? And then there's that compassion. Yeah, once you open our eyes to these are the patterns. We start to see them in ourselves and the people that we love and people that we don't love. We just start to see them as, wow, well then everyone really has stored trauma. And my answer is yes, everyone does. Everyone does. It's just then a matter of what do you want to do about it? Do you want to do something about it or are you the kind of person who will be like, and I'm just going to numb and bury that back down? Gonna keep living life as is. Yeah, but most people get to the point where living life as is isn't the choice. You get a breast cancer diagnosis. You get some chronic disease diagnosis and staying as is isn't really a choice. Exactly. Yeah, I remember that when I started my podcast, the biology trauma podcast episode number one, I interviewed a lady who had breast cancer. She was a breast cancer survivor and she shared her story of doing this nervous system work while going through her treatments because she realized just like you're saying, resuming life as normal was no longer an option. I've since had two other people on my podcast who are breast cancer survivors and they said the same thing. I thought I could keep living like this and tell my diagnosis of breast cancer. Well, the thing is it's their normal that got them there. Exactly. Right. Yes. People ask me all the time. Am I going to go back to normal? Right. After treatment. Please don't. Why? Why would you want to? Normal. It's what all you hear. Dr. Jen, this is what makes you different because what they told me was that their regular provider, their cancer surgeon told them life as normal. Uh-huh. You're the one who says, no, don't do life as normal. It's what got you here and that's why they need to listen to you. So how do you break this cycle? How do you stop suffering today in what happened five years ago, 10 years ago, 20 years ago? How do you not let the fear that is associated with the breast cancer diagnosis not pile on to whatever you're carrying in with you and how do you change that trajectory going forward? Hey, Breastie, if you're listening to this and thinking, okay, I'm ready for real help. I want you to know that you don't have to figure this out alone. Everything I offer lives at Jen Simmons MD dot com. And no matter where you are in your journey, there's a place for you to start. If you've been feeling depleted, stuck, inflamed, or like you've lost yourself in the stress of all of this, I get it. And my three day healing experience is where you begin. It's designed to help you reset your body, reconnect with your power, and remember what it feels like to be alive again. If you've recently been diagnosed or you've been through treatment and you're wondering now what, start with my foundations course. This is where I walk you step by step through what matters most so you can calm the chaos, make smarter decisions, and stop feeling like everything is happening to you. This is how you build the foundation for the rest of your life. And if you're high risk and not wanting to wait for a diagnosis to take action, my prevention course is for you because prevention isn't a slogan, it's a strategy. We're adding new content all the time so make sure you get on my mailing list and that way I can share updates with you as soon as they drop. So if you're ready for guidance that's clear, proactive, and built around you, go to Jen Simmons MD dot com and choose your plan and your path to health. All right, Breastie, let's get to this week's episode of Keeping Abressed. And how do you change that trajectory going following? The good news is that it's actually quite simple to start. We don't need to complicate it and we don't need to do everything. The bad news is that this is just the place to start. And so don't expect to just do this what I'm going to share with you and then that's all you have to do. It's the beginning of a lifelong journey, the beginning of what will be a new lifestyle living for you because we're not going to go back to normal. Right. And I think what you're saying is particularly important because as I always say, your health is not a destination. It is a journey. And you're going to be on that journey and you're going to encounter things along the way. Right. Like it's not going to be up up from here. No, that there are that life is filled with hills and valleys and mountains. Right. And each time you get over one, there's one in the horizon. You're going to get there. And that that is the beautiful part of life. Right. And we gain so much out of our challenges when we when we meet and master them. But know that there's always going to be another one. - Yeah, so we get to even look at how would we define healing? How would we be able to say, "Oh, Dr. Amy, you're healing." How does that look different? How do we measure that? And the way that I measure that is I measure it based on your responses. And our nervous system in its brilliant design has a feature that's called neuroplasticity. And what it does is it wires in patterned responses so that when something happens, you always do the same thing. When it's afternoon and you're feeling a little tired and you see that you have a meeting with that person on your calendar, you know what you do. Like, you already know that you go to the cupboard for chocolate or maybe you grab an extra cup of coffee. Well, like, you already know what you do. Why do you know that you do this because it's so patterned that you live your life by these default responses. And so healing is when our default responses start to change. And if I've always done this, this time, I'm going to be able to do something different. That's how we know that the healing is happening. When we start to be able to choose a different response that is more aligned with who we want to be in the world. That sounds easy, it is not easy. And there are five core nervous system skills that are required to be able to make that happen. The first one, the first one is just can we feel our feelings? Now, many of the women who have had breast cancer that I've known personally are ones that I would describe as those who have learned to push through. They have learned to be the strong one. How have they been the strong one? Because they live in their head analyzing everything, over analyzing everything. They are the ones who study, they are the ones who take on those responsibilities. They are the ones who take care of other people. And to be able to change, we need to be able to get out of our head and connect with our body. That's a very hard thing for someone who's lived their entire life up in their head thinking about how they feel rather than actually feeling how they feel. This is where we look at how many women don't give themselves permission to do that or time or space, the safety. And it's also because when we have had those moments when we started to feel, we've realized that there's so much that's buried that we would probably fall apart if we allowed ourselves to feel. And so in effort to remain functional and responsible and the adult one of the control thing, maybe even a control thing. Absolutely. Because that person that you're describing is a person that is totally uncomfortable with being out of control. Exactly. Exactly. And so this is where we reach the first obstacle. Is you take someone like that and you say, "Oh, I want you to start feeling safe," which means relaxing. And they start panicking in the first 15 seconds of relaxing. And they're like, "I just can't do this. I just can't do this." Why? It's because for them, Dr. Jen, feeling safe doesn't feel safe. They only feel safe when they are hyper-regulant, when they are bracing, when they are in control of everything. That's how they feel safe, 'cause that's how they've survived their life. That's what kept them safe when they were maybe a child. And so they've learned that and they've just adapted to that. And now you come along and say, "Let's do whatever modality it is that is introduced to them to feel safe." And they panic. It causes them anxiety. They start fidgeting. They start pacing. They're like, "I can't sit still. I can't do this." It's because we're trying to create too big of a change, too fast. And even if it's a good thing, too much too fast is still too much too fast. And so this is where I realized that if I really wanted to help people who were so unfamiliar with actually feeling their feelings and feeling the hard, uncomfortable feelings and being okay with that. I had to microdose it. So this is my version of microdosing. We are only going to have you feel two seconds of safety before we are going to let you go back into your bracing. Two seconds, safety, back to your bracing, where it feels familiar because familiar feels safe to a nervous system, even if that unfamiliar is unhealthy. And this is how we then baby step it. 'Cause if I do two seconds today, then I can maybe do four seconds tomorrow. And then maybe the next day will be six seconds of safety. And give it a week, two weeks, two months. We're gonna be up at a whole minute, two minutes of actually allowing my body to have that safety, the deep, the deep safety that is the only state in which our body can actually start to heal itself. - Yeah. And you're talking about the difference between being in that sympathetic fight or flight state and the parasympathetic rest and repair. And there is no mechanism to heal when you're in that danger zone, right? Because the danger zone is not a zone of healing. - No, it's not. - 'Cause we only understand two states. We only understand safety and danger. And danger means you have a saber-to-tiger on your tail. - This is not the time for your body to repair. You're about to be eaten by a tiger. Your repair mechanisms are not on. - Yes. And then for those who decide that they wanna read my book, they will find that there are three states 'cause there are actually two different levels of danger. - Ooh. - So they are. - So talk about that more. - There are two levels of danger. There is the danger that is hard, but I think I can escape. So I'm gonna try my best. It's the tiger chasing me. I'm going to run. But what if I can't outrun the tiger? He's bouncing on me. There's nothing else I can do. I've come up against a wall maybe. I can't escape the tiger. That's a different level of danger. So there's the escapeable danger and then there's the inescapable danger. And that's the trauma response. The trauma response is when there's nothing else I can do. I have to give out. So is this the difference between resolved and unresolved trauma? Is that the unresolved you were in inescapable danger? - Exactly. - And had irreversible harm? - Yeah. Yeah, because we're designed to reset after an experience like that. But we haven't been taught how to do that. And our culture is one of rush and hurry. And so we don't even allow ourselves the time that our body and nervous system needs to come back from an experience like that. And really know at a visceral level that the danger is over and I'm okay now. And so we live with that ongoing sense of danger in the background. And that's what keeps us in the loop. And that's what ultimately creates a biology of trauma. Do you think that on some level and there are probably studies to show this? Do you think that for instance, people who were maybe involved in one assault as opposed to people who were involved in repeated assaults or live with their assault or something along those lines? Are there is there data to show that you're more likely to recover from an isolated incident than from repeated trauma? Yes, and so much has to do with what we call the pre-existing state. This is something that they teach in functional medicine as it relates to disease, but this is actually very relevant to trauma. And we can look at the example and the data coming out of the military. Those who have had a harder childhood, they're the ones who get the PTSD. Wow. - I know that. - What is your state going into an event? It's not the event itself. It's who were you before the event? That's what more determines whether you will come through it or whether it will break you. Same with breast cancer, right? It's not about the breast cancer itself. It's about who you were just prior to the diagnosis. Was your life already overwhelming? Were you already at the edge? Well, then you're going to tip over. This is going to be what makes everything else fall apart. It's your pre-existing state that determines your response, not the event. And yet there are so many women that come and say, I'm healthy, but I have breast cancer, right? And. Part of that is that people don't even know what healthy means anymore. They don't. There's a total disconnect between, I mean, I saw someone today who gained and lost in her adult life 70 pounds so far. She's 39. And doesn't understand how that might have contributed to her breast cancer diagnosis. And there is so much disconnection between our what we perceive as healthy and what is actually healthy. And this is exactly where I would have put myself is in that category. I had no idea that my body was holding on to trauma to the degree that it made me sick had no idea. It came out of the blue for me. How did you have that revelation? Because this again, I know you heard about ACEs in medical school, but that's a big leap. Because even if you go through that ACE score, I'm guessing I don't know, but I don't think that you were the child of an alcoholic and it doesn't sound like your father hit you or, you know, the typical things that we associate with child abuse doesn't sound like you would have checked any of those boxes. Not at all. This is where I had the advantage of my home becoming a study lab when I foster parented and then decided to adopt. It was in my home. It wasn't something that I could just read about and be interested in. I had a child at home who had such significant trauma that his behaviors were often very unsafe. And so as a parent, now that I'm a mom, I have committed to finding help for him. And so in that process, I learned so much more than the adverse childhood experiences. I dove deep into attachment because he was four and then five when I adopted him. So I knew that that was his core wound, his attachment. He'd been in the foster care system since age nine months. So that was easy for me to know. That's his type of trauma, attachment trauma. But I started to see aspects of myself that showed me, Amy, you've got attachment issues as well. You also guard your heart. You also are afraid that if people saw the real you, they wouldn't like you. You also escape connection. So I started to have this window reflecting back to me, my own issues so that then in 2014, what precipitated it was the adoption failing and the grief of that six years. The grief, the grief was so deep and it was one month later that I developed a chronic fatigue syndrome and couldn't get out of bed when I woke up one day. So for me, what do you mean the adoption failing? You didn't adopt that child? I did. I had him for six years. And then the adoption failed. And I had to transition him to another family. Oh, there was, I mean, there's just layers, layers, deep of loss, identity loss, purpose and life lost, guilt, regret. It was the most hard and intense thing I've ever been through. I think it'll probably be the most hard thing I will ever have to go through. And that is what then precipitated my body, my health falling apart. So in my mind, it was very obvious to me. This grief was so big, it was a trauma response. And this is what that trauma response did to my body in a matter of one month. I need to now do my own trauma work. I'd never, never done my own trauma work. I was busy. I mean, I'm a single mom. I'm in surgery residency. This actually happened to happen while I was on transplant surgery rotation, no less. So talk about already burning the candle at both ends between call nights and long surgeries. And it was just, it was just, it was just way too much. And so my body fell apart. And that was when I realized that if I wanted to get my health back, it wasn't going back to life as normal. I now had to do my own trauma work. How? I'm speechless. I just, so how did you recover from that? I mean, how do you, how do you, even if you have the recognition, where do you go from there? Well, I didn't know where to go. So I did what I think most people do and found the therapist that my insurance covered and started there and realized that's not helping. That just seems to be stirring things up and making it worse. And so that's when I started on my own journey of trying to find the map to get all of that back, get my health back, get my life back, get my career back. I I I lost all of that with this burnout breakdown. And what I found not only in terms of the whole puzzle, but the order in which the pieces need to come together. That was one of the critical aspects that I had to learn and that I now teach others because it's otherwise very confusing and people want to start with EMDR. They want to start with psychedelics or they want to start with this. And I'm like, that's not going to go well. You're trying to do, you know, the third step or the fourth step. You're starting to go to, yeah, step three. When we haven't even done step one yet. And so that's why I come back to this is the place to start is learning how to your five core nervous system skills. Feel your feelings shift your state, frack your state. So you know what state you're in in any given moment. Are you in stress right now? Or are you in the trauma response right now? I need you to pace the interventions, pace the change. And then I need you to learn how to create the space to change your responses. So just that is enough to keep you busy for many months. But this is what I teach people because again, like I feel like these are life skills that we should be really teaching in kindergarten. How to how to feel your feelings and not fall apart. How do you track your nervous system? How to know what your body needs in any given moment based on your nervous system? And so these are just what we have to learn now as an adult because we didn't get it earlier. I know how hard it is to write a book. You know how hard it is to feel all of that again and then put it out there for the world to see. And also when you do it with integrity, you're doing it because you generally genuinely want to help people. So tell me about when did you start to write this book in your head? And tell me about the journey of putting that out to the world the biology of trauma. It was harder to write than I expected. I have lived this for so long and I've taught this for so long now. I've even got it organized into my sixth biology of trauma modules and I have written chapter curriculums for each week of each of those modules. So I thought that I could just take what I've already done and written and just put it together into a book. I could not have been more wrong. As I put this together, I found that I would read it from that learner's perspective and be like, it wouldn't make sense to me. It wouldn't make sense to me. I've got to start with this. And so I wrote the entire book. So there's 18 chapters. I wrote the entire book seven times. Start to finish. You know like the whole you write it and then you throw it in the trash and start from scratch. That's what I did set times to get it to where it is right now, which is very accessible, story based so that you can read it and not have to feel like, okay, I'm going to go read about trauma. Let me make sure that I'm really ready for this. It's you're being invited into stories of my patients and their everyday stories. You're not going to get the worst case scenarios. You're not going to walk away feeling like I'm justified. I can now say that I've had trauma because it was this bad or this this this is just life. Like let's pull back the curtain on the human body and what it does to survive life and do its best every day for us. And how we can help support it so it can support us better. So it was a much harder process than I thought to start from a beginner's perspective of someone who doesn't know me. They're picking up this book and where would I start them. So I start them with a story of my patient Elena. She's in a car accident. She's going to develop auto immunity one year from that car accident and I walk them through the body's trauma response with the example of that car accident. And then we follow her through the book and I bring in Dana and I bring in Laura and I bring in Claire and I bring in all of these patients with different stories and different aspects that people can see themselves and it be accessible and practical. Yeah, that's amazing. You briefly mentioned psychedelics. You briefly mentioned microdosing. I want to talk about psilocybin and the work that's been done in this space with psilocybin and what psilocybin does and what you think of the role of psilocybin and other guided experiences in helping to facilitate healing trauma. What I know is that I want people to become the experts in their own nervous system and not be dependent on anything to be able to create the change that they want in their life. And it seems like for some people at some point on their healing journey, something like psilocybin can be helpful in creating a shift that's been hard to create other ways. I also know that it's not required and necessary. So if you can't access it or don't want to, that's fine. You can still create the change in our nervous system. And there are many, many things that we can do to leverage that change because we're really wanting to work at the neuroception and neuroplasticity level, which is the long game. It's a long game. Neuroplasticity is a long game. It's not the short game. And so as I look at again, how are we going to define healing? If healing is defined as changing my default responses to a trigger, then that can't just be a weekend retreat. It can't just be one journey because those are short term interventions and neuroplasticity plays the long game. And when it sees us consistently doing something, then that's when it says, oh, I guess that's what we're doing now. Let me create those neural pathways, but pathways are built through experiences over time. And so the consistency is the most important thing for someone. The consistency and how I show up for myself, consistency and how I create safety for myself, consistency and how I create space for myself. That's what will change our life more than anything else. But point taken in that it takes time. Time takes time. It does. Yeah. And what we all have to remember is that if you do this and you want to survive, then you have to pave that road forward. Right? And this is something that I talk about all the time where everyone tells me, oh, well, I want this testing and that testing and I want supplements and I want a protocol. And I say that that is all well and good, but you're not supplementing your way out of this. Like you need the foundations. Everyone needs the foundation. We all need to be eating well and drinking well and moving well and thinking well and sleeping well and socializing well and detoxing well. We all need those foundations and part of those foundations are do you have the tools to manage what you encounter in life, right? And we all have to lay this foundational work before we can do anything to enhance. So yes, the psilocybin might be a facilitator, but if it has nothing to stand on, it's not going to work. Yeah, it needs, it needs something to integrate. And that's where everything else comes in that we're doing in our life. Yeah, absolutely. Dr. Amy, where can people find you? They can find me at biologyoftrauma.com. There's even a page there that's just dedicated to the book and resources that they can download from my book, including a nervous system journal so that they can start tracking their own nervous system states to see am I in stress most of the day or am I in overwhelm most of the day and start to become that expert in their own nervous system. And the truth is that so many of us do live in stress and overwhelm. This is our normal. Yeah. Yeah. Well, it's, well, we've normalized it, but it's normal. That's a great way to say it. We have normalized it. Society has normalized it. Yeah. It's a huge problem and one of the major reasons why I'm as busy as I am and yours busy as you are. Right? Because we have, we have normalized this state and we have tied our self worth to how busy we are. And oftentimes I do think that it largely comes down to we don't allow ourselves to feel because if we did, we would just feel uncomfortable. Exactly. And who would want that? Right. Yeah. Many people tell me I don't want to be in my body. My body has pain. Why would I want to be in my body? I prefer to be in my head. Yeah. That's absolutely true. Well, thank you for taking something that is very, very difficult and painful and sharing it with the world. Thank you for painting the picture because I think that some of this is too intangible for people to be able to understand how trauma that happened 40 years ago could possibly be the reason for their breast cancer diagnosis now or, you know, name this, the thing, whatever the thing is, infertility, right? Why is your body going to bring a child into this world when your body doesn't feel safe? Right? Why would you bring a helpless being into this world if the world isn't safe? And if you just think about it from that standpoint, why would your body fight off chronic disease if the world isn't safe? Like the world isn't safe. You're going to die, right? So I'm not going to, I'm not going to fight off this chronic disease because we have bigger fish to fry. Yeah. So thank you so much for the work that you do for your beautiful book. Congratulations on that book, by the way, because I know that it was met with a lot of acclaim and it's very, very, very well-deserved, the biology of trauma. And I just, I love the contribution that you made and I know that it came at a great price and a great expense, but that I know that you're better for it in the end and you've made all of us better for it as a result. So I thank you. Hmm. Well, I am very grateful. I am very grateful for the life that I have. I think all of you for being here today for sharing this time with us and make sure that you share this with someone who needs to hear it. And if the statistics are correct, the person that needs to hear it is probably sitting right next to you because we are all in some way affected and our nervous systems are going to dictate our health going forward and we can help each other by sharing information like this and enriching each other's lives. So thank you so much for enriching mine. Thank you for being here today and know that I will be back next week, same time, same place. It's Dr. Jen. Bye for now. [music] All right, Breastie. That's it for today's episode of Keeping Your Breast. If this conversation gave you clarity, share it with a woman you love because the truth spreads faster when we spread it together. And if you haven't yet, make sure you're subscribed so you never miss an episode. I would love to hear from you. Leave a review, take a screenshot, tag me on Instagram at Dr. Jen Simmons and let me know what landed for you most. If you want more help, more support and more tools between episodes, head to JenSimmonsMD.com and make sure you get your copy of the Smart Woman's Guide to Breast Cancer. It's the roadmap I wish every woman had from day one because, as I always say, Breast Health is Health. I'll see you here next time on Keeping Your Breast with Dr. Jen.