← Huberman Lab

How to Heal From Post-Traumatic Stress Disorder (PTSD) | Dr. Victor Carrión

Episode 195 Sep 23, 2024 2h 26m 17 insights
In this episode, my guest is Dr. Victor Carrión, M.D., the Vice-Chair of Psychiatry and Behavioral Sciences at Stanford School of Medicine and a world expert on the understanding and treatment of post-traumatic stress disorder (PTSD) in children, adolescents, and adults. We explain why, as children, we are particularly vulnerable to PTSD and how stress and trauma affect the developing brain. We also discuss how PTSD is related to attention-deficient hyperactivity disorder (ADHD) and vice versa. Dr. Carrión shares effective therapeutic interventions for PTSD, including cue-centered therapy (CCT) and how to create a custom “toolbox” to help you identify triggers and manage stress. We discuss an emerging curriculum that combines yoga and mindfulness to help people with PTSD improve their stress resilience, mood, and sleep. The episode will provide listeners of all ages with a clear understanding of PTSD and effective strategies to heal from it. Access the full show notes for this episode at hubermanlab.com.
Actionable Insights

1. Prioritize Quality Sleep

Control the temperature of your sleeping environment (e.g., using a smart mattress cover) to allow your body temperature to drop 1-3 degrees to fall and stay deeply asleep, and increase 1-3 degrees to wake refreshed. This practice is foundational for mental health, physical health, and performance, optimizing deep and REM sleep.

2. Engage in Regular Therapy

Incorporate regular, quality therapy into your routine, considering it as important as physical exercise. This provides a trusted rapport, emotional support or directed guidance, and useful insights to improve emotional, relationship, and professional aspects of life.

3. Maintain Meditation Practice

Cultivate a consistent meditation practice, even if only for 2-3 minutes daily, utilizing varied guided programs or mindfulness trainings to improve focus, manage stress and anxiety, and enhance mood. The variety and flexibility of durations can help overcome challenges in maintaining consistency.

4. Avoidance Fuels PTSD

Do not avoid or pretend that traumatic experiences will simply disappear, as avoidance is a primary factor that exacerbates PTSD symptoms. This can lead to further complications such as substance abuse or self-injurious behaviors, making treatment harder.

5. Seek Support for Trauma

Do not ruminate on traumatic experiences in isolation, as attempting to make sense of trauma alone may lead to focusing on the wrong aspects of the insult. Seeking support is crucial because PTSD often stems from an accumulation of stressors, not just a single event.

6. Practice Positive Thoughts

Regularly practice positive thoughts, even when not actively stressed, to build them into automatic responses. Unlike negative thoughts which are often automatic, positive thoughts require practice to become proficient and serve as helpful tools for self-regulation.

7. Develop Custom Coping Toolbox

Create a personalized ’toolbox’ of coping mechanisms by identifying what naturally helps you (e.g., listening to music, playing sports, drinking orange juice) and incorporating learned techniques like deep breathing, muscle relaxation, mindfulness, or simple yoga poses. This empowers individuals with a sense of control and agency over their responses, as self-developed tools are often most effective.

8. Use Toolbox for High Stress

When experiencing very high levels of stress (e.g., 8-10 on a 1-10 emotional thermometer scale), immediately deploy a tool from your personalized ’toolbox’ to calm down. This helps reduce emotional charge before attempting more cognitively demanding interventions.

9. Analyze Stress with Four Corners

Use the ‘four-corner system’ (thinking, emotional feelings, physical feelings, and actions) to break down and understand your stress responses. By focusing on and altering one corner, you can cascade changes across the others, leading to new, more adaptive responses and creating space for choice.

10. Engage Four Corners at Moderate Stress

Apply the ‘four-corner system’ for analyzing stress responses when stress levels are moderate (e.g., 3-5 on a 1-10 scale), rather than when highly emotionally charged. This approach requires a level of cognitive engagement that is difficult to achieve during peak emotional distress.

11. Cold Exposure for Stress Control

Engage in deliberate cold exposure (e.g., cold showers) to practice controlling your stress response. The non-negotiable adrenaline rush offers an opportunity to exert frontal control over limbic pathways and observe your psychological return to baseline, serving as a general exercise for the nervous system.

12. Set Social Media Boundaries

Establish clear boundaries for social media use within the family, such as designated ‘phone-free’ times (e.g., during dinner), to prevent passive overuse and encourage engagement with the real world. This treats social media as a tool that needs rules, similar to other household tools.

13. Model Desired Behavior

When establishing rules, especially for children (e.g., for social media use), consistently model the desired behavior yourself. Children observe parents closely, and modeling is crucial for the effectiveness and adherence to these boundaries.

14. Prioritize Mental Health Funding

Advocate for and prioritize mental health and education in national and local budgets, ensuring dedicated funding and resources are allocated for early intervention and support programs. This is crucial for addressing widespread issues like PTSD and improving overall societal well-being.

15. Support Teachers in Mental Health

Provide teachers with increased time, space, and resources to effectively implement mental health programs in schools. Teachers are often overworked and under-resourced, yet are key to delivering interventions like yoga and mindfulness curricula.

16. Implement School Yoga/Mindfulness

Introduce school-wide yoga and mindfulness curricula, ideally by training teachers to deliver 15-50 minute sessions 2-3 times per week. This intervention has been shown to significantly increase sleep duration (by 73 minutes on average) and depth, and decrease amygdala activity in children, serving as a powerful preventive measure.

17. Practice Active Listening

Actively listen to the experiences of others, both children and adults, to create a supportive space where they feel heard and not isolated. This approach helps individuals identify their own strengths and capabilities for self-improvement, fostering a sense of support and agency.