adult. And then that’s eventually what became my career. And that’s what I do now.

 

Manon Bolliger  04:59

Well, it’s fascinating, right? Because it’s almost like in reverse. And yet it themed interestingly, right, like, it’s funny how, you know, it’s like, he was perfect for your healing, as well like life all this is kind of perfect, including the traumas. Once we get there.

 

Dr. Aimee Apigian  05:21

Yes, it’s almost like my calling found me, it came searching for me and it created my life experiences that I would need to eventually land in and step into my calling.

 

Manon Bolliger  05:34

Yeah. So maybe I’m trying to think what…why don’t we talk a little bit about the difference between trauma and like the stress response, we can start with that. And then you can expand a little bit what the differences are.

 

Dr. Aimie Apigian  05:58

This is a really important difference. And even in functional medicine, or integrative medicine, we haven’t really understood the difference in the physiology. And yet that difference is critical. And when we realize that there is a very specific process, a step-by-step sequence that happens with our physiology, with our nervous system for the body to go into a trauma response, it really helps clarify things, especially as a practitioner. Because otherwise, we find ourselves talking about this word trauma without really defining it. And we’re left with a definition of will some big bad event that happened to me in my past, or if we’re talking to a patient, it’s whatever big bad event they had that happened in the past. But what does that even mean? Like, how big, how bad? Or if you want to talk about little T trauma? Okay, well, How bad did the little T trauma need to be? So, it still just creates a lot of confusion about well, what is a qualifying event that makes me or my patient have experienced trauma. And when we look at just the physiology, rather than the event itself, it clarifies everything. So, we’d love to just walk through that physiological process that happens. So, this would be the body’s trauma response. And the body has a stress response. And I think that everyone is very familiar when that adrenaline hits you like that is the initiation of your stress response. And to go into the stress response, we first have a startle. And for many people, they’re not even aware of that startle because it just so quickly moves on into the full stress response. But there actually always is that first step of a startle. I get startled by something in my sensory world, a sound, something I see, something nice smell, whatever it is, there’s always a startle step first. So that’s the first step. And then we have a few seconds for our nervous system to collect more information about it before it decides no like this actually is a real threat. And we need to turn on the full stress response. And when it turns on that full stress response, it moves all of the signaling over to our sympathetic chain that runs down our back. This is actually before anything else has happened. We talked about the HPA axis turning on, but the HPA Axis hasn’t even turned on yet. That comes later. The first step in the stress response is this sympathetic chain and it communicating to the adrenal glands. Hey, we need adrenaline, start making adrenaline. So, adrenaline hits our system about 30 seconds after a stress response has been alerted. Now that adrenaline is going to stay in our body for about 15 minutes. It’s a wave, a surge of adrenaline, and then we have cortisol, turn on. So that’s when our HPA axis is turning on. Now, how do we get from this then to the trauma response? The trauma response is communicated through a different branch of our nervous system. It’s not going to be communicated to the sympathetic chain. That is only the stress response. It only knows how to turn on the stress response and to initiate adrenaline. The trauma response then, is initiated by two triggers when that stress response has been activated. If whatever is going on, feels like it’s too much too fast. Or we are in a situation where it feels just like, it’s been too little of something that we need for just too long. Those are the two triggers, that our body will say, Hmm, we actually, we’re not big enough for this, we’re not strong enough for this, we’re not smart enough for this, we’re not fill in the blank enough for this. And our better strategy, better strategy for surviving this moment in time is actually to shut down. If we were driving a car, that stress response would be if our foot is on that gas pedal, and it is all the way down. And so, the car is speeding up, it’s the engine is revving up. This is where if we’re not careful, we can burn out our engine, we can burn out our transmission, we can get into serious trouble. And that’s why the stress response is only meant to be temporary, we’re not meant to drive our life in that accelerator mode all the time. But when the trauma response happens in the body, it would be the equivalent of us throwing on the emergency brake, it’s a completely different system. I’m not taking my foot off the gas pedal to put on the brake pedal, that would be what we call the parasympathetic system. This is a completely different system of the body, that even if our foot is still on the gas pedal, it doesn’t matter because the emergency brake is more powerful than the gas pedal, our trauma response is more powerful than our stress response. And so, for any reason, that at that time, our body gets overwhelmed. And has that thought or I want to say comes to that conclusion that I don’t think I’m enough for this, it goes into the trauma response. And this is where the communication immediately stops going down the sympathetic chain and instead it comes down the vagus nerve. Now this is not the vagus nerve, the ventral parasympathetic that you think of which is your social engagement, your rest and digest. No, this is not that communication down the vagus nerve, this is actually communicated through a different nucleus in the medulla where the vagus nerve originates. So, in your brainstem, the lowest region of the brainstem is that medulla. And this is where it controls your autonomic functions of your body. So, your heart rate, your breathing, all of your digestive system, like it controls all of these automatic functions. And of course, that’s where your vagus nerve originates from. Without that medulla, without that vagus nerve, we would not be able to survive life. But the vagus nerve does not just have one nucleus as its origin, it actually has several, and the dorsal nucleus, so just meaning the one that’s behind all the others, that is the one where the trauma response gets communicated. And this is when everything will shut down. And you’ll be standing there perhaps, and someone will say something to you, criticize you. I remember being a general surgery resident, and I would be standing there in the operating room. And maybe I had forgotten to do something, or maybe whatever, and this person who’s big and important, and I really had wanted to do everything perfect and please them, and they start chewing me out. And I immediately just go into that shutdown space. And I just inside I become super small, of course, on the outside, I’m standing there, you probably wouldn’t know that I’m shutting down inside. But that’s exactly what happens when our body goes into the trauma response is it just constricts and it just shuts down, it collapses, we can start to feel like our brain just kind of goes offline, our body kind of goes offline, everything gets off. And that is the physiology of the trauma response so that when we’re in a stress response, our foot is on the gas pedal. This is actually when we have high energy, high high high energy this is where we can actually do like superhuman strength stuff. The mom who lifts the car off of her child whose pinned underneath the firefighter who runs towards the building on fire and saves people and has never been able to do anything close to that when he works out for his daily exercise routine. This is when we have more focus, we have more energy we have more aliveness than any other time. And people who are stressed or I should say think that they are stressed but don’t have energy. That’s actually their body being in the trauma response.

 

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Dr. Aimie Apigian  16:16

This is most people, most people are overwhelmed. And they’re doing things to try to deal with the overwhelm. Maybe they’re scrolling on social media, maybe they’re mindlessly watching TV, maybe they are doing some eating or grabbing that second glass of wine or whatever it is that they’re doing. But they’re not…they’re not in high energy, they’re in low energy, they feel overwhelmed by it. That is actually their body being in a trauma response, not in a stress response.

 

Manon Bolliger  16:49

So, I mean, you’ve explained this so beautifully. It’s really, I can see it very, very clearly, it’s rare to have such clear explanations of this. What I’m thinking though the parasympathetic response that, you know, people try to elicit by taking deep breaths and becoming present and all that, from the way you’re explaining it, that typically, I mean, it might impact but it’s not really the impact to the dorsal vagus nerve that can’t really touch it, because it’s more to do with the sympathetic stress response.

 

Dr. Aimie Apigian  17:33

Exactly.

 

Manon Bolliger  17:34

Yeah, so when you’re dealing with the trauma response, and this overwhelm freeze reaction, what have you found to be the most helpful way? You know, because that does happen, right, I mean, a lot. Although people are in that state, you know, there’s so what is the way in to to help people that you have found to be effective or that you’ve possibly created?

 

Dr. Aimie Apigian  18:07

This is really important. Whether again, you’re working on your own system and noticing, oh, like, my body’s going into trauma response, or whether you’re working with a patient, and you can see that they’re just overwhelmed, and they’re, you know, in front of you, and there’s no chance that they’re even hearing what you’re telling them, let alone going to be able to follow up with the instructions that you’re giving them. What I would love to be able to say is that you can just talk to them and help them snap out of it. And that’s just not true. So, what we have to do, there are three things that the trauma response needs, once the body goes into that place, there’s three things that it needs, it needs a felt sense of safety. This is common in a lot out of the work of Dr. Steve Porges, the polyvagal theory, where it’s been very clear that the body goes into that place when it feels like the stress, the danger, the threat is inescapable. And if it’s inescapable, I don’t want to be here. I don’t want to feel this. And so, I’m just going to disconnect, I’m just going to do things mindlessly, I’m going to try not to feel my body and feel the discomfort of being in something that feels completely inescapable. And bringing in that felt sense of safety of actually, right now, like, the danger is gone, the threat is gone. You’re safe. But what happens is that most people don’t even know what it feels like to be safe. They’re trying to tell themselves that they feel safe. They’re trying to tell themselves that they should feel safe. Maybe they even go to yoga or meditation or say mantras or affirmations that all tell them that they are safe, but it’s not an experience of the body. Like, it’s not actually the body feeling safe, it’s the brain still trying to convince the body. And that’s not the way it works. The body has felt experiences. And the body is what needs to inform the brain that, hey, we’re safe down here, we’re good, you can focus on other things. But as long as the body feels insecure, unsafe, it’s going to stay in this in this place. The other thing that the trauma response needs is energy. So, one of the reasons why the body even goes into a trauma response is because it doesn’t have enough resources. If it had more energy, it would have been able to fight longer. If it had more energy, it would have been able to stay in that stress. And yeah, let’s go let’s solve this problem. Let’s take action. But it went into that trauma response, because it’s like, yeah, I don’t have enough energy for that, that mountain is too big for me. That problem? Oh, no, that’s, that’s too big for me. And so, trauma is an energy problem. And it causes energy problems, it causes damage to our mitochondria starts to build up oxidative stress, not only outside of ourselves, but inside of ourselves. And just by the fact that the body is in the trauma response, it also shuts down our detoxification system. So, we’re not even cleaning up that oxidative stress. So, there’s so many things that just start to accumulate that drain our body’s energy. And so, we need to come in and we need to provide it energy. The other thing that the trauma response needs is time. And we see this even from the animal kingdom. And so, if you’re, if you’re studying how animals go into their freeze response, right, maybe you’re watching an antelope being chased by a cheetah, whatever. And in this circumstance, you know, the antelope is gonna get away, but he freezes when that cheetah goes to pounce on him. And then the cheetah, you know, goes and chases someone else thinking that this one is dead. It takes time like that antelope just doesn’t jump up immediately. Like it goes into this dormant hibernation. And all animals that do this, they just lay there. Like, it’s just it’s a time thing, their body has to have time, and then it resets, and then it wakes up. And then it’s like, oh, okay, time to go. And that’s exactly what our body does as well, when it goes into this trauma response. It’s almost like it gets stunned. It’s a shock. And it’s like, it’s got to process that shock before it comes out of that, and kind of lifts its head up is like, Oh, it’s over. Hopefully it has, hopefully it gets the message that it’s over. Which is why we have to provide it that felt sense of safety so that when the body is waking up out of that trauma response, it does get the sense that all is well all is safe. And I really can come out of this place of shutdown and collapse.

 

Manon Bolliger  23:03

So, when you see animals, we have lots of animals around here who are nearly killed, but they stop, and they freeze. I mean often yeah, they don’t move, and you think, okay, no move, because, you know, there’s gonna be another car if you’re not careful. But often it ends with this kind of like shaking of their whole body, right, which is, again, a very physical release response. And I think humans do it. Instinctively. We’ve been cultured into like, Oh, that’s too weird, you know. But what’s your take on that?

 

Dr. Aimie Apigian  23:45

So, what’s happening is that they’re discharging adrenaline. And that’s what needs to be done in order for there not to be the long-term consequences to their physiology. What they’re doing is they’re completing a response. And in the animal kingdom, they complete a stress response. And if they go into a trauma response, they complete that trauma response. As humans, we don’t tend to do either. We don’t tend to complete our stress responses, which takes us into the trauma response. And then we don’t really complete a trauma response. And so, we’re now kind of chronically living in this place of going in and out of that trauma and stress response and back and forth between the two. But that adrenaline needs to be discharged in order for us to complete a response and have that reset of coming back to baseline coming back to health. Otherwise, that adrenaline creates a charge, and it causes a lot of damage to our tissues. This is where over time, you start to accumulate more muscle damage, more tissue damage, extracellular matrix damage, and you can start to have symptoms of chronic pain, fibromyalgia, chronic fatigue. It is because of these changes to our biology that are caused from that adrenaline, and then from going into the trauma response. And so, becoming immobile, and not discharging this adrenaline that was there to tell us to move to take action, but instead, we shut down. So, it’s so important to know that there is this aspect of adrenaline that needs to be discharged. There’s lots of different ways that we can help discharge adrenaline, we can even do different things with our diet, if we know that we are a person who tends to be experiencing a lot of stress. And so, a lot of adrenaline, we can actually eat certain foods that help metabolize adrenaline. But at the end of the day, we also need to be moving and be in movement in proportion to the amount of adrenaline that we are creating every day.

 

Manon Bolliger  25:52

Interesting. So how do you think we became so disconnected? Because I’ve certainly seen human beings do this, you know, have this urge, right? And, you know, and yeah, if you’re gonna judge it, you’re gonna say, what are they doing? But you know, I’m more grateful that wow, there are still humans doing this. But why do you think we became, as a general culture general statement, so disconnected?

 

Dr. Aimie Apigian  26:25

From my perspective, what I’ve seen is there, there is the larger threat of what would people think of me?

 

Manon Bolliger  26:34

Interesting.

 

Dr. Aimie Apigian  26:36

And we are, by nature, social creatures, we know that we need other people to survive, even though we can have this attachment tension for sure. And so, it’s always in the back of our mind of, well, what do I need to do to not get kicked out of the group? What do I need to do in order to be normal enough? And I was thinking about this just the other day, I went hiking with my dog, Amada, and she’s an all-black, medium size Belgian Shepherd. We were way up into the hills. And so, I took her off leash, and we’re walking, and a coyote crosses the path oh, about 30 feet in front of us. And you know, Coyotes, their so egotistical, he just kind of slowly, you know, like struts across the path like, this is my this is my territory, and I know exactly what I’m doing. Now, of course, if you know anything about coyotes, that’s exactly what they do. They lure a dog away, and then they lure them right into the middle of their pack. And then that’s how they get them. And so of course, my dog being a shepherd, she takes off after this Coyote, talk about stress for me, right? Like I am now in this stress mode, and I’m calling her name and I’m running towards where she bolted into the shrub edge, and I can hear some growling and I can and I’m just like, oh my goodness, right. stress, stress, stress. Now, thankfully, she pops out and she emerges, and she’s all happy. All is good. Mom look at me. I chased this duck This coyote away. I’m keeping you safe. Aren’t I the best dog ever? I of course, I’m like, Oh, right. Like, I need to now complete the stress response. But here’s what happens if we’re with other people. Or if we don’t know this, we would just be like, Oh, well, let me just keep walking, right? Stress is over. Let me just keep walking. Let me pretend that everything is fine now. No. Adrenaline had surged through my whole bloodstream. Even though I had used my legs to run. I hadn’t used my arms much. And so here I am up in the middle of the hills, and I’m like, Okay, what does my body need? What does my body need? And I’m like, I can still feel all this energy. And so, I started moving my arms. And it was almost like I moved my arms as if I were fighting the coyote off myself, right? I’m like, No, you’re gonna get away you’re gonna get away from my dog. And I did that until I felt complete, which was for about 15 seconds. Now if anybody had been watching me, they would be like, oh my goodness, like what a lunatic out there all by yourself, like flailing her arms. But it was a very intentional movement. And that’s what’s important also, to discharge adrenaline, and complete a stress response. But it allowed me to then again, kind of stop and since like, my body, and I got this deep, spontaneous breath, my shoulders came down, I could feel that the stress just kind of left me and that’s what we need to do in order to discharge a stress response. But what most people do is that they kind of look around being like who’s watching me? And let me pretend that Oh, haha, yeah, no, that didn’t bother me at all. That’s totally right. Like this adrenaline and you he’d be discharged. And I would love for it to just become common practice.

 

Manon Bolliger  30:03

Yeah, yeah. Well, we give more attention to what our thoughts and our mind says than what our body and our body that actually governs all this. Yes. Yeah. So, we’re actually out of time. That’s, that’s it that was been just a wealth of information. And yeah, so much. So how do people I saw that you have a 21-day journey for people available on your on your website, we’re gonna put the links, is there any closing statement you’d like to make?

 

Dr. Aimie Apigian  30:36

That would be my encouragement to people is for them to just become curious and actually become the expert in their own body. That is my process with the 21-day journey is actually helping people understand their trauma response and start to learn how to work with it in a healthy way. So that is the 21-day journey, a very specific process to start working with a body that’s in a chronic trauma response. But my words of hope would be that there’s so much that we can do we just haven’t known and especially when we can understand the difference between stress and trauma. We can recognize just how much we have lived our lives in trauma and know that there are tools that we can change that and relatively very quickly.

ENDING: 41:33

Thank you for joining us at the Healers Café with Manon Bolliger. Continue your healing journey by visiting TheHealersCafe.com and her website and discover how to listen to your body and reboot optimal health or DrManonBolliger.com/tips.