In this insightful episode, Dr. Aimie Apigian, MD, MS, MPH joins host Jill to delve into the intricate relationship between trauma, the body, and healing. They explore the concept of creating a safe environment for healing, the importance of understanding trauma at a biological level, and practical approaches to managing trauma.

Key Discussions
① Introduction to Trauma and Healing:
👉 Dr. Aimie Apigian discusses her journey from conventional medicine to focusing on trauma. She highlights the importance of addressing trauma as a root cause in functional medicine.

② Creating a Safe Environment:
👉 The conversation emphasizes the necessity of creating a safe space for patients to heal. Dr. Aimie Apigian compares the body to a turtle retreating into its shell when overwhelmed and stresses the importance of safety for healing.

③ The Role of Empathy in Medicine:
👉 Both Jill and Dr. Aimie Apigian reflect on their experiences in medical training, discussing how empathy plays a crucial role in patient care despite the traditional emphasis on objectivity.

④ Understanding Trauma at a Biological Level:
👉 Dr. Aimie Apigian explains how trauma impacts the body at a cellular level and the need for therapies that address these biological changes. She introduces her book, “The Biology of Trauma,” which explores these concepts in depth.

⑤ Practical Tools for Trauma Management:
👉 The episode provides listeners with practical tools for managing trauma, such as using weighted blankets and creating a sense of safety through simple physical actions..

⑥ Addiction and Trauma:
👉 Dr. Aimie Apigian discusses her work in addiction medicine, highlighting the connection between trauma and the need to escape through addiction. She shares insights from her mentor, Gabor Mate, on addressing the underlying pain rather than the addiction itself.

⑦ Co-regulation in Relationships:
👉 The episode touches on the importance of co-regulation in relationships, especially for those dealing with trauma. Practical advice is given on how partners can support each other in creating a safe and healing environment.

Takeaways
📌 Safety is paramount for healing from trauma.
📌 Trauma impacts the body at a deep biological level, requiring comprehensive therapeutic approaches.
📌 Empathy and understanding are crucial in medical practice and patient care.
📌 Practical tools and strategies can empower individuals to manage their trauma effectively.
📌 Addressing the root cause of pain is essential in overcoming addiction.

Websites
21 Day Journey Training
Free guide to identify and heal trauma

​👩🏻‍⚕️ Dr. Aimie Apigian, MD, MS, MPH

Dr. Aimie Apigian, MD, MS, MPH is a double board-certified physician in Preventive and Addiction Medicine with dual Master’s degrees in Biochemistry and Public Health. She is recognized as a leading medical expert on how trauma becomes stored in the body and how it can lead to chronic health issues.

Combining her medical background with personal experience and cutting-edge research, Dr. Aimie developed The Biology of Trauma®—a unique approach that helps people understand and heal the nervous system to address the root causes of fatigue, anxiety, and chronic illness. Through her programs at Trauma Healing Accelerated, she supports individuals and health professionals in learning the science of trauma and how to effectively reverse its effects.

Dr. Apigian’s new book Biology of Trauma

Dr. Jill Carnahan, MD

Dr. Jill Carnahan is Your Functional Medicine Expert® dually board certified in Family Medicine for ten years and in Integrative Holistic Medicine since 2015. She is the Medical Director of Flatiron Functional Medicine, a widely sought-after practice with a broad range of clinical services including functional medical protocols, nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy.

As a survivor of breast cancer, Crohn’s disease, and toxic mold illness she brings a unique perspective to treating patients in the midst of complex and chronic illness. Her clinic specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and tailoring the intervention to specific needs. 

A popular inspirational speaker and prolific writer, she shares her knowledge of hope, health, and healing live on stage and through newsletters, articles, books, and social media posts! People relate to Dr. Jill’s science-backed opinions delivered with authenticity, love and humor. She is known for inspiring her audience to thrive even in the midst of difficulties.

Featured in Shape Magazine, Parade, Forbes, MindBodyGreen, First for Women, Townsend Newsletter, and The Huffington Post as well as seen on NBC News and Health segments with Joan Lunden, Dr. Jill is a media must-have. Her YouTube channel and podcast features live interviews with the healthcare world’s most respected names. 

The Podcast

The Video

The Transcript – Overview

Overview

• Dr. Aimie Apigian, a double board-certified expert in preventative and addiction medicine, advocates for understanding how trauma is stored in the body, impacting chronic health issues.
• Her ‘Biology of Trauma' approach combines medical expertise with personal experiences, tailored for both individuals and health professionals through programs at Trauma Healing Accelerated.
• Healing is predicated on creating safety; overwhelming environments can lead to body retreating and inability to heal, with neuroception being critical for safety assessment.
• The podcast distinguishes between three nervous system states: ventral vagal (calm), sympathetic (action), and dorsal vagal (immobilized), critical for recognizing emotional responses and healing pathways.
• A stomach pressure technique can provide an immediate 30% reduction in anxiety, highlighting the importance of physical safety measures in trauma healing.
• Relationship dynamics are crucial; pre-trigger conversations about safety needs are more effective than addressing them during crises, recognizing individual differences in what constitutes safety.
• Dr. Apigian emphasizes awareness of nervous system states, both in oneself and partners, as a transformative step towards co-regulation and emotional safety in relationships.
• The podcast discusses how trauma manifests as physical memory, affecting bodily responses; muscle memory of trauma can lead to symptoms during care experiences like massage.
• A three-level trauma healing model includes mind (thoughts and behaviors), body (safety support and movement), and biology (cellular impacts and epigenetics).
• Adverse Childhood Experiences (ACEs) are linked

️ Podcast Introduction and Documentary Promotion (00:00 – 00:00)

• Dr. Jill introduces Resiliency Radio podcast focusing on integrative and functional medicine insights.
• Documentary ‘The Doctor Patient Movie' available on Amazon Prime, YouTube, and Tubi at doctorpatientmovie.com – encourages viewers to share with loved ones going through illness.

‍️ Guest Introduction – Dr. Aimie Apigian (01:19 – 01:19)

• Dr. Aimie Apigian introduced as double board-certified in preventative and addiction medicine with dual master's degrees in biochemistry and public health.
• Recognized as leading medical expert in how trauma becomes stored in the body and leads to chronic health issues.
• Developed ‘Biology of Trauma' approach combining medical background with personal experience and cutting-edge research.
• Supports individuals and health professionals through programs at Trauma Healing Accelerated.

️ Dr. Aimie Apigian's Personal Journey into Trauma Work (02:26 – 05:21)

• Career shift from conventional medicine: Originally on conventional medical career path, completed four years of general surgery before pivoting to trauma work.
• Foster adoption catalyst: Decision to foster adopt during break between master's in biochemistry and third year of medical school at Loma Linda University.
• Miguel's story: Received call from social worker Rosa about 4-year-old boy needing home – brought significant trauma into her household.
• Key realization: Learned that leaving traumatic environment doesn't mean trauma leaves the body – ‘the body holds on to that until it has what it needs to heal'.
• Treatment challenges: Traditional evidence-based therapies on medical campus were making Miguel's condition worse, leading to hour-long rages.
• Six-year journey: Took six years to find all pieces needed for Miguel's healing, resulting in complete transformation from guarded/defiant to able to express love and gratitude.

Understanding Trauma's Impact on the Body (05:21 – 11:05)

• Homeostatic capacity: Early childhood bonding shapes physiological homeostatic capacity as adults – not just emotional but actual physiological need.
• Medical training disconnect: Medical school reinforces disconnection from body through extreme demands (no eating, sleeping, showing emotion).
• Healing requires safety: Fundamental principle that healing cannot happen outside of safety – body retreats like turtle into shell when overwhelmed.
• Autonomic nervous system power: Body's decision-making power is more powerful than logical brain – neuroception determines safety vs. threat assessment.

Polyvagal Theory and Nervous System States (12:27 – 15:39)

• Three nervous system states explained: Ventral vagal (cruising mode – calm, creative, connected), sympathetic (mobilized action state), and dorsal vagal (immobilized/frozen state).
• State recognition: Internal feeling differentiation – ‘Do I feel strong inside or deflated inside?' vs. external mobilization energy.
• Medical residency patterns: Recognition of living in paralyzed/immobilized state while over-caffeinating and using stimulants to push through.
• Physiological shutdown: Vagus nerve shuts down metabolism and repair mechanisms when body perceives inability to overcome challenges.

Personal Healing Experiences (16:43 – 17:55)

• Dr. Jill's realization: Described dissociation patterns from childhood through medical school, using work addiction as escape mechanism.
• Illness as communication: Cancer at 25 and Crohn's at 26 potentially body's way of forcing rest and attention.
• Stillness challenges: Experience of feeling like dying when being still – body's way of avoiding depression and heavy emotions buried underneath constant activity.
• Healing pathway: Coming out of shutdown follows same path as entering – must go through stress, panic, and terror phases before reaching safety.

️ Practical Trauma Healing Strategies (24:43 – 27:34)

• Safety creation tools: Seven refined exercises developed for addiction medicine patients that work within seconds.
• Stomach pressure technique: Placing something over stomach creates immediate sense of safety due to anatomical vulnerability – can reduce anxiety by 30%.
• Weighted blankets: Recommended tool for creating physical sense of protection and safety.
• Self-practice necessity: Patients need tools they can use independently rather than depending on therapist availability.

Relationship Dynamics and Co-Regulation (30:15 – 35:29)

• Pre-trigger conversations: Importance of discussing safety needs before triggers occur rather than during crisis moments.
• Individual safety differences: What feels safe varies by person and healing stage – some need space, others need presence.
• Nervous system state recognition: Learning to identify sympathetic (problem-solving, flushed skin, quickened heartbeat) vs. dorsal (collapsed posture, difficulty with words/decisions) states in partners.
• Trigger awareness: Becoming conscious observer of own trigger patterns rather than unconsciously reacting.

Dr. Aimie Apigian's Surgical Training Awakening (35:29 – 37:03)

• Attending surgeon incident: Detailed description of trigger response when male attending criticized her – regression to childhood feeling of failing father.
• Physical awareness: Noticing body's complete shutdown response – eyes down, numbness, disconnection from external voice while internal criticism played.
• Pattern recognition: First time seeing lifelong pattern of freeze response and functional coping mechanisms (eating, caffeine).

Trauma Memory and Tissue Storage (43:14 – 47:31)

• Muscle memory concept: Trauma creates lasting physical memory patterns similar to piano muscle memory – body remembers powerlessness.
• Tissue memory manifestation: Unexplained crying during massage, physical therapy, or moments of care represents stored trauma releasing.
• Somatic completion: Need to physically complete blocked trauma responses through movement to reverse powerlessness at tissue level.

Three-Level Trauma Healing Model (50:11 – 51:35)

• Mind level: Working with thoughts, beliefs, behaviors, and coping mechanisms through parts work.
• Body level: Using body for safety support and completing previously blocked movements to regain agency.
• Biology level: Addressing cellular-level trauma impacts including DNA changes, epigenetics, oxidative stress, and mitochondrial function.

️ Trauma-Related Health Conditions (53:05 – 54:28)

• Adverse Childhood Experiences (ACEs): Every chronic health condition associated with childhood trauma experiences.
• Common conditions: Autoimmunity (especially in high performers), chronic fatigue, IBS, digestive issues, skin problems all manifestations of nervous system in danger mode.
• Systemic impact: Every body system affected when nervous system operates in danger mode rather than safety.

Book and Resource Information (55:35 – 55:35)

• Book release: ‘The Biology of Trauma' releasing September 23rd.
• Website and resources: All information available at biologyoftrauma.com including quiz, course, and book.
• Documentary reminder: Final encouragement to watch and share ‘The Doctor Patient Movie' for those going through illness.

Transcript

00:00
Dr. Jill Carnahan
Hey everybody. Welcome to Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine. I'm your host, Dr. Jill and with each episode we dive into the heart of healing and personal transformation. Join me as I interview renowned world experts, medical thought leaders and everyone in between. Today is no different. You are going to love this episode on the biology of trauma with Dr. Aimie apogenic and I will introduce her in just a moment. If you guys have not yet seen the documentary, it is available Amazon prime free with commercials on YouTube and Tubi and you can find that@doctor patientmovie.com there's no reason you shouldn't watch it on a plane or when you're resting or need something interesting to watch. I would love to know if it's impacted you. 

00:46
Dr. Jill Carnahan
If it has, I would love for you to share that journey with someone you love who's going through illness or cancer or some other thing. I think it's a powerful documentary that really just takes into account patients journeys and how we thrive in the midst of complex and chronic illness. And you can find that@doctor patient movie.com so today's guest I want to introduce without further ado, Dr. Aimie Apen. She's a medical doctor, double board certified in preventative and addiction medicine with dual master's degree in biochemistry and public health. She's recognized as a leading medical expert in how trauma becomes stored in the body and how it can lead to chronic health issues. I know you're going to enjoy this episode as we dive deep into why this is powerful medicine. 

01:31
Dr. Jill Carnahan
Combining her medical background with personal experience and cutting edge research, she developed the Biology of Trauma, a unique approach that helps people understand and heal the nervous system to address root causes of fatigue, anxiety and chronic illness. Through her programs at Trauma Healing Accelerated, she supports individuals and health professionals in learning the science of trauma and how to effectively reverse its effects. Let's welcome Dr. Aimie. Dr. Aimie, it is so good to have you on the show and it's been so fun to reminisce. We met back last fall. I'm sure we've crossed paths before but like talked face to face after I spoke at plmi. And one thing that I did that I've actually never done before is go really deep into my story and how it had to do with mast cells and trauma and all these things. 

02:16
Dr. Jill Carnahan
And as we know, in functional medicine there is a root cause. Right? And I'll just say from my experience, I've been doing function medicine a long time and there's environmental toxic load and infections. And yet there's this other layer that we're going to talk about today that may be the most important thing that we bring into functional medicine. And you are doing that. You got a book coming out called the Biology of Trauma. Let's talk trauma. Why don't you tell us your story? Like, how did you get to be writing this book? How did you get to be interested in trauma? And why is it maybe the most important thing that people are dealing with right now? 

02:49
Dr. Aimie Apigian
I love that you see it that way, Jill, because not many practitioners see that. And yet so much of my journey is also coming to that awareness. And then it completely changing my career path. So I was on a conventional medical career path. In fact, I did four years of general surgery before I was like, no, I really need to be doing trauma. Trauma work in medicine. And it really changed for me when I foster adopted and it was just after finishing my master's in biochemistry and I had a few months free before jumping into the third year of medicine. I was attending Loma Linda University for medical school. And I thought, I really want to make a difference in my life. My father was adopted, let me be a foster parent. I had no idea what I was getting myself into, Jill. 

03:37
Dr. Aimie Apigian
And the call came that you never forget. It was a social worker, Rosa, and she says, I have this 4 year old boy and he needs a home. And just with that, Jill, like, my heart was like, yes, you don't need to tell me anymore. Just yes. But his story was so hard and without going into all the details, he brought all of that trauma into my home. 

04:02
Dr. Jill Carnahan
Yeah. 

04:03
Dr. Aimie Apigian
And that was the first real lesson that I had to learn about trauma, is that just because you leave your environment, the trauma doesn't leave you. 

04:12
Dr. Jill Carnahan
Yeah. 

04:12
Dr. Aimie Apigian
And that was so much your story that you shared. Right. Like, the body holds on to that and I'm sure that we can talk about that. But this idea that, oh, we just need to change and, you know, for those of us who grew up in our family of origin, oh, once we leave our family, we're fine. We should be fine. No, we're not. 

04:33
Dr. Jill Carnahan
Yeah. 

04:34
Dr. Aimie Apigian
Our body is still holding onto that until it has what it needs to heal. But that experience completely changed my life because he was so heavy in his reactions and his reactivity that the traditional therapies were not working. 

04:51
Dr. Jill Carnahan
Yeah. 

04:52
Dr. Aimie Apigian
I was on a medical school campus, so I had access to some of the best. 

04:55
Dr. Jill Carnahan
Yeah. 

04:56
Dr. Aimie Apigian
Psychiatrists, psychologists, child therapists, and they're doing all of the Evidence based therapies and they're making him worse, Jill. I would bring him home and there would be hour long rages and again, I don't want to even go into all that he did in my home because it is so heavy for most people to realize that's the reality of how much trauma can affect a young child. But because I couldn't find answers then I went on a journey and I'm searching for answers and that's when I started doing and studying things that were far outside of my medical school training. But I'm learning about attachment and not just what I'm learning in about child development. I'm learning about this idea that there's regulation that is needed, that there's this physiological need for emotional bonding. It's not just the emotional needs like that. 

05:52
Dr. Aimie Apigian
Bonding actually shapes our physiology and our sense of. I'm going to use a big term here, but I think that your audience is ready for it. Right. Like the homeostatic capacity, our early childhood affects our homeostatic capacity as an adult. Wow. Mind blowing. So it took me six long years to finally find all the pieces that Miguel needed. And they were long, hard years. But when all of those pieces came together for him to see that transformation in him and him being able to go from someone who was so afraid to open up to me. 

06:31
Dr. Jill Carnahan
Yeah. 

06:31
Dr. Aimie Apigian
Someone that was so guarded and defiant in the face of love that he was never going to let himself love and be opened up to being able to look me in the eyes and hold my hand and reach out for my hand. Things he'd never been able to do and actually experience express gratitude and love. It was such a 180 degree that I'm like, my goodness, anything is possible at this point. But that's just where my journey was starting, Jill. And at that point, I had been through so much. I had neglected myself. I had poured everything into him, poured everything into my patients, my residency. I did not even know that I was living disconnected from my own body. 

07:16
Dr. Aimie Apigian
I didn't know that it was a trauma pattern that I was living out to focus on other people and not to even listen to my own body. 

07:25
Dr. Jill Carnahan
Wow, wow. I can so relate, Dr. Aimie. Because I remember like when I finally realized how dissociated I was to get through medical school. And it started with a pattern of childhood, you know, little t trauma and trauma that affected me and made me think that I had to be brave and strong and show up and not show those cracks. Right. And I always credit. I'm sure. You as well. It's almost. And medical school training reinforces that because you don't pee, you don't eat, you don't sleep, you don't, you know, like you deny yourself to the extreme. You're taught to do that. In fact, it's weakness if you show any sort of. And then like talk about talking to the patients, that you are taught to not show emotion, to be objective, and you create this shell. 

08:07
Dr. Jill Carnahan
Thank goodness you and I as empaths got through it and we didn't lose our empathy. 

08:11
Dr. Aimie Apigian
Right. 

08:11
Dr. Jill Carnahan
It's almost like despite the training, we thank goodness didn't lose that empathy. But gosh, I want to talk just a little bit about. I mean, I am almost in tears as I hear you talk about Miguel and the story there. Because all any of us ever really want is love and connection. It says Maslow's kind of based needs after food and shelter. Right. And so even in trauma, the most horrific trauma that a child or adult could ever experience, at the core, somewhere deeply buried, is that longing to be safe in connection. And I want to want you to talk a little bit about, like, how do you navigate that? 

08:46
Dr. Jill Carnahan
Because what I talked about at the lecture that we connected at was we must as physicians start by creating a safe container for that patient to be present and to be heard and to be held. Not necessarily physically, but emotionally, mentally. And it is our duty because no healing can happen when the body is not safe. Do you want to kind of talk about that in your experience? 

09:09
Dr. Aimie Apigian
You nailed it right there. Healing cannot happen outside of safety. And the fundamental need of the body after it's experienced trauma is safety. I think of it as the body is like a turtle that goes into its shell. It has been so overwhelmed, it has experienced so many moments of powerlessness. I can't stop the bad things that are happening. 

09:35
Dr. Jill Carnahan
Yeah. 

09:36
Dr. Aimie Apigian
And so we retreat and the process of opening up is the healing journey. 

09:42
Dr. Jill Carnahan
Yes. 

09:43
Dr. Aimie Apigian
Many people, as you know, Jill, they don't open up, they stay guarded, they stay closed down because it's why it's not safe. And so we as practitioners, that is our job. Our job is to be the safe person. Our job is to create the safe container that our patients can come in and they can feel like they can start to come out of their shell because it's safe now. There's so much more that needs to happen for healing after safety. Safety is just the first step. 

10:16
Dr. Jill Carnahan
Right. 

10:16
Dr. Aimie Apigian
But healing cannot happen without that safety because the body will stay shut down. And this is a key distinction that I had to learn is that I thought that I could use my mind to tell my body that it was safe. Safe. And that I should open up and that I should feel safe in this relationship and that I should do this. And the body has its own decision making power. And I did not realize at that time that my body or my autonomic nervous system is more powerful than my logical brain. I was taught, and it was reinforced in medical school, the logic, the conscious brain, the machine that you know is supreme above all else. And it's not. It is a servant. 

11:08
Dr. Jill Carnahan
Yes. 

11:09
Dr. Aimie Apigian
To that neuroception, if you want to use some polyvagal terms, that neuroception, that background equation that our body is making all the time of how safe am I versus how much threat is in my environment. And when we have not experienced safety after moments of trauma, we are seeing threat everywhere, even if it doesn't exist. Because that's the lens that we now have on. 

11:37
Dr. Jill Carnahan
Yeah, let's bring that with polyvagal theory and how people can, you know, fight, flight or freeze. So like the sympathetic overdrive versus like the dorsal vega responses and how might that look? And let's just take it clinically. But you could also bring in if you're a parent to a traumatized child or if you have a partner. Because all of this matters in all of our relationships. Right? 

11:57
Dr. Aimie Apigian
Right. I consider this nervous system map the manual for the human body, Jill. And so I don't care where you are, whether you're parent, whether you're a partner, whether you're a practitioner, you're going to be working with nervous systems. You're going to see these patterns. So there are three states of the nervous system. This was a misunderstanding that I had coming out of medical school where I had lumped fight, flight or freeze as one category. And it's not true. According to the polyvagal theory, we have three different states. And it's like the three different states kind of our car, if you want to think of it this way. You have the cruising mode. Cruising mode is when ventral vagal parasympathetic. This is what we are all familiar with in terms of rest and digest. 

12:47
Dr. Aimie Apigian
It's when we are going to be naturally in our best health and our best self because we're calm, we're creative, we're connected. And we're not having to force ourselves to be that way. It's just an outflow of our nervous system. But then if there is a sense of threat or danger, our nervous system moves into the sympathetic state. We're familiar with sympathetic. It's driven by adrenaline. And it's. The whole purpose of that state is to mobilize us, move us to take action. And so there comes this moment where that action becomes inaction, that mobilization becomes immobilization. And we can even use the terms I become paralyzed. Yes, I freeze. And even though that may not be what happens on the outside, if it's what happens on the inside, that's what defines the change in the state of our nervous system. 

13:45
Dr. Aimie Apigian
And so I started learning to look to how I felt inside. Do I feel. Do I feel strong inside or do I feel deflated inside? Do I feel, let's do this kind of energy, or do I have. The energy of. It is so hard to just move and get off the couch right now. Where's the cup of coffee? 

14:11
Dr. Jill Carnahan
Yeah. 

14:11
Dr. Aimie Apigian
And that's how I started to be able to differentiate the two states in my body. And what I came to realize was that as a physician, as a resident physician, I was actually most of the time in that paralyzed, immobilized state. But I was over caffeinating myself. I was using exercise, I was using sugar and food in order to push myself through and create the adrenaline to keep me going and then to crash later on. So it's fascinating now to then be able to see this in my patients and the people who come through my courses now, because it's so defining. Just asking them, well, how do you feel inside? And you can see it in their posture, because if they're in that sympathetic, they're open. Because that's what the body does when it's facing a challenge that we think that we can overcome. 

15:05
Dr. Aimie Apigian
But the moment that our body, again, our autonomic nervous system says, I don't think we can overcome that problem, it is going to shut us down. And it shuts everything down through that vagus nerve. It shuts down our metabolism, it shuts down our repair mechanisms, so that now we have all of these downstream effects happening in our immune system, in our DNA, our epigenetics, our everything is being impacted by this shutdown mechanism that happens in order to help us survive. 

15:39
Dr. Jill Carnahan
Something that's so profound, and what's beautiful is even if, again, we all have some sort of trauma, and I think it's so powerful for us to think of it that way is not that we have to compare ourselves to people who've been through rape and war and some of these really horrific things, but the truth is, the more we're actually aware of our own issues and triggers the more we can show up in the world and be our best selves. Whether you're a physician or you're a mother or you're a. What place that we have, where we're being brought. My thought is, as you're describing, that is so interesting because I know before my divorce and before I started dealing with my own trauma, I was exactly as you described. 

16:13
Dr. Jill Carnahan
I was over caffeinated, you know, totally like pushed for that, getting through medical school. But underneath that all, I'm sure I was much more dorsal vagal, kind of shut down because I had to really push. And what we see now in clinic is like these people who are completely adrenally depleted because they pushed and pushed and pushed. And I also wonder in hindsight if some of my illnesses, my cancer at 25, my Crohn's at 26, were my body's way of saying, hello, Jill, you're really not taking care of us. We're going to force you to rest because you're not listening right. And I'm sure you see that in illness. Now, one other thing that I realized is as I started to deal with this, I had trouble sitting still. You're not going to. Let's talk about that because I'm sure you can describe. 

16:53
Dr. Jill Carnahan
Now I know why and I've dealt with that and I've now I'm able to very much be at ease and still. But what happens when you're so dorsal vagal? And again, you can better describe this, but I'll just talk about my experience. I felt like I was going to die if I was too scared still. Right. Talk about that and why that someone might feel that if they stop moving and doing and going and being right. Yes. 

17:12
Dr. Aimie Apigian
Oh, and I love this because not many people bring that up, Jill. So I don't get to talk about this that often. And there's two aspects that are going on. One is that as we come out of that shutdown place, our body, our nervous system, follows the path by which it went into the shutdown. And so it's going to go up into the stress. So if we think about the five steps that our body experiences a trauma response, it reached a point where it went through stress and it. And it reached a peak with the panic and I use the word terror. It reached a point where we felt terror for our life. And at that point, our body shuts us down in order to help us survive that. But when we come out of that shutdown, guess where we go? 

17:59
Dr. Aimie Apigian
Like we're Going to go through that terror, through that clinic and into that stress. And there is so much activation. This is why one reason why so many people self sabotage themselves unknowingly on their healing journey is that they're expecting to just come back into peace and relaxation and a sense of safety. They don't realize that, no, you're going to have all of this activation as that opens up and you can go too fast on the healing journey. Do not, please do not open things up, meaning open pain, fear, trauma, your childhood. Do not open things up too fast because in the process we don't have the skills to manage those big emotions. And it re traumatizes us because it shuts us back down. 

18:50
Dr. Aimie Apigian
The other reason that I see a lot of people, oh like having a hard time sitting still is because they still have so much of that dorsal or a term that I've used in the trauma therapy. Space is functional freeze. 

19:04
Dr. Jill Carnahan
Yeah. 

19:05
Dr. Aimie Apigian
Where we have the dorsal, we have that freeze response. But we've learned to function through it. Even though we're limping through life, we're still pushing ourselves to limp through life. And so there's this constant sense of, well, if I were to stop, I'd fall back into that low place and it feels depressing, it feels heavy. I don't like that place. I like to be the high performer. 

19:31
Dr. Jill Carnahan
Dr. Aimie. That's exactly because I would never describe myself as depressed or even anxious. Like I don't have the depression gene. I'm happy and optimistic. And what happened as I started working through this? I went into this like two week period. Like, this is what it feels like to be depressed. It was so scary and of course I got through it. But I totally get that because for the first time, this is like at 40 years old, I felt this heavy sadness and I was like, ooh, no wonder I'm not still. This is horrible. Exactly. 

19:57
Dr. Aimie Apigian
Why would I want to feel this way? It makes sense why I've never let myself be still if this is what I would have felt. 

20:05
Dr. Jill Carnahan
So what would you advise? I mean, I got through that and for me it was just like I had therapist, I had people surrounding me. I was very supported, good friends. And for me, knowing it was like a wave where I was going to peak and it was going to hit, but I wasn't going to forever go up, up, up. That's what helped me get through it and knowing there was an end. But it had to be like, logically, like telling myself, oh, this is, but there will be. And what would you tell her, how would you talk to someone if they are working through trauma and actually experiencing some of this? Because as you mentioned, it can be so scary. 

20:37
Dr. Aimie Apigian
It was. And that's what I noticed when I was working with my patients. So after surgery, once I decided that I needed to do something different with my life to fulfill my life purpose, I changed my career to preventive medicine and addiction medicine. 

20:51
Dr. Jill Carnahan
Wow. 

20:51
Dr. Aimie Apigian
And so I started working with all of these patients who had addiction. And Jill, one of my mentors has been Gabor Mate. He wrote the forward to my book and he clearly states that it's not asking why the addiction, it's asking why the pain. It's the pain that drives the need to escape. 

21:15
Dr. Jill Carnahan
Yeah. 

21:15
Dr. Aimie Apigian
An addiction is just an escape. And as I looked at my life, I'm like, oh, shoot. Like, I use all forms of escape as well. No, it's not a substance. 

21:24
Dr. Jill Carnahan
Right. 

21:25
Dr. Aimie Apigian
But I still escape the reality of my life. When I don't like my life, I escape the reality of my body. That's unhealthy. And I haven't been able to find answers. And yet I'm a physician and I should have answers. 

21:37
Dr. Jill Carnahan
Yeah. 

21:37
Dr. Aimie Apigian
There's all these elements that I saw myself escaping. But then we look at, well, how does someone actually move beyond the need to escape? And working with addiction medicine patients clarified this for me because they have such a hard time coming back into their body. They've gotten so used to being able to escape whenever they want to, however they want to. 

22:06
Dr. Jill Carnahan
Yeah. 

22:07
Dr. Aimie Apigian
Why would they want to be connected with their body? Why would they want to feel that? And so as soon as they started to feel something uncomfortable, well, they would just go use their substance of choice. 

22:17
Dr. Jill Carnahan
Yeah. 

22:18
Dr. Aimie Apigian
And so I had to develop a plan that even they could follow. 

22:24
Dr. Jill Carnahan
Yeah. 

22:24
Dr. Aimie Apigian
So that when they started to feel that discomfort, they could ride the wave that you just described. 

22:32
Dr. Jill Carnahan
How did you do that? What's the tools? Because people listening are like, I want to know. And I love that you said. Because I. I remember I was in a lecture, well known mastermind. And he was like talking about addiction. I tuned out because I'm like, I don't do drugs, I don't do alcohol. Self righteous me. You know, stupid as that was. And then all of a sudden, he looked at all of us. He said, every one of you in this room is an addict. And you know what you're addicted to? You're addicted to your work and your success. Because we're all health entrepreneurs. Right. I was like, oh, you know what? I didn't say that bad word. But I was like, oh, you know what that is? That's me. And I kind of. It hit me so strong. 

23:06
Dr. Jill Carnahan
And ever since then I've been able to talk about, yeah, we all have some form of escaping pain. And the more we admit it, the more we can. But what? So talk to someone, whether it's there another doctor who's listening like us, who is using work to escape and maybe having consequences of their family life or whatever kinds of things, or someone out there who's over exercising or restrictive eating or shopping or on chat. GBT24.7. Right. These new kinds of things that our dopamine hits. Talk to, talk to that person. Where do we start? How do we titrate? 

23:39
Dr. Aimie Apigian
Careful, Jill, you're stepping on a lot of toes. What? We can be addicted to good things, right? Like I thought this was a good thing. Even those can be forms of escape. So it goes back to even what you were saying before, where it has to start with safety. Because if I don't feel safe, Jill, I am going to look for an escape. 

24:08
Dr. Jill Carnahan
Yeah. 

24:08
Dr. Aimie Apigian
Because I can only feel unsafe for so long before my body is tired and exhausted and it's going to need an escape just to get a rest and a reprieve before jumping back into the war zone where I don't feel safe all the time. So the first step that I saw that I needed to create for my patients was a sense of safety. But here's what happened, Jill. I would be able to help them feel safe in the office. And they'd go and they'd use a few hours later and I'd be like, what for you? And they're like, yeah, you did. But where are you when I go home? 

24:46
Dr. Jill Carnahan
Yeah. 

24:46
Dr. Aimie Apigian
And I was like, oh, you need something to do for yourself? Yeah, you need a self practice that you don't need me. Because so often the cases that someone experiences, okay, this is feeling unsafe, this is feeling a lot. I'm having a big emotion or I'm having a memory, I'm having a trigger. Let me call my therapist. Oh, good. I booked an appointment for a week. 

25:09
Dr. Jill Carnahan
Yeah. 

25:11
Dr. Aimie Apigian
What are you going to do for the next week? 

25:13
Dr. Jill Carnahan
Yeah. 

25:13
Dr. Aimie Apigian
So I realized, oh, I need to be teaching you how to create safety for yourself. And I need you to be able to do it within a few seconds. Because if you can't do it within a few seconds, you're going to reach for this other thing that works within seconds. 

25:29
Dr. Jill Carnahan
Yeah. 

25:30
Dr. Aimie Apigian
So working with this population of addiction medicine was wonderful for me because it really Made me find somatic self practices that they could use that would work for them. And very quickly. So I put together seven different exercises that I had pieced together for myself as I was going through my trauma therapy trainings. And I said, all right, try these. And so I just started trying them on my patients and having them go and practice them and come back and tell me, did that work? What? And I started just revising them until I got it so refined that it was working for even the hardest of patients who did not even think that they could do anything different other than use their substance of choice. 

26:20
Dr. Aimie Apigian
And then I said, well, as you know, as I'm going to show your nervous system is going to start surfacing activation as soon as you start creating safety. And if I don't give you the skills for that, when that happens, you're gonna go use. So now I need to teach you the next level of skills. And again, I realized that I don't want you to depend on me. I need you to be able to do this for yourself. So you mentioned that you had a ton of support around you. Awesome. They did not. Yeah, they work. 

26:54
Dr. Jill Carnahan
How you practically. I would go walk, I would listen to music, I would color. 

26:58
Dr. Aimie Apigian
Yes. 

26:59
Dr. Jill Carnahan
Amazing. 

27:00
Dr. Jill Carnahan
And I would call. I'd have, like a few friends that I call. This is like, right after the divorce, I was definitely deep in trauma and dealing with that. And it was definitely. It was hard. Like, I, I. It's. It's crazy how. And I was like, you know, successful. I had friends, I had resources. I was. Wasn't drugs and alcohol. Again, not that makes it any different. I'm no better or worse than anyone. But the truth is, like, I remember those things. Days when I had to know. Yeah. So what would you tell? Give us a few of your top ones that would be practical for people to actually implement. 

27:27
Dr. Aimie Apigian
Yeah. One of the craziest things is that if you put something over your stomach, you feel safer. 

27:34
Dr. Jill Carnahan
Wow, that makes sense because I always put a heart and stomach in. In that pressure is soothing. And weighted blankets. 

27:40
Dr. Aimie Apigian
And weighted blankets. I had them buy weighted blankets. 

27:43
Dr. Jill Carnahan
Yeah. 

27:44
Dr. Aimie Apigian
But even just this idea of knowing your body, knowing your anatomy, and knowing that our stomach is anatomically a vulnerable place, which is why when we feel overwhelmed, we want to curl up into a fetal position. Well, what if we just put something over our stomach and created that sense of protection and they started to notice. When I do that, my anxiety drops by 30%. 

28:12
Dr. Jill Carnahan
How wonderful and simple. I love it. 

28:14
Dr. Aimie Apigian
How wonderful and simple. And it makes it Possible to ride the wave, Jill. 

28:18
Dr. Jill Carnahan
Yeah. 

28:19
Dr. Aimie Apigian
That's what I was trying to get them to be able to do when that uncomfortable feeling comes. Because it will come, I guarantee you. 

28:25
Dr. Jill Carnahan
Yes. 

28:26
Dr. Aimie Apigian
I want you to have the tools that you can. Okay, let me support my body so that we can ride through this wave and not go back into shutdown. Because only as we ride those waves can we resolve that and heal it. If we continue to just go into shutdown, we're not going to heal it. 

28:46
Dr. Jill Carnahan
Wow. One thought as you're talking is there is a huge body of evidence in attachment in relationships, and I'm talking romantic relationships. Because in those settings, even more than child, mother and physician patient, we tend to trigger each other. Right. Like it's. We're dealing with the stuff for sure. Because that's the nature of that. So I want to just briefly talk to a partner of someone who's had trauma or if you have trauma and you have a partner, how could you co regulate? Because I think as we are able to. For me, I couldn't ask for help until I learned some of this stuff. So years ago, I probably couldn't have asked for what I needed. But how might you instruct a patient to ask their partner or a partner to help one of your patients also co regulate? 

29:27
Dr. Jill Carnahan
Can you give us a few practical tips there? 

29:29
Dr. Aimie Apigian
This is so important because as you say, we end up just triggering each other. 

29:33
Dr. Jill Carnahan
Yeah. 

29:33
Dr. Aimie Apigian
Rather than being safe people for each other, we are sources of re. Traumatization. One of the most important things that I've seen is being able to have these conversations before the triggers happen. Because once the trigger happens, there is no time spiraling. Exactly. So the conversation to have is what feels good and safe to you. It's going to be different for different people, Jill. And it's also different based on where they're at in their healing journey. For someone who is strong dorsal still, meaning they get overwhelmed easily and they just go into shutdown. What feels safe to them is being left alone. And so if you have a partner who is worried about you and he's. And they're checking in on you and what do you need now? 

30:20
Dr. Aimie Apigian
And they're trying touch you and they're trying to talk to you, and they're trying to get you to talk to them, you are. You are gonna snap at them and want to kill them. 

30:28
Dr. Jill Carnahan
Yeah. 

30:28
Dr. Aimie Apigian
And so we have to understand that it's going to be different for each person and different where we are in our healing journey. So you have to have that conversation because you may have good intentions, but actually be doing the opposite of what makes them feel safe. And remember, this is not about you. I have seen so many people in a partnership relationship where they would say, but this is what I would want them to do for me. 

30:54
Dr. Jill Carnahan
Right. 

30:54
Dr. Aimie Apigian
You are. 

30:55
Dr. Jill Carnahan
It could be the total opposite. And usually the avoidant and the anxious together, and then they're totally triggering each other. Right. 

31:01
Dr. Aimie Apigian
So you need to know, how does the other person experience. 

31:06
Dr. Jill Carnahan
Yeah. 

31:06
Dr. Aimie Apigian
Felt sense of safety. Because for you, that may be walking away. And that is not what you would want them to do for you, but that's what you need to do for them. And when they see you able to do what they have asked you to do, that creates a felt sense of safety and trust. 

31:24
Dr. Jill Carnahan
Oh, that's beautiful. And I'm assuming the question could be something like, you know, sweetheart, when you feel overwhelmed, what is it that you need from me to feel safe? Is that kind of a way you could frame it? 

31:35
Dr. Aimie Apigian
That is. And yet I would say a lot of people would have no idea how to even answer that. 

31:39
Dr. Jill Carnahan
Right. That's one of them. Like, how do you ask this for someone who maybe is in trauma where. Right. 

31:44
Dr. Aimie Apigian
So a lot of it is you're not going to get it right the first time. I promise you that. You're not going to get it right the first time. So it's noticing that there's a shift happening in their nervous system. So being present enough, hopefully to your own state that you notice the changes in their state. 

32:00
Dr. Jill Carnahan
Pause there. What might be some clues to changes in state? Because this get real practical if you're watching, you know, eyes or pupils or whatever skin. Talk about that. Because I think that's important. 

32:10
Dr. Aimie Apigian
Absolutely. So the sympathetic shift or that shift into stress is easier to notice because it. You'll see flushing in the skin as the blood flow changes and moves to one's muscles and their brain in order to think and move fast. There's also a quickening of their heartbeat. And you will see them go into, like, stress. So you'll see their eyes start to be like, going into problem solve, moving like that's what you want to look for. Are they in problem solving mode? 

32:42
Dr. Jill Carnahan
Got it. 

32:43
Dr. Aimie Apigian
If they are in shutdown, they are not problem solving. They're just in this place where it's even hard for them to think. Think. It is hard to make decisions. You may even see them struggle to find words. 

33:00
Dr. Jill Carnahan
Yeah. 

33:00
Dr. Aimie Apigian
Or if they're so shut down and you're pestering them, expect the lash out of get away from me. In order because. And then you'll see them just like, you'll see their posture go into kind of like the collapse. So you're looking for any form of heaviness or collapse in their. In their posture, as opposed to a more open one and one of taking action that is characteristic of the stress response. 

33:28
Dr. Jill Carnahan
Hey, everybody, Just a quick second to remind you, if you have not yet subscribed on YouTube or left a review. Wherever you listen to podcasts, please take a moment to do that. It helps us reach a larger audience and get great guests on here for you. And if you haven't yet visited drjillhealth.com for optimal beauty products and things to optimize your health and human performance, please check that out as well. You can browse by topic, by illness, by package. We have all kinds of things like the mast cell bundle, the detox bundle, the Epstein Barr bundle, and more. So check that out@drjillhealth.com okay, let's go back to our show. Oh, that's so good and so practical. 

34:08
Dr. Jill Carnahan
What about one thing that I've learned and I'm still learning is whether it's a friend, a partner, a business associate, or whoever, if I feel a little bit irritable or anxious or triggered. I think often it's important to kind of examine versus us lashing out at someone for, you know, to like, look at ourselves, because usually there's clues there about why we're triggered, and it's usually about us and not about the other person. Right. And I love talking about that and working on that myself, because so often we don't have control of another person. We never do. So in a relationship, in a parent, child, in a boss, we can never control that person, but we can always control our own responses. 

34:46
Dr. Jill Carnahan
Do you want to talk a little bit about, like, maybe how someone would notice they're triggered and then how they could ask themselves a question or two to get to a root of why that is. 

34:56
Dr. Aimie Apigian
Jill. I still remember the first time that I became aware of that in myself. 

35:00
Dr. Jill Carnahan
Yeah. 

35:01
Dr. Aimie Apigian
And it happened when I was standing in front of my attending surgeon. I had already been working on understanding my nervous system because I'd already had to go on a medical leave because of my fatigue. And then we discovered autoimmunity. And as I'm coming back, I'm so much more aware of my nervous system states because I've been studying this and mapping them out. So it was fascinating for me now because it's like I could watch myself from a third person observer. 

35:29
Dr. Jill Carnahan
Yes. 

35:30
Dr. Aimie Apigian
Be like, oh, look at her. Oh, there she spirals again. 

35:34
Dr. Jill Carnahan
Yeah, exactly. 

35:35
Dr. Aimie Apigian
One day. And it was fascinating to watch myself do this and be like, oh, this is what happens. I'm standing in front of my attending surgeon. It happened to be a male. He's larger than me. So I'm looking up at him, and it put me back in that place of being a little girl looking back up at my dad. And he was getting on my case about something that I had done that he didn't like. And it put me right back into that place of, once again, I've failed my dad and I'm not lovable. And I noticed my whole body changing in front of him. And he's still talking as if he didn't know anything of what's happening inside of me. 

36:17
Dr. Aimie Apigian
And I'm standing there, I'm taking it like a big girl, because that's what I do, and that's what we've been taught to do. But inside, I crumbled. And I could feel myself crumbling. I could feel myself going from that energy of busyness, and I'm just trying to get everything done. You know, that feeling of being in residency to just feeling your inner world crumbling, falling like pieces on the floor around you. And I noticed my eyes go down and off to the side. And I noticed. I noticed. I. I went numb. 

36:54
Dr. Jill Carnahan
Yeah. 

36:54
Dr. Aimie Apigian
And I really stopped listening to him. I didn't even know what he was saying at that point because I just was in my inner world and hearing my own thoughts of. You're so stupid, Aimie. You believe that you're not getting this, right? They're going to kick you out of the program. You're going to be the worst doctor in the world. All of these thoughts that I was having, that's what I was hearing. I was no longer even hearing him. And being able to see that and be aware of it for the first time, as if I were watching it happen. It was like, this place feels so familiar. This is the pattern that I've done my life, whole entire life without even realizing it. 

37:35
Dr. Aimie Apigian
And what I would have done before is go and eat a chocolate bar, have some coffee, because I need the energy I need. 

37:42
Dr. Jill Carnahan
Because you just went dorsal. 

37:44
Dr. Jill Carnahan
Exactly. 

37:44
Dr. Aimie Apigian
I just. I just dive bombed. I need the pickup in order to finish my day and get my job done. And now I was able to see all of those patterns laid out and my coping mechanisms and how I have this freeze response, but how I function despite of it. And it was just like, wow, Aimie, what your body has been through and what you put your body through when it just wants to curl up and it all go away and was fascinating for the first time to have that awareness of this is what's happening and this is what it feels like when this happens. This is awful. 

38:22
Dr. Jill Carnahan
Aimie, that is such a powerful thank you for sharing. And it's so interesting to me because as you share, I'm sure there's many women and men who can kind of relate in some form. And when we're not conscious. When we're not awake until we're awake. And I always say, like my divorce was my awakening because before that I was not conscious of trauma at all. And it's interesting, I don't share this a lot, but I had a very similar experience. I was in therapist office who does pack therapy. So she was watching for flight. Flight or freeze in my ex husband and my bodies. That's her therapy, right? She's watching for this trauma response months. And we had tried for months to try to, you know, before the divorce, see if we could patch things up. 

39:02
Dr. Jill Carnahan
And she was watching me at one moment and she looked at me, she said, just randomly I thought, jill, has anyone ever hurt you? And at that moment I started falling apart. And I was witnessing myself kind of like you did. I started sobbing and weeping, not knowing why my body knew. And my ex husband said, enough. He said a name from someone in my childhood that had perpetrated abuse. And he didn't know either. But he had enough sense to think this might be an issue. He just said one name. I completely fell apart on that floor. And as I witnessed myself falling apart, my logical brain was like, jill, get up. This is so stupid. What's wrong with you? Like, what is going on? This was so weird. And my heart self was like, this is real. I'm not making this up. 

39:45
Dr. Jill Carnahan
I could never in a million years make this up. So therapist saw me completely freeze. I fell apart when it was called out that there could be trauma because I started to remember my body, remember that there was trauma when I was a child. And what had happened that was so fascinating was my ex husband was very intense. He wasn't mean, he never abused me. There was nothing like that. But his male intense gaze triggered this shutdown of the little girl who had no control. And my whole marriage, I realized later that whole that happened in the marriage, the whole 20 years were married, he'd look at me with intense kind of angry look. Although he again, he never Hurt me ever. 

40:20
Dr. Jill Carnahan
But that male gaze triggered in me the little girl, the five year old who was helpless and abused by a male perpetrator. And I shut down and. But it was so crazy because that moment, what happened was I realized, oh, he is not available to repair this marriage. My only choice is to activate, take agency and file for divorce. Which was so bizarre. But literally within 24 hours I had filed for divorce. And it was a cordial, beautiful thing. It wasn't. There was no anger, but it all took that and literally that. That filing agency that I did at the hands of that re. It was re abuse. It wasn't him doing anything. It was the re. Traumatization of me for 20 years. Literally saved my life and saved my. Like I was able to come out of that trauma. 

41:05
Dr. Jill Carnahan
So I really can relate to what you're saying because I was. And why I'm saying that so vulnerably to this audience is because I lived 40 years not having a clue of what was happening over and over in the marriage. None. And you probably live for many years in surgery and whatever else, like not realizing. And then when we become awake, we can never go back. And it's a beautiful thing because as we're aware then we're like, oh, wait, this. And what I thought as you were talking, what I wanted to say to myself and to yourself is, oh, sweetheart, you are good and you are strong and you're worthy of love. And my healing has come from that self compassion and love that I never had. Because we had those voices. Right. Right in our heads. So cruel. 

41:47
Dr. Jill Carnahan
Yeah. 

41:48
Dr. Aimie Apigian
And those voices become our voices. 

41:50
Dr. Jill Carnahan
Yeah. 

41:50
Dr. Aimie Apigian
Whether they were actually said or implied in our childhood, we adopted them and we've got them now playing as tapes in our head. So one of the aspects that I've seen is essential in the healing journey is not just the body work, the somatic work, but also those thoughts, those beliefs, working with those parts of us that said, oh, I need to remind you that you're not good enough. I need to remind you that you're not lovable. But Jill, as I think back on my career as a physician, there were so many patients who, when I would ask questions along those lines, what happened? They would start crying. And I would ask them, why are you crying? And they would say, I have no idea. 

42:39
Dr. Jill Carnahan
Yes, yes. I love that you validate that. Because even to this day, when I say it still sounds so weird. I'm like, what? You know, talk a little. That's, that's the tissue memory Right. Let's talk about that. Because body keeps score. We know this. But I think if anyone's ever had that, or maybe someone's at a massage there. You know, massage or a physical therapy appointment. Some tissue is moved, and they start crying, and they don't know why. Let's talk about. About that and validate it. 

43:04
Dr. Jill Carnahan
Yes. 

43:04
Dr. Aimie Apigian
Or if someone comes and gives you a back rub and you have this moment of rest, and someone's actually caring for you, and you start crying, and they're like, why are you crying? It. It. Is this not enjoyable? You're like, oh, no, this is great. I have no idea why I'm crying. 

43:17
Dr. Jill Carnahan
Yeah. 

43:18
Dr. Aimie Apigian
It's because we've been fighting for so long, we've had to be the strong ones. So we have this tissue memory that is often not recognized, but it is part of what makes us sick, which is why so many of the patients that you've seen. So many patients that I've seen. Those are the kinds of questions that we need to ask them for when we're seeing them for chronic health issues, especially anything related to the adrenal glands or adrenal fatigue. That is the dorsal freeze response. That is the trauma stored. So we need to be asking these questions because the memory will still be held in the tissues. What do I mean by that? Our body. Our body is so amazing. Right, Jill? Our body is amazing. And I grew up playing the piano. Now, that may sound cool. 

44:05
Dr. Aimie Apigian
When I was young, it was not cool. 

44:07
Dr. Jill Carnahan
Right. 

44:08
Dr. Aimie Apigian
Practicing sitting on that piano for one hour every single day. There was a timer that was on the piano. You could not get off that piano bench until that timer was done with an hour that started at age five. 

44:19
Dr. Jill Carnahan
Wow. 

44:19
Dr. Aimie Apigian
So I spend a lot of time on that piano. And guess what? I would be able to memorize these songs that were pages. Pages long. Why? Because of something called muscle memory. Did I actually remember every single note on the page? No. But my muscles had learned how to move, when to move, where to move. It was muscle memory. That is what happens when we undergo a trauma. Trauma is something that is so disruptive to our body and how we think life should go that it creates this memory that's like a lightning bolt that says, never forget this. Yeah. And it's never forget that you were powerless. 

45:09
Dr. Jill Carnahan
Oh. 

45:09
Dr. Aimie Apigian
So if you and I want to go back to our childhood being that little girl looking up into our father's eyes that. That were not safe and welcoming. We had a muscle memory form that says, you're powerless, we're powerless. And that muscle Memory is then what continues to play over. Because then when another hard thing happens, our muscle memory says, oh no, we're powerless against powerful people. Oh no, we're powerless against men. Oh no, when there's that look on someone's face, we're powerless. And just like me playing the piano, we're gonna play the same song. Yeah, we don't have any other song to play because that's the memory stored in our tissues. And so one of the aspects that I consider essential, I consider there are three pieces that are essential if someone wants to heal. 

46:04
Dr. Aimie Apigian
If you're missing one, your healing is going to be inadequate. It. And that piece, one of those pieces is this tissue memory where I actually need you to do the muscle movements that reverse that powerlessness that you experienced before. I had an experience when I was 12 that I did not know had been programmed into my muscle memory. But it was an experience that I hope many, most everyone has not had. But I knew know that many women have where there was someone that sexually took advantage of me. And part of that process was them telling me that they were going to kill me if I moved. As a 12 year old, I believed them. And so I froze. Right. Because that's what our body does. 

46:52
Dr. Aimie Apigian
Okay, I'm not going to make a sound, but I don't want to feel my body while you're doing this to me. So I freeze. And I had no idea that muscle memory was still in my body, except I would wake up in the middle of the night. Now this is 10 years, 20 years later, and I'm still waking up in the middle of the night. And if I'm in that exact same position, I have a panic attack. And I don't put the two and two together. When going through my somatic training as a physician, I went through somatic trauma therapy training, and I'm learning that I need to complete these responses. And so one day I'm like, all right, Aimie, it's time. It's time. You have the skills to keep yourself present and not go back into the story, but work on the story. 

47:39
Dr. Aimie Apigian
And so I put myself in that position. I changed enough of it, meaning, like it was daylight, it's not dark. So I changed enough so that I could stay present in the present moment. We're going to work on the story. And I imagined that hand coming over my mouth again. But this time I paused the story. Jill, in my mind, I'm like, okay, I just felt a hand. Let me pause and see. What do I want to do? Oh, I want to turn around and kick the guy. I want to turn. So I do this. 

48:12
Dr. Jill Carnahan
Yeah. 

48:12
Dr. Aimie Apigian
And that's the. The reversing of the muscle memory that I'm talking about that someone needs to be able to do to have complete healing at the tissue level for it not to continue to cause disease and illness that you and I see so much of. 

48:26
Dr. Jill Carnahan
Oh, that's so powerful, because that's where that agency where we know it's the same. Right. And what's so fascinating, I just had a small procedure, and they were talking about if. If you get nauseous. Here's Zofran. And all the meds for the different reactions. Allergic reaction, Benadryl. And one of them was, if the patient's shaking, rigors. Right. And there was a med. I can't remember whether. What it was, but I thought, oh, wait, that's our natural response. Exactly. Don't shut trauma. And you know how people come after carcassonne and they're, like, so cold and shivering. That is our. So I always, like, make sure people know, if you ever do get in that state, let your body shake. 

49:01
Dr. Aimie Apigian
Let your body shake. Your body knows how to heal. If it has not healed, it's just because we have not given it what it needs. 

49:11
Dr. Jill Carnahan
Yeah. 

49:11
Dr. Jill Carnahan
Oh, and you mentioned three things. You mentioned one. And what's the other? I want to know the other two in this whole process, briefly, of what people want to do to get through that trauma. 

49:20
Dr. Aimie Apigian
Yeah. So this is what I share in my book, Joe. This is my book, and this is why it took me so long to write this book. This is a lot to share with the world. Like, this is everything that I've learned, starting with Miguel all the way through my own journey, and then with working with addiction medicine patients and now training practitioners around the world. This is a lot. And the way that I've organized it is I've said, look, trauma impacts us on the mind, body, and biology level. 

49:49
Dr. Jill Carnahan
Yeah. 

49:50
Dr. Aimie Apigian
Those are the three levels that you need to repair. And by repair, I mean they each need to have a restoration to a sense of safety, like the reset button. If that reset has not been set back to safety, one of those is still going to be operating on danger mode, and it's going to inform the other levels. No, no. We're still in danger. You can't relax. We're still in danger zone. So all three need to have that repair. So the way that I've learned how to work with it is on the mind. I'm working with the thoughts and the beliefs, the behaviors, the coping mechanisms through parts. Parts. Parts work or different parts of me. 

50:34
Dr. Aimie Apigian
And then the body level is this movement level that I just explained where I need to be able to not only use my body to create a sense of safety and support for me, like putting a pillow over my stomach in order to get that sense of safety and support, but also then completing movements that were blocked previously to regain my sense of agency at a tissue level. But we've got to go deeper, Jill. And this is really the essence of the title of my book, the Biology of Trauma. We do have to go to the biology level. Now, for us as functional medicine practitioners, this seems more obvious. The therapy world is missing this. They're still trying to just operate at the mind level. 

51:16
Dr. Aimie Apigian
Let me work on changing your thoughts, or let's look at analyzing your behaviors, or let's work on the story. They're missing the biology piece, which is why so many of those people still have their autoimmune conditions, still have their fatigue, still have their skin breakouts, because they haven't gone down to that cellular level. But trauma impacts the cellular level. You know that. This is your story. 

51:40
Dr. Jill Carnahan
So. 

51:41
Dr. Aimie Apigian
So why I came up to talk to you after you. Because he knows this, you know this, you've lived this. 

51:47
Dr. Jill Carnahan
Yeah. 

51:47
Dr. Aimie Apigian
It changes even our DNA. 

51:50
Dr. Jill Carnahan
Yes. 

51:50
Dr. Aimie Apigian
It changes our epigenetics through the oxidative stress. This isn't random. This isn't woo science. There is clear mechanism by how the body goes into shutdown. Oxidative stress accumulates, it impacts the mitochondria, it changes our epigenetics, it shuts everything down, creates all this accumulation of toxins. And we already live in a toxic world. And so now we've got this perfect storm that then erupts into trauma triggers and disease. 

52:20
Dr. Jill Carnahan
Yeah. 

52:21
Dr. Jill Carnahan
So what might be some of the common. I mean, even I know the things we treat the most. But with trauma, obviously anything could happen. But what are some of the most common conditions you see associated with unresolved trauma? 

52:32
Dr. Aimie Apigian
The list is quite long, Jill. And how I know this is just look at the adverse childhood experiences. That is not studying stress, that is studying trauma. 

52:44
Dr. Jill Carnahan
Yeah. 

52:45
Dr. Aimie Apigian
As a child. Those experiences that are measured in that study would have been overwhelming for a young child. So we're not measuring, oh, the impact of stress on your life. We're measuring the impact of overwhelm, trauma, fear, terror in your childhood as adult disease. And it's a long list. And I'm going to tell you that. That every single chronic health condition has been associated with the adverse childhood experiences. 

53:15
Dr. Jill Carnahan
Wow. 

53:16
Dr. Aimie Apigian
The most common ones that I have seen include autoimmunity, especially autoimmunity in those who are high performers. Autoimmunity is so much about perfectionism and pushing through. And I also see the chronic fatigue. I also see the ibs, all forms of digestive issues, whether that's gastric or stomach acid imbalances or leaky gut. This is all a manifestation of the nervous system being in danger mode. But I also see a lot of skin issues, and it's not surprising. The skin is directly related to our nervous system and it's related to our digestive system. And so now you start to look at, oh, well, then what would not be affected? Exactly. Every single system. Every single system is going to take a hit when the nervous system, which is driving all of our health is in danger mode. 

54:11
Dr. Jill Carnahan
Yeah. 

54:11
Dr. Jill Carnahan
Wow. I love how you bring that all the way back to. Like you said, really all of us need this work, and you and I know that, but it's been so powerful in my own life and the lives of my patients. I love the work you're doing. This is one of my favorite interviews because I feel like at the root of functionality medicine, this topic must be addressed. And I know you're, this very week, as we're recording, going to be speaking to one of our functional medicine colleague conferences. I'm so excited for that. Your book is coming out September, so depending on when this airs, that will be. Give us the date. September. 

54:41
Dr. Aimie Apigian
September 23rd is the birthday for my book. 

54:44
Dr. Jill Carnahan
Yay. 

54:45
Dr. Jill Carnahan
I am so excited for that because your work is so important, maybe more important than anything else in the last several decades. I really believe this is the. The core of where people are going to get true healing, you know, the kind of deep healing that people are really looking for. Thanks for sharing all of your personal stories and all of your personal journey. And thanks for using all of the difficulties you've encountered to transform yourself and to just engage the knowledge for those who need help. It's. It's priceless. Aimie. 

55:14
Dr. Aimie Apigian
Well, Jill, thank you for how you show up in the world. You show up as one of the most authentic people and that shines through your work and the message that you share. But the impact that you're able to have on the world because of your authenticity. 

55:28
Dr. Jill Carnahan
Oh, thank you. It's very mutual. So, guys, if you want to find, give us a website. Where can they find your book? Where can they find more information? I think you mentioned a course too, right? 

55:37
Dr. Aimie Apigian
Yes, I have all of that quiz course book over on biologyoftrauma.com awesome guys. 

55:43
Dr. Jill Carnahan
Check it out. Thanks so much Aimie. Hey everybody, I hope you enjoyed that episode with Dr. Aimie Apigian and her work the Biology of Trauma. Super excited for us to get a hold of that book. I think you saw heard her website biology of trauma.com and I hope you'll get a copy. Check out her course. Such powerful information. Please if it has touched you or there's something you're working through in your life, leave a comment below. Share this episode with a friend. I think this information is perhaps some of the most important healing information that you could encounter for your children, for your parents, or for anyone you love. So please do share and leave a comment below if it was helpful. I will see you again next week for another episode of Resiliency Radio right here on Resiliency Radio.