1 00:00:00,200 --> 00:00:10,840 Speaker 1: Family Secrets is a production of I Heart Radio. It 2 00:00:11,039 --> 00:00:13,960 Speaker 1: is my honor and pleasure to present the special bonus 3 00:00:14,040 --> 00:00:17,279 Speaker 1: episode of Family Secrets, the first in a two part 4 00:00:17,360 --> 00:00:23,520 Speaker 1: conversation with Dr Rachel Yehuda, Professor of psychiatry and Neuroscience 5 00:00:23,880 --> 00:00:27,200 Speaker 1: and Director of the Traumatic Stress Studies Division at the 6 00:00:27,240 --> 00:00:31,080 Speaker 1: Mount Sinai School of Medicine in New York City. Dr 7 00:00:31,160 --> 00:00:34,440 Speaker 1: Yehuda is one of our nation's foremost experts on the 8 00:00:34,479 --> 00:00:38,680 Speaker 1: intergenerational effects of trauma. This is one of my favorite 9 00:00:38,680 --> 00:00:48,760 Speaker 1: conversations ever. Could you begin by telling me how you 10 00:00:49,080 --> 00:00:54,560 Speaker 1: ended up studying trauma and its effects At the beginning, yes, 11 00:00:54,680 --> 00:00:56,920 Speaker 1: it was a little bit of an accident. Um. I 12 00:00:57,080 --> 00:01:00,720 Speaker 1: was a graduate student in the late nineteen eighties and 13 00:01:01,080 --> 00:01:06,000 Speaker 1: I was studying the effects of stress on beIN development. 14 00:01:06,160 --> 00:01:09,640 Speaker 1: I was doing so in laboratory RAPS. I was a 15 00:01:09,680 --> 00:01:14,640 Speaker 1: student of neuroscience, and I found the idea that stress 16 00:01:14,680 --> 00:01:18,440 Speaker 1: can affect brain development really very fascinating. But I did 17 00:01:18,440 --> 00:01:23,000 Speaker 1: not find RAPS very fascinating, and I really the whole 18 00:01:23,040 --> 00:01:25,319 Speaker 1: time I was in graduate school wondered if there would 19 00:01:25,360 --> 00:01:29,679 Speaker 1: be any way that I could possibly pivot towards working 20 00:01:29,840 --> 00:01:35,520 Speaker 1: with people, and I ended up meeting somebody in my 21 00:01:35,680 --> 00:01:41,679 Speaker 1: graduate school who was very interested in studying psychosis proneness, 22 00:01:42,520 --> 00:01:45,199 Speaker 1: which is really the idea of being able to look 23 00:01:45,280 --> 00:01:48,760 Speaker 1: to see if college students are at risk for the 24 00:01:49,000 --> 00:01:53,520 Speaker 1: later development of mental illness. And he had developed a 25 00:01:53,640 --> 00:01:58,960 Speaker 1: screening tool. But this was the emerging era of biological psychiatry, 26 00:01:59,080 --> 00:02:02,400 Speaker 1: and so we met casually one time, and I was 27 00:02:02,440 --> 00:02:04,840 Speaker 1: a student of neuroscides. He said, I wonder if there 28 00:02:04,920 --> 00:02:09,880 Speaker 1: is a test that could be used to biologically validate 29 00:02:10,200 --> 00:02:15,240 Speaker 1: my UM questionnaire. And I looked in the literature and 30 00:02:15,280 --> 00:02:19,280 Speaker 1: I found that indeed, people were starting to talk about 31 00:02:19,880 --> 00:02:24,079 Speaker 1: UM risk for developing psychosis in terms of a biological 32 00:02:24,120 --> 00:02:28,640 Speaker 1: alteration in a in an enzyme called monoamine oxidase. And 33 00:02:28,760 --> 00:02:32,239 Speaker 1: so I thought to myself, I wonder if this could 34 00:02:32,280 --> 00:02:35,440 Speaker 1: be measured, and learned that it can be measured in 35 00:02:35,480 --> 00:02:39,520 Speaker 1: plate lists. So it was so organic. I said to him, 36 00:02:39,560 --> 00:02:41,760 Speaker 1: you know what, I bet I could figure out how 37 00:02:41,800 --> 00:02:46,200 Speaker 1: to measure this enzyme in plate lits. And my advisor 38 00:02:46,440 --> 00:02:51,280 Speaker 1: wasn't that happy about this whole new development, but I 39 00:02:51,320 --> 00:02:55,600 Speaker 1: promised him I would finish my dissertation in the rats um. 40 00:02:55,639 --> 00:02:58,080 Speaker 1: And this is such a challenge for me to figure 41 00:02:58,080 --> 00:03:00,960 Speaker 1: this out. But I did figure it out, and we 42 00:03:01,120 --> 00:03:06,000 Speaker 1: did find UM that the enzyme levels were associated with 43 00:03:06,080 --> 00:03:11,000 Speaker 1: his test. And after that, I just really wanted to 44 00:03:11,040 --> 00:03:15,880 Speaker 1: do clinical work and it wasn't necessarily important for me 45 00:03:15,960 --> 00:03:18,800 Speaker 1: to do it in trauma. About what happened was this 46 00:03:18,880 --> 00:03:23,320 Speaker 1: professor's name was Dr William Addell, moved to Yale and 47 00:03:23,520 --> 00:03:26,359 Speaker 1: UM asked me to come with him, and I ended 48 00:03:26,440 --> 00:03:29,640 Speaker 1: up doing a post doctoral fellowship at Yale Medical School 49 00:03:30,320 --> 00:03:34,000 Speaker 1: UM starting looking for people that knew about this enzyme, 50 00:03:34,600 --> 00:03:39,120 Speaker 1: monoman oxidase, and ending up at the v A UM 51 00:03:39,280 --> 00:03:42,880 Speaker 1: at the West Haven v A where UM somebody had 52 00:03:42,920 --> 00:03:45,600 Speaker 1: actually done work with this enzyme but had now moved 53 00:03:45,640 --> 00:03:50,360 Speaker 1: towards studying post traumatic stress disorder. And I thought that 54 00:03:50,440 --> 00:03:53,200 Speaker 1: was magnificent. I hadn't heard of it before, but I've 55 00:03:53,240 --> 00:03:57,440 Speaker 1: been studying the effects of stress in rats for so 56 00:03:57,480 --> 00:04:02,280 Speaker 1: long that I thought, oh, this is perfect. So how 57 00:04:02,320 --> 00:04:05,880 Speaker 1: long had post traumatic stress disorder had a name and 58 00:04:05,960 --> 00:04:09,000 Speaker 1: been been something that was in maybe not the popular 59 00:04:09,080 --> 00:04:13,200 Speaker 1: lexicon but the medical Yeah, that's a really good question. 60 00:04:13,280 --> 00:04:16,920 Speaker 1: It had only been a diagnosis for seven years by 61 00:04:16,920 --> 00:04:20,960 Speaker 1: the time that I began my post doc um which 62 00:04:21,000 --> 00:04:25,520 Speaker 1: is seven and PTSD was first described in the d 63 00:04:25,640 --> 00:04:31,799 Speaker 1: s M three in Night, so there was very little 64 00:04:31,839 --> 00:04:35,120 Speaker 1: known about the disorder. That disorder itself was kind of 65 00:04:35,160 --> 00:04:39,680 Speaker 1: controversial when it first came out, and in fact, my 66 00:04:39,760 --> 00:04:42,960 Speaker 1: mentors at Yale that I ended up working with, doctors 67 00:04:43,040 --> 00:04:48,320 Speaker 1: Earl Giller and Dr John Mason Um had just published 68 00:04:48,440 --> 00:04:53,400 Speaker 1: what was the first biologic study in PTSD, and they 69 00:04:53,440 --> 00:04:59,400 Speaker 1: showed very counterintuitive findings. One paper they published showed that 70 00:05:00,120 --> 00:05:04,159 Speaker 1: adrenaline levels were higher in Vietnam veterans compared to other 71 00:05:05,080 --> 00:05:09,560 Speaker 1: veterans with other psychiatric conditions. But another paper that they 72 00:05:09,600 --> 00:05:13,600 Speaker 1: published showed that levels of the stress hormone cortisol or 73 00:05:13,760 --> 00:05:18,080 Speaker 1: lower in Vietnam veterans with post traumatic stress disorder compared 74 00:05:18,480 --> 00:05:23,560 Speaker 1: the patients with depression and schizophrenia and other conditions. And 75 00:05:23,640 --> 00:05:27,440 Speaker 1: this lower cortisol level than a stress disorder had everybody 76 00:05:27,480 --> 00:05:31,159 Speaker 1: really baffled. And when I heard about it had just 77 00:05:31,200 --> 00:05:35,400 Speaker 1: been published, it had me baffled because everybody knew that 78 00:05:35,720 --> 00:05:40,800 Speaker 1: stress related conditions were associated with elevated stress hormone levels, 79 00:05:41,839 --> 00:05:45,120 Speaker 1: and against the backdrop of the fact that people were 80 00:05:45,160 --> 00:05:48,000 Speaker 1: having a hard time in the field of psychiatry wrapping 81 00:05:48,000 --> 00:05:51,560 Speaker 1: their heads around post traumatic stress disorder. You know, this 82 00:05:52,080 --> 00:05:55,520 Speaker 1: was sort of an inconvenient truth in a way, because 83 00:05:55,560 --> 00:05:58,960 Speaker 1: it would have been better had the initial study found 84 00:05:59,080 --> 00:06:02,800 Speaker 1: high stress formal levels. Then you could say, see, I 85 00:06:02,839 --> 00:06:05,360 Speaker 1: told you they still are under stress. But this seemed 86 00:06:05,400 --> 00:06:11,119 Speaker 1: to be a very challenging initial observation. So the first 87 00:06:11,200 --> 00:06:14,120 Speaker 1: study that I ever did in the field of PTSD 88 00:06:14,360 --> 00:06:18,440 Speaker 1: was to try to replicate this observation, and I was 89 00:06:18,480 --> 00:06:22,480 Speaker 1: astonished when I actually found the same thing, low cortisal 90 00:06:22,560 --> 00:06:28,000 Speaker 1: levels in combat Vietnam veterans with PTSD compared to combat 91 00:06:28,040 --> 00:06:31,840 Speaker 1: veterans without PTSD. And what did you make of that? 92 00:06:31,920 --> 00:06:34,960 Speaker 1: I mean, what what? And over time? What have you 93 00:06:35,000 --> 00:06:37,560 Speaker 1: made of that? It must be you know, I'm not 94 00:06:37,600 --> 00:06:41,040 Speaker 1: a scientist. It must be so sort of provocative in 95 00:06:41,040 --> 00:06:44,279 Speaker 1: a way as a scientist when you know the results 96 00:06:44,279 --> 00:06:47,800 Speaker 1: are there and they're irrefutable, and yet they're not. They're 97 00:06:47,800 --> 00:06:50,960 Speaker 1: frustrating because they're complicated or confusing or not not what 98 00:06:51,120 --> 00:06:55,239 Speaker 1: was expected or creates I guess, create new challenges. Yeah, 99 00:06:55,480 --> 00:06:59,920 Speaker 1: so irrefutable is a big word, because um, no stud 100 00:07:00,040 --> 00:07:03,240 Speaker 1: these a refutable. What what people like me do when 101 00:07:03,360 --> 00:07:06,320 Speaker 1: when we do a study is we try very hard 102 00:07:06,760 --> 00:07:11,520 Speaker 1: to minimize the kind of confounds that might contribute to 103 00:07:11,600 --> 00:07:15,800 Speaker 1: having false results UM. And so you always wonder when 104 00:07:15,800 --> 00:07:19,160 Speaker 1: you do a study, is this really right? Did I 105 00:07:19,200 --> 00:07:24,360 Speaker 1: minimize all the things that could contribute to something that 106 00:07:24,520 --> 00:07:27,400 Speaker 1: might give me a distorted readout? And so what most 107 00:07:27,440 --> 00:07:31,560 Speaker 1: people do is think I better retreat the study. And 108 00:07:32,040 --> 00:07:36,720 Speaker 1: since the results really were so counterintuitive, but by this 109 00:07:36,760 --> 00:07:40,040 Speaker 1: time it was the second finding, because I was replicating 110 00:07:40,040 --> 00:07:44,760 Speaker 1: a finding already. But still the results are so counterintuitive 111 00:07:45,240 --> 00:07:47,040 Speaker 1: that I thought I had to replicate them. And then 112 00:07:47,040 --> 00:07:50,120 Speaker 1: I wondered if there had been something special about Vietnam 113 00:07:50,240 --> 00:07:54,200 Speaker 1: veterans who were at the v a UM that might 114 00:07:54,240 --> 00:07:59,440 Speaker 1: not be prototypic of other kinds of trauma survivors. And 115 00:08:00,280 --> 00:08:05,560 Speaker 1: for my replication I chose to study Holocaust survivors UM 116 00:08:05,680 --> 00:08:09,200 Speaker 1: because I thought, well, you know, Holocaust survivors have also 117 00:08:09,280 --> 00:08:13,880 Speaker 1: suffered extreme trauma. I grew up in a Jewish community 118 00:08:13,920 --> 00:08:17,560 Speaker 1: where there were a lot of Holocaust survivors, and to me, 119 00:08:18,160 --> 00:08:22,000 Speaker 1: they seemed initially like they might be different from Vietnam 120 00:08:22,080 --> 00:08:25,560 Speaker 1: veterans who were at the v a UM. But that 121 00:08:25,640 --> 00:08:29,520 Speaker 1: was a false first impression. But in any event, I thought, look, 122 00:08:29,760 --> 00:08:33,679 Speaker 1: I'm going to go and find out if cortisol levels 123 00:08:34,280 --> 00:08:39,120 Speaker 1: are lower in Holocaust survivors and adrenaline levels are higher 124 00:08:39,720 --> 00:08:45,040 Speaker 1: also in Holocaust survivors within without PTSD, And in kind 125 00:08:45,040 --> 00:08:50,120 Speaker 1: of putting that study together, UM, I learned that first 126 00:08:50,200 --> 00:08:53,640 Speaker 1: of all, yes, we were able to replicate the finding 127 00:08:53,679 --> 00:08:58,960 Speaker 1: of lower cortisol levels and increased levels of adrenaline in 128 00:08:59,000 --> 00:09:03,320 Speaker 1: Holocaust survivors PTSD. But the thing that gave me the 129 00:09:03,360 --> 00:09:09,240 Speaker 1: biggest jolt was how many Holocaust survivors had PTSD even 130 00:09:09,360 --> 00:09:15,200 Speaker 1: fifty years after the Holocaust, and how infrequently this has 131 00:09:15,280 --> 00:09:18,440 Speaker 1: been talked about, how they didn't have a name for it, 132 00:09:19,200 --> 00:09:22,200 Speaker 1: how they hadn't sought treatment for it, and how how 133 00:09:22,320 --> 00:09:24,360 Speaker 1: many of them were people that I had grown up 134 00:09:24,360 --> 00:09:28,840 Speaker 1: with and never suspected we're suffering. We'll be right back. 135 00:09:34,800 --> 00:09:37,920 Speaker 1: I think it would be so helpful um to listeners, 136 00:09:38,480 --> 00:09:41,880 Speaker 1: even though it's really so basic for you to actually 137 00:09:42,360 --> 00:09:48,480 Speaker 1: define PTSD in regard to its symptoms, because I know 138 00:09:48,600 --> 00:09:52,560 Speaker 1: it can take on many different shapes and forms, but 139 00:09:52,679 --> 00:09:55,679 Speaker 1: it is it is diagnosable in terms of symptoms as 140 00:09:55,720 --> 00:09:58,880 Speaker 1: well as in terms of the science of the cortisol levels. 141 00:09:59,640 --> 00:10:04,760 Speaker 1: It's a it's a good point PTSD, as as it 142 00:10:04,880 --> 00:10:10,679 Speaker 1: was defined then, was a condition that occurs following exposure 143 00:10:10,720 --> 00:10:14,600 Speaker 1: to an extremely traumatic event, generally a life threatening event 144 00:10:15,480 --> 00:10:18,640 Speaker 1: UM and at that time there were three symptom clusters 145 00:10:18,679 --> 00:10:22,800 Speaker 1: associated with PTSD. There are now four, but they are 146 00:10:23,040 --> 00:10:29,600 Speaker 1: UM having intrusive distressing recollections of the trauma, either because um, 147 00:10:29,679 --> 00:10:33,199 Speaker 1: you get reminded of what happened, or just out of 148 00:10:33,240 --> 00:10:37,280 Speaker 1: the blue, you know, you're just minding your own business 149 00:10:37,360 --> 00:10:41,160 Speaker 1: and you have an intrusive recollection of something horrible, or 150 00:10:41,200 --> 00:10:43,720 Speaker 1: the memory comes to you in the form of a nightmare. 151 00:10:44,559 --> 00:10:46,920 Speaker 1: And one of the things that happens when you do 152 00:10:47,000 --> 00:10:50,040 Speaker 1: get triggered or you do have a memory, is you 153 00:10:50,120 --> 00:10:53,800 Speaker 1: become very, very distressed. So it's easy enough to ask 154 00:10:53,880 --> 00:10:58,320 Speaker 1: people about whether they have UM distressing recollections of a 155 00:10:58,360 --> 00:11:01,400 Speaker 1: trauma that they've been exposed to you. And the second 156 00:11:01,559 --> 00:11:05,720 Speaker 1: category of symptoms have to do with avoidance. That is 157 00:11:05,840 --> 00:11:11,920 Speaker 1: that trauma survivors with PTSD tried desperately to do whatever 158 00:11:11,960 --> 00:11:15,880 Speaker 1: they can do to not think about the trauma or 159 00:11:15,920 --> 00:11:20,000 Speaker 1: not get triggered by the trauma. And this involves not 160 00:11:20,160 --> 00:11:23,640 Speaker 1: dealing with people that might remind them of what happened 161 00:11:23,720 --> 00:11:28,160 Speaker 1: or going to places where the trauma occurred, and it 162 00:11:28,200 --> 00:11:32,160 Speaker 1: could be a real barrier in therapy because if you 163 00:11:32,240 --> 00:11:37,120 Speaker 1: have an illness or condition where you one of the 164 00:11:37,200 --> 00:11:41,160 Speaker 1: symptoms is that you want to avoid thinking about what happened. 165 00:11:41,200 --> 00:11:44,480 Speaker 1: You're reluctant to talk about what happened, and healing from 166 00:11:44,559 --> 00:11:48,360 Speaker 1: trauma often involves that. But you can ask people about 167 00:11:48,400 --> 00:11:53,120 Speaker 1: their avoidance behavior. And the third UM symptom cluster with 168 00:11:53,240 --> 00:11:57,440 Speaker 1: hyper arousal, and these are the real physiological symptoms that 169 00:11:57,440 --> 00:12:00,680 Speaker 1: are probably a function of the higher address all levels. 170 00:12:01,200 --> 00:12:06,280 Speaker 1: But there's a difficulty sleeping and difficulty concentrating UM. There's 171 00:12:06,559 --> 00:12:09,680 Speaker 1: something we call hyper vigilance, which is scanning the environment 172 00:12:09,760 --> 00:12:13,120 Speaker 1: just sort of sort of being in a new place 173 00:12:13,160 --> 00:12:16,240 Speaker 1: and feeling like it might be unsafe, looking for the exits, 174 00:12:16,600 --> 00:12:20,880 Speaker 1: making sure that um, you know where the doors are UM, 175 00:12:20,960 --> 00:12:26,160 Speaker 1: and having a startle response um uh to loud noises. 176 00:12:26,640 --> 00:12:29,959 Speaker 1: One of the one of the hyperreusal symptoms are also 177 00:12:30,040 --> 00:12:33,560 Speaker 1: being very irritable and angry. And this is something that 178 00:12:33,600 --> 00:12:37,560 Speaker 1: many trauma survivors just cannot understand why they're so irritable 179 00:12:38,240 --> 00:12:40,600 Speaker 1: and why little things make them so angry. But it's 180 00:12:40,640 --> 00:12:44,040 Speaker 1: part of a physiological complex, and now in the d 181 00:12:44,280 --> 00:12:47,679 Speaker 1: s M five there's a new symptom cluster that is 182 00:12:47,720 --> 00:12:52,120 Speaker 1: really reflecting changes in mood and changes in cognition, which 183 00:12:52,160 --> 00:12:55,560 Speaker 1: simply means that you think about the world differently. You 184 00:12:55,679 --> 00:12:57,800 Speaker 1: just don't see the world the same way as a 185 00:12:57,880 --> 00:13:00,360 Speaker 1: result of trauma as you used to see it. And 186 00:13:00,720 --> 00:13:03,120 Speaker 1: for people who have been exposed to trauma early on, 187 00:13:03,520 --> 00:13:06,280 Speaker 1: so it's really confusing because they don't remember there before. 188 00:13:07,080 --> 00:13:09,560 Speaker 1: They just know that they don't feel safe and that 189 00:13:09,640 --> 00:13:12,480 Speaker 1: the world is a dangerous place and that you can't 190 00:13:12,520 --> 00:13:16,640 Speaker 1: trust strangers, or they may feel that they are incompetent 191 00:13:16,720 --> 00:13:20,320 Speaker 1: to deal with what life has to offer them. And 192 00:13:20,360 --> 00:13:23,439 Speaker 1: the mood disturbances are such that you feel pretty sad 193 00:13:23,800 --> 00:13:28,880 Speaker 1: most of the time, sometimes anxious, sometimes hopeless. In that sense, 194 00:13:29,520 --> 00:13:33,720 Speaker 1: um PTSD can often be confused with depression, or sometimes 195 00:13:33,720 --> 00:13:37,880 Speaker 1: it just can co occur with it. It's so interesting 196 00:13:37,960 --> 00:13:44,360 Speaker 1: too and complex that the person suffering may and I 197 00:13:44,360 --> 00:13:48,479 Speaker 1: guess that goes to the fourth cluster, may not actually 198 00:13:49,400 --> 00:13:53,079 Speaker 1: consciously be able to identify what the source of the 199 00:13:53,120 --> 00:13:58,000 Speaker 1: suffering is. That there's a kind of dissociative way of 200 00:13:58,040 --> 00:14:02,240 Speaker 1: sort of distancing avoiding. Does that make sense? Completely and 201 00:14:02,240 --> 00:14:04,720 Speaker 1: that and that that's what I found in the Holocaust 202 00:14:04,800 --> 00:14:08,240 Speaker 1: survivor is that they knew they were distressed. They thought 203 00:14:08,240 --> 00:14:11,720 Speaker 1: it was their lot in life. Um. They never gave 204 00:14:11,960 --> 00:14:16,679 Speaker 1: their own symptoms that much consideration because they were, after all, 205 00:14:16,720 --> 00:14:20,160 Speaker 1: the survivors, and compared to the fact that so many 206 00:14:20,240 --> 00:14:25,560 Speaker 1: people had died. Um, they didn't even feel perhaps entitled 207 00:14:26,160 --> 00:14:30,520 Speaker 1: to complain about the symptoms that they did have. And 208 00:14:30,600 --> 00:14:33,680 Speaker 1: certainly there wasn't this idea that anyone could do anything 209 00:14:33,720 --> 00:14:37,160 Speaker 1: for them. Um. As one woman put it to me, 210 00:14:37,280 --> 00:14:40,400 Speaker 1: what is somebody going to do take back the Holocaust? 211 00:14:41,440 --> 00:14:43,680 Speaker 1: Make it like I didn't go through what I went through. 212 00:14:43,720 --> 00:14:47,280 Speaker 1: So there there really was this feeling that they were 213 00:14:47,320 --> 00:14:50,360 Speaker 1: as marked as the tattoo on their arm, that this 214 00:14:50,440 --> 00:14:52,280 Speaker 1: is something that they were going to just have to 215 00:14:52,280 --> 00:14:56,520 Speaker 1: live with. Um. And they didn't think about it as 216 00:14:56,600 --> 00:15:00,640 Speaker 1: a cluster of symptoms that might be able to be treated, 217 00:15:01,240 --> 00:15:04,360 Speaker 1: or that even the things that they now thought as 218 00:15:04,360 --> 00:15:09,440 Speaker 1: a result of the trauma might be revisited or contemplated 219 00:15:09,560 --> 00:15:12,760 Speaker 1: or discussed in therapy so that you could get a 220 00:15:12,760 --> 00:15:16,120 Speaker 1: different idea about them, which is actually one of the 221 00:15:16,160 --> 00:15:20,880 Speaker 1: main purposes of psychotherapy. So to me, it was just 222 00:15:21,120 --> 00:15:26,120 Speaker 1: striking to see what something looks like when you don't 223 00:15:26,120 --> 00:15:29,280 Speaker 1: deal with it for so long. Now, of course, many 224 00:15:29,320 --> 00:15:33,720 Speaker 1: Holocaust survivors had primary care doctors, and many primary care 225 00:15:33,760 --> 00:15:37,840 Speaker 1: doctors saw the anxiety and prescribe things for insomnia and 226 00:15:37,920 --> 00:15:40,640 Speaker 1: for anxiety. But that's not really the same thing as 227 00:15:40,800 --> 00:15:45,520 Speaker 1: naming something that happened as a result of a terrible 228 00:15:45,560 --> 00:15:51,040 Speaker 1: traumatic experience, and maybe even something that UM might not 229 00:15:51,760 --> 00:15:54,440 Speaker 1: need to exist in its current form. If you can 230 00:15:55,400 --> 00:15:59,000 Speaker 1: work yourself around what has happened and what it means, 231 00:16:00,240 --> 00:16:03,080 Speaker 1: some of those symptoms will go away. I mean that 232 00:16:03,280 --> 00:16:07,520 Speaker 1: that's so much what the you know, thematic material of 233 00:16:07,560 --> 00:16:12,040 Speaker 1: this podcast has been over the course of four seasons, UM, 234 00:16:12,600 --> 00:16:17,360 Speaker 1: because you know, we talk about my you know, my guests, 235 00:16:17,360 --> 00:16:20,360 Speaker 1: and I talked about secrets, all different kinds of secrets. 236 00:16:20,360 --> 00:16:22,160 Speaker 1: I mean that the tagline is the secrets that are 237 00:16:22,200 --> 00:16:24,040 Speaker 1: kept from us, the secrets we keep from others, and 238 00:16:24,080 --> 00:16:28,400 Speaker 1: the secrets we keep from ourselves. And UM, I find 239 00:16:29,080 --> 00:16:33,080 Speaker 1: most poignant and distressing in a way the secrets we 240 00:16:33,160 --> 00:16:36,680 Speaker 1: keep from ourselves. But there's you know, where they're like 241 00:16:36,720 --> 00:16:39,000 Speaker 1: if I were going to draw a Van diagram, like 242 00:16:39,080 --> 00:16:46,560 Speaker 1: where there is the intersection between secrecy and silence, UM, 243 00:16:46,840 --> 00:16:53,480 Speaker 1: silence and shame UM the places where those three sort 244 00:16:53,480 --> 00:16:58,480 Speaker 1: of states intersect. And you know, you're you're talking about 245 00:16:59,040 --> 00:17:04,600 Speaker 1: UM studying the Holocaust survivors in Cleveland, where you grew up, 246 00:17:04,640 --> 00:17:09,359 Speaker 1: and and I remember that that is when you came 247 00:17:09,400 --> 00:17:13,399 Speaker 1: across my radar for the first time. UM was when 248 00:17:13,440 --> 00:17:17,439 Speaker 1: I was deep, deep, deep into the research and the 249 00:17:17,480 --> 00:17:22,880 Speaker 1: experience of having discovered a family secret that was so 250 00:17:22,960 --> 00:17:25,720 Speaker 1: deep and so powerful that I could never have actually 251 00:17:26,359 --> 00:17:29,520 Speaker 1: consciously imagined it, which was that I was the family 252 00:17:29,600 --> 00:17:32,960 Speaker 1: secret that my dad had not been my biological father. 253 00:17:33,080 --> 00:17:37,240 Speaker 1: And I had never consciously entertained that thought consciously being 254 00:17:37,480 --> 00:17:40,640 Speaker 1: you know the key word. And and I had grown 255 00:17:40,720 --> 00:17:44,040 Speaker 1: up in New Jersey, in a neighborhood that was filled 256 00:17:44,040 --> 00:17:47,119 Speaker 1: with Holocaust survivors, and I felt like I knew the 257 00:17:47,160 --> 00:17:50,200 Speaker 1: people you were talking about. And for the most part, 258 00:17:50,400 --> 00:17:52,600 Speaker 1: because I you know, I can't say it to the person. 259 00:17:52,680 --> 00:17:55,560 Speaker 1: But wouldn't have sought therapy. I mean, it would have 260 00:17:55,600 --> 00:17:57,919 Speaker 1: been like the last thing that they would have And 261 00:17:58,000 --> 00:18:01,440 Speaker 1: they very often didn't speak of it UM or it 262 00:18:01,480 --> 00:18:03,800 Speaker 1: would leak out sideways, or they wouldn't speak of it 263 00:18:04,080 --> 00:18:05,600 Speaker 1: with their children or there. You know, it was like 264 00:18:05,640 --> 00:18:10,840 Speaker 1: you shouldn't know from that, and so they carried it. 265 00:18:10,880 --> 00:18:16,600 Speaker 1: But carrying something without speaking it has such a profound cost, 266 00:18:17,080 --> 00:18:19,960 Speaker 1: which I think is what I've been learning in a 267 00:18:20,000 --> 00:18:22,560 Speaker 1: way as a student of all this um for the 268 00:18:22,640 --> 00:18:25,479 Speaker 1: last number of years, is what the cost of that is. 269 00:18:25,520 --> 00:18:29,480 Speaker 1: It doesn't go away because you wanted to. It doesn't 270 00:18:29,480 --> 00:18:33,679 Speaker 1: go away because you wanted to, And keeping and not 271 00:18:33,840 --> 00:18:36,520 Speaker 1: using your words to talk about it doesn't mean you're 272 00:18:36,520 --> 00:18:42,840 Speaker 1: not conveying the narrative in some nonverbal way, and that 273 00:18:43,000 --> 00:18:46,119 Speaker 1: I think is a lot of the information that we 274 00:18:46,200 --> 00:18:51,200 Speaker 1: do get sometimes from our parents is nonverbal. I mean 275 00:18:51,520 --> 00:18:55,879 Speaker 1: we internalize the information even if it isn't spoken in words. 276 00:18:56,840 --> 00:19:01,320 Speaker 1: Um So, but that trilogy of silence, change, secrecy, I 277 00:19:01,359 --> 00:19:07,679 Speaker 1: think is something that really unites many trauma survivors because 278 00:19:07,720 --> 00:19:13,080 Speaker 1: I think you're exactly right about those three aspects of 279 00:19:13,119 --> 00:19:18,760 Speaker 1: the problem. And also, when you seek treatment UM you 280 00:19:18,840 --> 00:19:22,600 Speaker 1: have to feel in some way that you're entitled to it, 281 00:19:22,880 --> 00:19:26,040 Speaker 1: which many trauma survivors don't. And in fact that many 282 00:19:26,080 --> 00:19:31,120 Speaker 1: trauma survivors end up in therapy because someone that they 283 00:19:31,160 --> 00:19:34,399 Speaker 1: live with or someone that they love tells them that 284 00:19:34,440 --> 00:19:39,440 Speaker 1: they should go to therapy because they're not able to 285 00:19:39,440 --> 00:19:44,000 Speaker 1: tolerate some of the manifestations of trauma UM that either 286 00:19:44,119 --> 00:19:47,240 Speaker 1: they do or don't recognize as manifestations of trauma. But 287 00:19:47,320 --> 00:19:52,119 Speaker 1: sometimes trauma survivors go for therapy without even understanding that 288 00:19:52,160 --> 00:19:56,720 Speaker 1: they're there to process the trauma UM, which is very 289 00:19:56,800 --> 00:20:00,600 Speaker 1: interesting but is not at all unusual. No, that doesn't 290 00:20:00,800 --> 00:20:05,679 Speaker 1: that doesn't surprise me. I but why the sense of 291 00:20:05,920 --> 00:20:10,240 Speaker 1: undeserving or and I'm sure that there are many different 292 00:20:10,240 --> 00:20:16,119 Speaker 1: reasons for different individuals. But is it because um, because 293 00:20:16,119 --> 00:20:21,560 Speaker 1: it's really a sense of minimizing the trauma or kind 294 00:20:21,560 --> 00:20:26,119 Speaker 1: of erasing the trauma, or is it the shame or 295 00:20:26,320 --> 00:20:29,240 Speaker 1: sort of shame based feeling of like I don't deserve 296 00:20:29,320 --> 00:20:32,040 Speaker 1: to feel better or I don't deserve to be better. 297 00:20:32,880 --> 00:20:34,879 Speaker 1: I think a lot of it is shame based UM, 298 00:20:35,560 --> 00:20:39,359 Speaker 1: certainly depending on the trauma of a lot of people 299 00:20:39,440 --> 00:20:43,240 Speaker 1: that are exposed to sexual violence or sexual trauma, particularly 300 00:20:43,440 --> 00:20:47,919 Speaker 1: early on, are convinced that they somehow provoked it, and 301 00:20:47,960 --> 00:20:52,439 Speaker 1: they feel very ashamed about that. And even if they 302 00:20:52,480 --> 00:20:55,560 Speaker 1: don't feel that they provoked it, many people feel very 303 00:20:55,600 --> 00:20:59,960 Speaker 1: ashamed that they couldn't stop it. UM. And I heard 304 00:21:00,040 --> 00:21:04,280 Speaker 1: this also from Holocaust survivors, just the they could really 305 00:21:04,320 --> 00:21:08,040 Speaker 1: do nothing, and yet there was the shame of being 306 00:21:08,640 --> 00:21:14,879 Speaker 1: so degraded and so humiliated by the circumstance. So I 307 00:21:14,920 --> 00:21:21,280 Speaker 1: think that that shame is connected to feeling undeserving in 308 00:21:21,359 --> 00:21:26,040 Speaker 1: some way. And it's very complicated for combat veterans. We 309 00:21:26,160 --> 00:21:30,240 Speaker 1: talked now a lot about moral injury and people being 310 00:21:31,880 --> 00:21:33,840 Speaker 1: very ashamed of some of the things that might have 311 00:21:33,880 --> 00:21:38,960 Speaker 1: happened in combat. So again, combat is an pretty uncontrollable 312 00:21:39,000 --> 00:21:43,960 Speaker 1: situation most of it, and um, people are going to 313 00:21:44,520 --> 00:21:47,880 Speaker 1: often second guess themselves. Even after nine eleven, so many 314 00:21:47,920 --> 00:21:52,120 Speaker 1: people talked about what they could have done, what they 315 00:21:52,160 --> 00:21:56,040 Speaker 1: didn't do. Kind of a lot of recriminations of running 316 00:21:56,040 --> 00:21:59,200 Speaker 1: down the stairs instead of helping other people down the stairs. 317 00:22:00,680 --> 00:22:04,840 Speaker 1: Anywhere you go in a traumatic situation, there's room to 318 00:22:04,920 --> 00:22:07,960 Speaker 1: second guess yourself. We refer to it in the field 319 00:22:08,000 --> 00:22:13,320 Speaker 1: as the basis of developing negative cognition. So you start 320 00:22:13,359 --> 00:22:15,200 Speaker 1: to wonder why you didn't do this, that or the 321 00:22:15,280 --> 00:22:18,680 Speaker 1: other thing, and then you develop an answer for that, Well, 322 00:22:18,720 --> 00:22:20,760 Speaker 1: it must be I'm a bad person, it must be 323 00:22:20,800 --> 00:22:24,800 Speaker 1: I'm incompetent, alright, So it feeds into the same thing. 324 00:22:25,200 --> 00:22:28,080 Speaker 1: The reality is that when you're under a fight or 325 00:22:28,080 --> 00:22:32,119 Speaker 1: flight response, you're not really thinking that much. Your body 326 00:22:32,400 --> 00:22:35,879 Speaker 1: is doing what it is evolutionarily designed to do, which 327 00:22:35,960 --> 00:22:39,520 Speaker 1: is save those genes that they can be cassed. And 328 00:22:39,680 --> 00:22:43,000 Speaker 1: so you don't go into an entire analysis of what 329 00:22:43,040 --> 00:22:46,679 Speaker 1: should I be doing at this moment. You just do 330 00:22:46,840 --> 00:22:50,560 Speaker 1: it at this moment what your genes are programmed to 331 00:22:50,600 --> 00:22:54,440 Speaker 1: help you do, which is survived by any means necessary. 332 00:22:56,160 --> 00:22:58,680 Speaker 1: We'll be back in a moment with more family secrets. 333 00:23:03,800 --> 00:23:11,400 Speaker 1: Are certain people's genes programmed more toward one of those 334 00:23:12,359 --> 00:23:16,920 Speaker 1: evolutionary responses In other words, I mean I recently came 335 00:23:17,000 --> 00:23:20,080 Speaker 1: to be aware that you know that the freeze response 336 00:23:20,160 --> 00:23:23,720 Speaker 1: is part of that like it's it's and so it's 337 00:23:23,720 --> 00:23:26,520 Speaker 1: like this trio of I came to realize it because 338 00:23:26,560 --> 00:23:29,320 Speaker 1: I'm a freezer. I'm not a fighter, I'm not a 339 00:23:29,320 --> 00:23:32,920 Speaker 1: flear I'm a freezer. I go into like just I'm 340 00:23:32,920 --> 00:23:35,840 Speaker 1: going to be as still as possible and maybe this 341 00:23:35,920 --> 00:23:41,439 Speaker 1: will pass. UM. I'm just wondering whether that's is that 342 00:23:41,560 --> 00:23:47,880 Speaker 1: genetic or is that circumstantial. It's probably got features of both. Um, 343 00:23:48,040 --> 00:23:53,000 Speaker 1: but sometimes the body makes different decisions based on what's happening, 344 00:23:53,119 --> 00:23:57,200 Speaker 1: So freeze might be exactly the right response under some circumstances. 345 00:23:57,800 --> 00:24:01,800 Speaker 1: Don't move over, else something bad will happen. Sometimes fleeing 346 00:24:01,880 --> 00:24:06,040 Speaker 1: is the best and wisest response, and sometimes fighting is. 347 00:24:06,600 --> 00:24:10,600 Speaker 1: You know, So I think that I actually think that 348 00:24:10,640 --> 00:24:14,600 Speaker 1: we might have I think we have the capacity to 349 00:24:14,640 --> 00:24:19,200 Speaker 1: do all of those things under different circumstances. But that 350 00:24:19,520 --> 00:24:23,199 Speaker 1: you make the best choice you can given how you 351 00:24:23,320 --> 00:24:28,280 Speaker 1: size up a situation at the moment. So I think 352 00:24:28,280 --> 00:24:30,920 Speaker 1: that that I think we all do that when when 353 00:24:30,920 --> 00:24:34,399 Speaker 1: a trauma occurs when you're younger, it's probably the most 354 00:24:34,440 --> 00:24:38,879 Speaker 1: adaptive thing to just freeze through it, because you're not 355 00:24:38,920 --> 00:24:41,119 Speaker 1: going to be able to fight, and maybe you're not 356 00:24:41,160 --> 00:24:45,399 Speaker 1: even going to be able to flee, So just breathe 357 00:24:45,440 --> 00:24:48,760 Speaker 1: through this and let's see where it goes. Do you 358 00:24:48,800 --> 00:24:52,920 Speaker 1: think some of that then becomes learned and ingrained, so 359 00:24:53,040 --> 00:24:58,680 Speaker 1: that if when we were younger we learned that freezing 360 00:24:59,040 --> 00:25:01,879 Speaker 1: was what was going in too get us out of this, 361 00:25:02,080 --> 00:25:05,280 Speaker 1: or or or be the best recourse, maybe we've become 362 00:25:05,440 --> 00:25:08,600 Speaker 1: more freezers as adults, or or any of the any 363 00:25:08,600 --> 00:25:11,879 Speaker 1: of the responses. Maybe maybe we did flee or maybe 364 00:25:11,880 --> 00:25:14,119 Speaker 1: we did fight, or is it as you say that, 365 00:25:14,200 --> 00:25:17,480 Speaker 1: it really does depend on the circumstances. No, no, no, 366 00:25:17,560 --> 00:25:20,240 Speaker 1: that's exactly right. I mean one of the most important 367 00:25:20,280 --> 00:25:24,480 Speaker 1: things that happens when you're in a situation of extreme 368 00:25:24,640 --> 00:25:29,200 Speaker 1: stress is that the body's release of stress hormones, among 369 00:25:29,320 --> 00:25:33,879 Speaker 1: other things, helps you remember what has happened, presumably for 370 00:25:33,960 --> 00:25:36,840 Speaker 1: the purpose of allowing you to have a better response 371 00:25:36,920 --> 00:25:42,320 Speaker 1: next time. So, yes, our responses to trauma very much 372 00:25:42,400 --> 00:25:45,199 Speaker 1: depend on what has happened to us before that moment, 373 00:25:45,920 --> 00:25:48,399 Speaker 1: which is why when you're responding to a trauma in 374 00:25:48,440 --> 00:25:51,399 Speaker 1: the here and now, if you're also responding to a 375 00:25:51,480 --> 00:25:54,360 Speaker 1: lot of things that have happened in the past. And 376 00:25:54,400 --> 00:25:56,119 Speaker 1: this is why we start to get a lot of 377 00:25:56,160 --> 00:26:00,560 Speaker 1: individual differences in the way people respond to events, because 378 00:26:00,600 --> 00:26:04,080 Speaker 1: so much of what you're doing in the moment, Sure 379 00:26:04,200 --> 00:26:08,919 Speaker 1: it's biologically conserved and your program to save yourself, but 380 00:26:09,000 --> 00:26:13,920 Speaker 1: a lot of the decision making about how to respond 381 00:26:13,960 --> 00:26:16,119 Speaker 1: to trauma does have to do not only with what 382 00:26:16,280 --> 00:26:19,560 Speaker 1: happened in the past, but what the outcomes of those 383 00:26:19,600 --> 00:26:23,959 Speaker 1: decisions were. That makes so much sense. So let's go 384 00:26:24,040 --> 00:26:29,000 Speaker 1: back for a moment to Cleveland and the Holocaust survivors. 385 00:26:29,240 --> 00:26:35,840 Speaker 1: And was this the beginning of your exploration of or 386 00:26:35,960 --> 00:26:41,360 Speaker 1: sort of identification of epigenetics in the intergenerational effects of trauma. 387 00:26:41,560 --> 00:26:43,600 Speaker 1: Oh no, no, no, no, that didn't happen for a 388 00:26:43,680 --> 00:26:47,720 Speaker 1: really long time. Interesting. Yeah, no, no, no, I didn't 389 00:26:47,720 --> 00:26:50,440 Speaker 1: know the word every genetics when I first started studying 390 00:26:50,480 --> 00:26:53,639 Speaker 1: Holocaust survivors. It wasn't a word that was used in 391 00:26:53,680 --> 00:26:58,240 Speaker 1: neuroscience or matl health or psychiatry. And it wasn't even 392 00:26:58,240 --> 00:27:01,119 Speaker 1: a concept that was available to me, which is what 393 00:27:01,280 --> 00:27:07,440 Speaker 1: makes the whole story so much more um interesting, because 394 00:27:08,000 --> 00:27:11,160 Speaker 1: what I was thinking to myself, Well, what happened was 395 00:27:12,280 --> 00:27:15,720 Speaker 1: we study, we did a study on Holocaust survivors. We 396 00:27:15,720 --> 00:27:21,520 Speaker 1: were able to replicate the hormonal findings, which to me 397 00:27:21,520 --> 00:27:25,880 Speaker 1: meant this is real and worth pursuing because I got 398 00:27:25,880 --> 00:27:30,040 Speaker 1: to find out what is it that is resulting in 399 00:27:30,359 --> 00:27:34,720 Speaker 1: lower cordisol levels and people that have had a trauma 400 00:27:35,000 --> 00:27:38,760 Speaker 1: so long ago and now have PTSD, Like, what's that about? 401 00:27:39,400 --> 00:27:43,680 Speaker 1: But the other thing was, you know, there's a whole 402 00:27:43,680 --> 00:27:49,280 Speaker 1: population here of Holocaust survivors that there's an unmet mental 403 00:27:49,320 --> 00:27:52,760 Speaker 1: health need. And when I went back to New York 404 00:27:52,840 --> 00:27:56,200 Speaker 1: and I started my first job as an assistant professor 405 00:27:56,240 --> 00:28:00,440 Speaker 1: around Sinai in New York. I was dis gusting this. 406 00:28:00,520 --> 00:28:02,879 Speaker 1: With my chairman, I said, I really wish that we 407 00:28:02,960 --> 00:28:07,800 Speaker 1: could we could create a clinic for Holocaust survivors, and 408 00:28:07,840 --> 00:28:12,920 Speaker 1: he said, do it, and so I did it. UM. 409 00:28:13,000 --> 00:28:16,000 Speaker 1: What I found was that it was it was the 410 00:28:16,080 --> 00:28:20,119 Speaker 1: children of Holocaust survivors that began calling, and so I 411 00:28:20,160 --> 00:28:22,879 Speaker 1: didn't know what to make of that. UM. Some of 412 00:28:22,880 --> 00:28:25,600 Speaker 1: my best friends are children of Holocaust survivors, and they 413 00:28:25,680 --> 00:28:30,800 Speaker 1: didn't seem that different from me. UM. But again, things 414 00:28:30,840 --> 00:28:35,000 Speaker 1: are very different when you look deeper than on the surface. UM. 415 00:28:35,000 --> 00:28:38,400 Speaker 1: But these adult children of Holocaust survivors were really claiming 416 00:28:38,800 --> 00:28:42,960 Speaker 1: to be casualties of the Holocaust, and certainly casualties of 417 00:28:43,520 --> 00:28:46,719 Speaker 1: the way they were raised in their homes. So we 418 00:28:46,800 --> 00:28:51,800 Speaker 1: started clinical programming for both Holocaust survivors and offspring, and 419 00:28:51,840 --> 00:28:55,120 Speaker 1: we continued to do biologic work to try to figure out, 420 00:28:55,840 --> 00:28:58,600 Speaker 1: you know, what exactly is going on with this very 421 00:28:58,680 --> 00:29:02,880 Speaker 1: unusual hormonal us bonds, which, by the way, many offspring 422 00:29:03,040 --> 00:29:06,520 Speaker 1: showed as well the evidence of the low cortisol levels 423 00:29:06,800 --> 00:29:11,320 Speaker 1: and um the high adrenaline levels. And we kept at 424 00:29:11,400 --> 00:29:16,400 Speaker 1: it until we figured out that at least four adult 425 00:29:16,440 --> 00:29:21,240 Speaker 1: children of Holocaust survivors, many of the biological and clinical 426 00:29:21,280 --> 00:29:25,640 Speaker 1: features that we were observing that looked like a traumatic 427 00:29:25,800 --> 00:29:31,600 Speaker 1: stress response actually occurred when one of the parents had 428 00:29:31,640 --> 00:29:35,120 Speaker 1: post traumatic stress disorder, and that a few years later 429 00:29:35,280 --> 00:29:39,400 Speaker 1: even learned that there were kind of different effects if 430 00:29:39,440 --> 00:29:43,920 Speaker 1: the mother was traumatized or if the father was traumatized. 431 00:29:44,000 --> 00:29:47,760 Speaker 1: We started to just go deeper and deeper. Now every 432 00:29:47,840 --> 00:29:51,640 Speaker 1: genetics came along in kind of like maybe two thousand 433 00:29:51,680 --> 00:29:54,360 Speaker 1: and four or something like that, there was a paper 434 00:29:54,440 --> 00:29:56,960 Speaker 1: that was published by actually a very good friend and 435 00:29:57,040 --> 00:30:00,720 Speaker 1: colleague of mine, Dr Michael Meaney, and he was studying 436 00:30:01,400 --> 00:30:07,560 Speaker 1: again laboratory rats, but he was studying um parenting. Interestingly enough, 437 00:30:08,320 --> 00:30:10,920 Speaker 1: he thought he started out thinking he was going to 438 00:30:11,000 --> 00:30:16,880 Speaker 1: study maternal um stress. And what happens when you remove 439 00:30:17,520 --> 00:30:21,640 Speaker 1: a mother rat from the cage where her little babies 440 00:30:21,720 --> 00:30:26,000 Speaker 1: are right and you handle the animals, you return the 441 00:30:26,040 --> 00:30:29,120 Speaker 1: mother back. Um. It's a stressful thing for the mother. 442 00:30:29,160 --> 00:30:33,320 Speaker 1: It's probably a little stressful for the babies. UM. But 443 00:30:33,400 --> 00:30:36,400 Speaker 1: what the mother starts to do after being removed from 444 00:30:36,400 --> 00:30:40,760 Speaker 1: the home cage for fifteen minutes is she starts looking 445 00:30:40,800 --> 00:30:45,240 Speaker 1: and grooming her pups, and what Dr Meni and his 446 00:30:45,680 --> 00:30:48,960 Speaker 1: UM group noticed was that there was a lot of 447 00:30:49,080 --> 00:30:52,840 Speaker 1: variation in how much licking and grooming there was, and 448 00:30:52,920 --> 00:30:58,480 Speaker 1: eventually they realized that the licking and grooming of the 449 00:30:58,520 --> 00:31:02,880 Speaker 1: pups by the mother h was really having a profound 450 00:31:02,920 --> 00:31:08,240 Speaker 1: effect on the way that offspring the baby wrath as adults. Right, 451 00:31:08,840 --> 00:31:14,080 Speaker 1: um developed different kinds of stress responses and cognitive responses 452 00:31:14,280 --> 00:31:17,480 Speaker 1: as adults, and so they came up with this wonderful 453 00:31:17,520 --> 00:31:23,200 Speaker 1: theory of early developmental programming and really understanding that the 454 00:31:23,320 --> 00:31:27,520 Speaker 1: kind of mothering that you receive may have a profound impact. 455 00:31:27,880 --> 00:31:31,160 Speaker 1: And they started measuring this with stress hormones even in 456 00:31:30,840 --> 00:31:35,240 Speaker 1: the rats that as they became adults, which for fortunately 457 00:31:35,240 --> 00:31:39,600 Speaker 1: for rats it just takes a few months um. But 458 00:31:40,160 --> 00:31:43,040 Speaker 1: they began to see that they were the first really 459 00:31:43,080 --> 00:31:48,160 Speaker 1: to apply epigenetics to this question, and they began to 460 00:31:48,240 --> 00:31:52,280 Speaker 1: see that in the hippocampus of these rats that had 461 00:31:52,320 --> 00:31:58,120 Speaker 1: been exposed to differences in maternal care, they found differences. 462 00:31:58,640 --> 00:32:03,320 Speaker 1: Epigenetic differences is on a stress related gene, and it 463 00:32:03,480 --> 00:32:08,400 Speaker 1: just happened to be the gene that is the receptor 464 00:32:08,520 --> 00:32:12,880 Speaker 1: for cortisol, which is called the global cordicord receptor. So 465 00:32:12,920 --> 00:32:15,320 Speaker 1: when I read this, I was just all over it 466 00:32:15,600 --> 00:32:20,320 Speaker 1: and I actually called Michael Mini and said, I think 467 00:32:20,360 --> 00:32:24,760 Speaker 1: this work might apply to Holocaust offspring. At the time, 468 00:32:24,800 --> 00:32:28,880 Speaker 1: I thought maybe the Holocaust offspring for the way they 469 00:32:28,880 --> 00:32:33,000 Speaker 1: were because of parenting. That's certainly what I thought in 470 00:32:33,040 --> 00:32:38,240 Speaker 1: the early two thousands, right, and um, so I asked 471 00:32:38,280 --> 00:32:40,640 Speaker 1: him to help me figure out how to do ety 472 00:32:40,680 --> 00:32:46,240 Speaker 1: genetic measures. Um. We didn't have brains available to us, 473 00:32:46,680 --> 00:32:49,040 Speaker 1: but we decided we could measure the same part of 474 00:32:49,040 --> 00:32:53,240 Speaker 1: the gene in blood and indeed we began looking at 475 00:32:53,240 --> 00:32:58,280 Speaker 1: every genetic changes and then what we saw was that 476 00:32:58,360 --> 00:33:02,560 Speaker 1: there were different that that direction of change in offspring, 477 00:33:02,920 --> 00:33:06,840 Speaker 1: in Holocaust offspring was different depending on whether the mother 478 00:33:07,040 --> 00:33:11,680 Speaker 1: or the father had PTSD, And so we we knew 479 00:33:11,720 --> 00:33:14,800 Speaker 1: that this couldn't just be parenting. We knew that there 480 00:33:14,840 --> 00:33:19,320 Speaker 1: had to be a bigger story here, UM that would 481 00:33:19,360 --> 00:33:27,160 Speaker 1: explain a different epigenetic finding right in Holocaust offspring based 482 00:33:27,240 --> 00:33:31,680 Speaker 1: on parental gender. And that's when we started to really 483 00:33:32,000 --> 00:33:38,200 Speaker 1: explore epigenetic changes, looking at the contribution of in uterine 484 00:33:38,280 --> 00:33:42,240 Speaker 1: stress or perhaps thinking about the fact that some of 485 00:33:42,240 --> 00:33:48,000 Speaker 1: the changes might be UM might have been present preconception 486 00:33:48,320 --> 00:33:51,960 Speaker 1: and might have been transmitted through sperm or egg, And 487 00:33:52,000 --> 00:33:58,400 Speaker 1: that's when, you know, we began to really connect the 488 00:33:58,520 --> 00:34:04,080 Speaker 1: epigenetic findings with the concept of every genetic inheritance. So, yeah, 489 00:34:04,160 --> 00:34:06,440 Speaker 1: that that was a journey that really took a long 490 00:34:06,480 --> 00:34:09,839 Speaker 1: time and began. And that began with the fact that 491 00:34:09,840 --> 00:34:13,280 Speaker 1: those that those offspring of of the of the generation 492 00:34:13,320 --> 00:34:17,040 Speaker 1: of survivors were the ones who who reached out. Yeah, 493 00:34:17,280 --> 00:34:20,279 Speaker 1: we studied them. We found that, sure enough, there was 494 00:34:20,560 --> 00:34:25,520 Speaker 1: more anxiety and depression and PTSD in those offspring than 495 00:34:25,640 --> 00:34:35,400 Speaker 1: in Jewish very similarly demographically similar comparison people and UM. 496 00:34:35,480 --> 00:34:38,640 Speaker 1: And then we chased the hormonal findings and by then, 497 00:34:39,200 --> 00:34:41,520 Speaker 1: you know, we were just we just got lucky because 498 00:34:41,960 --> 00:34:45,319 Speaker 1: by then molecular neuroscience had given us all kinds of 499 00:34:45,360 --> 00:34:48,279 Speaker 1: tools to be able to look inside the cell and 500 00:34:48,320 --> 00:34:51,520 Speaker 1: look on the d NA, so we couldn't do this work. 501 00:34:51,560 --> 00:34:55,319 Speaker 1: Even though in the early nineties when I first encountered this, 502 00:34:56,680 --> 00:34:59,840 Speaker 1: I knew that it wasn't exactly genetics that was explaining this, 503 00:35:00,880 --> 00:35:03,760 Speaker 1: but I thought it was more than just being raised 504 00:35:04,280 --> 00:35:07,440 Speaker 1: in the environments that offspring were raised in, because there 505 00:35:07,480 --> 00:35:11,960 Speaker 1: was so much diversity in the homes of you know, 506 00:35:12,040 --> 00:35:15,640 Speaker 1: some parents talked all about the Holocaust all the time 507 00:35:16,040 --> 00:35:19,480 Speaker 1: and some didn't say a word, and so there was 508 00:35:20,239 --> 00:35:23,480 Speaker 1: I felt there had to be more, and indeed there 509 00:35:23,840 --> 00:35:33,520 Speaker 1: seems to be more. We'll be back tomorrow with part 510 00:35:33,680 --> 00:35:37,360 Speaker 1: two of my conversation with Dr Rachel Yehuda, and please 511 00:35:37,440 --> 00:35:40,480 Speaker 1: keep in mind that Season five of Family Secrets will 512 00:35:40,560 --> 00:35:52,279 Speaker 1: drop on April one with ten all new episodes. For 513 00:35:52,360 --> 00:35:54,799 Speaker 1: more podcasts for my Heart Radio, visit the i Heart 514 00:35:54,880 --> 00:35:57,839 Speaker 1: Radio app, Apple podcast, or wherever you listen to your 515 00:35:57,840 --> 00:36:00,560 Speaker 1: favorite shows.