Trauma: The Invisible Epidemic: How Trauma Works and How We Can Heal From It
By Paul Conti and Lady Gaga
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About this ebook
Imagine, if you will, a disease—one that has only subtle outward symptoms but can hijack your entire body without notice, one that transfers easily between parent and child, one that can last a lifetime if untreated. According to Dr. Paul Conti, this is exactly how society should conceptualize trauma: as an out-of-control epidemic with a potentially fatal prognosis.
In Trauma: The Invisible Epidemic, Dr. Conti examines the most recent research, clinical best practices, and dozens of real-life stories to present a deeper and more urgent view of trauma. Not only does Dr. Conti explain how trauma affects the body and mind, he also demonstrates that trauma is transmissible among close family and friends, as well as across generations and within vast demographic groups.
With all this in mind, Trauma: The Invisible Epidemic proposes a course of treatment for the seemingly untreatable. Here, Dr. Conti traces a step-by-step series of concrete changes that we can make both as individuals and as a society to alleviate trauma’s effects and prevent further traumatization in the future.
You will discover:
- The different post-trauma syndromes, how they are classified, and their common symptoms
- An examination of how for-profit health care systems can inhibit diagnosis and treatment of trauma
- How social crises and political turmoil encourage the spread of group trauma
- Methods for confronting and managing your fears as they arise in the moment
- How trauma disrupts mental processes such as memory, emotional regulation, and logical decision-making
- The argument for a renewed humanist social commitment to mental health and wellness
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Reviews for Trauma
4 ratings1 review
- Rating: 5 out of 5 stars5/5I loved it ! A touching and informative narrative. Thank you!
Book preview
Trauma - Paul Conti
Praise for Trauma: The Invisible Epidemic
"Trauma: The Invisible Epidemic will be a game changer. It provides not only the wisdom and intelligence of the author—an experienced professional in the worlds of psychiatry and sociology—but unlike other intellectual books written about trauma, Paul’s offers a multitude of solutions. These practical responses to trauma address everything from physical and mental health to encouraging self-care and correcting unhealthy behaviors. Trauma affects countless individuals and families, and Paul’s book is carefully thought out and explained in ways that are understandable to everyone. Wisdom and patience prevail in his unique outlook on a subject that has been largely ignored by doctors for years. It’s a must-read for professionals as well as anyone who has experienced trauma or other psychological stressors."
TOMMY HILFIGER Entrepreneur, author, and philanthropist
Dr. Conti is a physician and psychiatrist, and a person who has been through a lot, too. This gives him a unique perspective on how people function and how traumas can change us, specifically how traumas lead us to think and act differently without understanding why. Dr. Conti explains how trauma interacts with the way our brains work and how trauma is affected by certain aspects of society, and he does so with vivid illustrations of real people and their lives. But this book doesn’t just stop there. Dr. Conti also provides real solutions—solutions people can use for themselves and their loved ones, and solutions to help make the world a kinder and safer place.
KIM KARDASHIAN Actress, producer, and businesswoman
Paul Conti is one of the most unique and thoughtful physicians I have ever met. His approach to psychiatry is interactive both with the patient and with the referring physician. I have a large, successful concierge practice in New York and am often asked to see patients with complicated medical issues. Of all of the consultants I refer patients to, Paul is the most effective. Any time I have a patient with a complicated medical history and many previous evaluations, I reach out to Paul, who has taught me to look for and find the underlying trauma in their lives. Paul, my patients and I thank you for teaching me to be a better physician.
BERNARD KRUGER, MD Oncologist and cofounder of Sollis Health
"After reading Paul Conti’s excellent book, Trauma: The Invisible Epidemic, I now understand that trauma exists in all of us. Sometimes we remember it, but even when we can’t, it remembers us, keeping us from living our lives fully. Until we can identify it and bring it to the light, we exist with fears, anxieties, and masks that keep us from living in the light. Paul Conti’s book helps us identify the trauma(s) we have endured in our lives and helps us move toward healing—no small task in today’s traumatic world."
CAROLE BAYER SAGER Golden Globe– and Academy Award–winning lyricist, singer, and songwriter
I’ve known Paul Conti for nearly 25 years, and over the course of that time I have been privileged to witness, and benefit from, both his brilliance and his insight into the human condition. Paul has lived through terrible tragedies and, as such, can speak to the important subject of trauma as both a clinical expert and a regular person who has suffered and struggled as so many of us have. Paul’s impact on my own life, and the lives of many of my patients, has been greater than I could ever explain on the back of a book jacket.
PETER ATTIA, MD Physician, consultant, and cofounder of Zero
trauma
the invisible epidemic
Paul Conti, MD
trauma
the invisible epidemic
How Trauma Works and How We Can Heal from It
Boulder, Colorado
To my daughters, Colette and Amelie
Those are the same stars, and that is the same moon, that look down upon your brothers and sisters, and which they see as they look up to them, though they are ever so far away from us, and each other.
FROM THE NARRATIVE OF SOJOURNER TRUTH
Contents
Foreword by Lady Gaga, Stefani Germanotta
Introduction
PART ONE
What Trauma Is and How It Works
Chapter 1: How We Talk about Trauma
Analogies for Trauma
The Trauma Virus
Pollution
Parasites
Pre-Existing Conditions
I’ve Got a Story to Tell
Four Vignettes
Chapter 2: Types of Trauma and Post-Trauma Syndromes
Acute Trauma
Chronic Trauma
Vicarious Trauma
Post-Trauma Syndromes
Sometimes There Is No Vacation
Chapter 3: Shame and Its Accomplices
A Healthier You, a Healthier Us
Accomplice: Shame
Antidote: Uncovering Self-Talk
Antidote: Reattributing Shame
Accomplice: Poor Self-Care
Antidote: Clarifying What People Deserve
Antidote: Describing What You Would Change
Accomplice: Risk-Taking Behaviors
Antidote: Reviewing Motivations
Antidote: Investigating the Impulse
Accomplice: Poor Sleep
Antidote: Relaxing Body and Mind
Antidote: Employing Imagery
Accomplice: Mood Decline
Antidote: Activating Body and Mind
Antidote: Exploring Your Stressors
Accomplice: Anxiety
Antidote: Limiting Media
Antidote: Identifying Triggers
Accomplice: Damaged Immunity
Antidote: Taking Care of Your Body and Mind
Accomplice: Nightmares and Flashbacks
Antidote: Seeking Assistance
I Need to Learn from Him
Shame Works Best in the Dark
The Secret Lessons of Trauma
My Family’s Experience with Shame
Chapter 4: A Conversation with Stephanie zu Guttenberg
Chapter 5: Compassion, Community, and Humanity
Honey, You’re the First One Who’s Noticed
Trauma Changes the Map
Uncle Rango, the War Hero
PART TWO
The Big Picture—The Sociology of Trauma
Chapter 6: The Problems with Trauma and Health Care
Vomit Bag
Therapeutic Antidote: What to Look for in a Therapist
Doc, I’m Dead, and You’re a Busy Man
The Revolving Door
Chapter 7: A Conversation with Daryn Reicherter, MD
Chapter 8: Social Ills, Social Trauma
The Boy in the Gas Mask
Three Crises
Am I Doing a Bad Job?
Trauma and the Assault on Compassion, Community, and Humanity
Chapter 9: Social Ills, Social Solutions
Antidote: Fostering Humility
Antidote: Remembering Our Core Values
The Murder That Was and the Assault That Wasn’t
Antidote: Opening Ourselves to Others
Antidote: Managing Fear
Antidote: Avoiding Quick Fixes
PART THREE
An Owner’s Manual for Your Brain
Chapter 10: What Trauma Does to Thought
Logic, Emotion, and Memory
Cognitive Blinders
Who Put My Patient on the Train Tracks?
Victimization and the Victim Mindset
Antidote: Changing the Channel
My Own Limbic Firestorm
Chapter 11: The Limbic System
Affect, Feeling, and Emotion
Antidote: Finding Supportive Environments
Leaping and Landing
Memories Don’t Hold Meaning
Firing and Wiring
Antidote: Wait a Minute!
I Have to Kill the Rats
Chapter 12: The Physical and Mental Ravages of Trauma
Inflammation and Chronic Pain
Antidote: Reducing Tension
Autoimmune Diseases
Epigenetics and Childhood Stress
Accelerated Aging
New Normals Aren’t So Normal
You Can’t Help It—You’re Italian!
PART FOUR
How We Can Beat Trauma—Together
Chapter 13: The Way Home
Five Critical Links
Antidote: Activating Our Knowledge
Allies, Angels, and Devils
Antidote: Playing Tug-of-War
Antidote: Enhancing Awareness
The Murder That Wasn’t and the Assault That Was
Chapter 14: Leading with Wisdom, Patience, and a True Life Narrative
Leading with Wisdom and Patience
Clear Communication
Do You Know What That Word Means?
The Importance of Stories and a True Life Narrative
Antidote: Writing Your True Life Narrative
The Girl Whose Name Was Changed
Chapter 15: A Humanist Social Commitment
Our Commitment
Five Foundations
The Biopsychosocial-Spiritual Model
Five Goals
Ten Years Later, Ten Years Younger
Closing Thoughts
Acknowledgments
Bibliography
About the Author
Foreword
by Lady Gaga, Stefani Germanotta
Iwas gently thrown into an emergency care room at some private hospital in New York during a world tour. I remember a vision of a doctor and a nurse. They asked me calmly to count back from 100 as I continued to scream. I recall saying, Why is no one panicking?
They encouraged me to keep counting back from 100 until I got to about 69. . . . I think. That’s when I stopped counting and declared, Hi, I’m Stefani.
I also confessed that I couldn’t feel my body, that I was completely numb.
I watched as their eyes gazed at a heart monitor, which I then realized I was connected to. They both did their best to hide their concern for the high level of my heart rate. I understood their concern, but I didn’t have the wherewithal at the moment to be panicked about even one single thing more. I was in a deep state of disassociation from reality, and I was later told that I had a psychotic break.
A doctor is coming,
they assured me.
As I pleaded for medication (not knowing which one I wanted), I thought that certainly something strong could be made available to me. I felt incensed that they would not give any medicine to me until this doctor
arrived.
Soon thereafter, someone entered the room. I noticed instantly it was a man, and also that he was not wearing a white coat and that there was no stethoscope in sight.
Hello, I’m Dr. Paul Conti,
he said. "I’m a psychiatrist.
I looked at the nurse who had been waiting with me, not realizing the other doctor had left the room a while ago.
Why didn’t you bring me a real doctor?
I asked the nurse.
Paul replied by saying, I’m an Italian from New Jersey,
and that was when I decided I was willing to talk to him. My dad is an Italian from New Jersey, so I figured I at least knew what I was dealing with.
At that moment, I began a journey that I have continued ever since, a journey with a man I had never met before but who would somehow make it part of his life’s work to understand and help me. It wasn’t until two years of working together that he revealed to me that he took six months to assess me and figure out if I was moveable
when I was clearly in a state of traumatic paralysis.
I will not tell you everything that has happened between the two of us. But I will tell you this: Paul only wore his white coat when he needed to. To remind me he is a doctor. Most of the time, by mutual consent, Paul has related to me as a fellow human being and a safe man. We have learned about each other as we began a process of healing for me that I thought was impossible. I can now say with certainty that this man saved my life. He made life worth living. But most importantly, he empowered me to find and reclaim myself again. Whether Paul taught me this or we came up with it together, what I do know for sure is that women don’t need men to simply give us help—we need men (and people who are not men as well) to believe in us in order for our traumas to heal.
Dr. Paul Conti is one of these men. He believes in women’s stories, and the traumas they carry. He understands, as well, that trauma is not limited to any one demographic, that it is a human problem. And he believes in healing. Paul is kind, and we could all learn from his kindness. Once I began to see this in him, I knew healing was possible. I’m on that journey now, and so are you.
Introduction
Like you, I’ve experienced quite a bit since I first came into this world (for me, fifty or so years ago on the second floor of St. Francis Hospital in Trenton, New Jersey). Much of it has been joyful, but a lot has been difficult and emotionally painful. I see myself as a regular person who has been through some tragic experiences, felt them deeply, and thought about them a great deal. I am a physician and practicing psychiatrist with training in brain biology and psychology, and I approach my profession from a holistic point of view. I’ve had the privilege of being alongside countless people going through intense and often life-changing situations. All of these relationships are personal to me, and through these relationships and my own experience, I’ve come to think the way I do about trauma and the devastating role it plays in our lives.
Before deciding to apply to medical school, I had a career in business. My only experience with health care to that point involved visiting older relatives in the hospital—mostly first- and second-generation Italian immigrants, some who served our country in World War II (you’ll hear all about my Uncle Rango in chapter 5). As they aged, these relatives needed more care than they were used to receiving from trusted local doctors, and the shift to visiting hospitals wasn’t easy on any of us. The doctors and nurses always seemed so busy and remote, and they rarely communicated with us. When they did, we often struggled to decipher what they meant, and I was often left feeling intimidated and confused. I knew there had to be kinder, better ways to treat people in such difficult situations, but at the time I’d never have guessed that I’d eventually devote so much of my life to paying attention to people and doing my best to help.
My father is a businessman, so it seemed practical that I’d become one, too. I eventually got a job at a first-rate consulting firm, but after a while in the field I began to feel stagnant and trapped. It felt like all of my options were played out, and everything was going to be downhill from there on out. I became depressed. I was only twenty-five. And that’s when my youngest brother killed himself.
Jonathan was twenty. He shot himself in the home we grew up in with a handgun my father had been issued during the Korean War. My mother found his body.
After the shock decreased, my family and I tried to understand what seemed like such a senseless tragedy. My brother and his girlfriend had recently broken up, and we believed he might have been experimenting with drugs, but these issues didn’t explain Jonathan’s decision to take his own life. In retrospect, I understand much better.
Four years earlier, a rare congenital problem had shut down Jonathan’s entire digestive tract. Up until that point, he had been perfectly healthy. Now here he was—sixteen years old, his life in danger, and having to go in and out of Children’s Hospital of Philadelphia for one painful procedure after another. He couldn’t eat. He lost an unbelievable amount of weight and strength. He was scared. The entire ordeal was horribly traumatic for him. Later on, people who knew Jonathan before his illness would comment on how much he’d changed.
I hadn’t seen Jonathan much when I was away at college, but even in the years before his suicide, I was clueless as to what was going on with him. Jonathan wanted me to see him as strong and happy, so he hid his trauma from me (or, more accurately, he hid what he understood of his trauma). I’m not sure I would’ve noticed much anyway. Like I said, I was depressed at the time. I was lost in my own self-soothing strategies and largely blind to my own tribulations and trauma.
After Jonathan’s death, I gradually learned about the history of mental illness and suicide in my family. I spent a lot more time with my parents and my other (now only) brother, and I started to realize some things about how I’d been living my life up to that point. I began to see how I’d existed under a litany of shoulds born of fear—fear that I wouldn’t succeed, fear that I would lament leaving a good job, fear that I wouldn’t know what I was doing and would regret it later. After my brother’s death, those fear-based shoulds governing my life faded away, and I couldn’t remember why they had been so important in the first place. And that’s when I decided to explore my long-held fascination with becoming a physician.
Although it was at times arduous, medical school was a wonderful experience. I was eager to learn all the things I didn’t know when my elder relatives were getting sick—all the things I didn’t know when my brother was sick. And I wanted to wield this secret knowledge so that I could finally make a difference, one person at a time. As I rotated through different specialties during the last two years of medical school, I was struck over and over again by how the world inside of a person determines so much of their outside world. I began to see how our life choices and experiences of life emerge from whatever is going on inside of us, and I became amazed by the number of problems—some of them fatal—that were entirely preventable. Medical school taught me about the astonishing complexity of human beings, from head to toe, as well as the predictability of many of the preventable things that hurt or kill us—a poor diet, for example, or chronic smoking, or car accidents.
The more I learned about clinical medicine and spent time with patients, the more appalled I became by how mental health factors regularly went unaddressed, leading to both mental and physical pain and sometimes death. I saw how people were suffering and dying not just from physical illness but from underlying mental health factors that contributed to their issues in the first place. So often it was clear that there were better ways to