George Bonanno

Welcome to the Puck Venture Capital and Beyond, the show that examines the changing landscape of our world. We'll have candid conversations with VCs, entrepreneurs, and thought leaders grappling with our current challenges and providing solutions to key problems we face as a nation. I'm Jim Beer, president of CMBG Advisors. This podcast brings change makers to the table to discover the inner workings behind their decision making strategies and ultimately how they got to where they are today. One of the things that happens in life is that we are really wired to adapt.

We have the most flexible brains in the animal kingdom. We have more neurons than any other creature, more cortical neurons. We take longest to develop than any other creature on the planet to fully develop. It take twenty five years for our brains to mature. It's an evolutionary strategy.

And the strategy is that we're continually adapting. We're born completely helpless. And eventually, we begin to be a little bit less helpless, but it takes a long time. We can adapt and change, and we really have that skill as human beings. On today's episode of The Puck, I have a fascinating discussion with George Bonanno, a professor of clinical psychology at Columbia University.

Bonano is a researching pioneer in the field of bereavement and trauma. Our conversation takes a deep dive into his insights on traditional concepts of PTSD, the different trajectories of grief, and the common misconceptions today about trauma and stress. Well, George Bonanno, welcome to the Puck. We are excited to have you. And your new book, The End of Trauma, How the New Science of Resilience is Changing How We Think About PTSD.

One question I have is, what what was it that actually prompted you at the time to write the book? Oh, I think it was I've been doing quite a bit of research. I mean, I've been doing research all my life, and it became increasingly apparent that the general public, the the public beyond sort of the academic research clinical world did not know about a lot of the new research, a lot of the new findings that really do change the way we think about trauma, PTSD, etcetera. It was time to to just make it clear to tell people. Gotcha.

And in terms of your expertise and a little bit about your background, could you share that with us as well? Sure. Well, I've been doing research in this area for over thirty years now. I began studying bereavement, how we deal with the death of a loved one, and then that sort of morphed slowly into more broader ranges of things and traumatic events. And now I pretty much study anything that is really hard for people to deal with, you know, in a psychological way.

And really from the beginning, my work, I I came out of left field in a sense from a different I came from more experimental science oriented background to study these very real things that are normally relegated to the clinical world. And we basically began to apply the methods of science a little bit more rigorously than they had been before. And right from the beginning, we began to see a different story than was in the literature, and that's persistent really to this day. Well, I I know you've written about veterans, and one of the things that I I remember is that there were certain things you saw that changed your outlook after studying PTSD? Yeah.

Well, I I think the main thing is that we saw right away that most people do not develop PTSD, but it goes beyond that. Most people actually show what I call the resilience trajectory. They they show pretty much a minimal reaction. You know, everybody, Jim, everybody gets, I would say, 85, ninety percent of people exposed to horrific events get very upset. That's very it's human.

It's natural. And it's actually adaptive. But if for most people, it doesn't last that long. It lasts much less. Those, reactions abate much more quickly than most people realize they will.

And for most people, the majority, they're pretty much able to move away from those events without lasting harm. That's not the way trauma is understood by most people. PTSD is assumed to be much more prevalent than it actually is. So when you talk about this change that you kind of determined existed in this, I love how when you look at historical evidence, it's changing this. How should we, as people reading your material and thinking about this, change our approach based on your analysis?

Well, that's a really great question. I think we we have to come to grips with a few things. One is that we when we're in the midst of of an immediate reaction, it seems to us very unlikely that that will go away. And so we run with enormous upset we feel in the beginning. And I have decided to start calling that the resilience blind spot.

And it happens in particularly when there's large scale events like disasters or say, for example, the recent troubles in The Middle East where many people are affected, many people are upset. And when that happens, there's a kind of, almost I wanna say hysteria, but that's such a lousy word, sort of nineteenth century word, you know, but there's a contagion. That's a better word. Contagion that happens of this sort of joint upset, this sort of community upset that's that spreads among people. And it feels like we'll never get beyond this.

This has changed life forever and we're upset forever. And then it does go away. And I think it'd be very important to come to realize that. And, you know, I mean, I I can tell people that. I can say the research shows that unequivocally, but we can also pay attention to ourselves and kind of make note of that, that this is what happened.

Remember the last time something happened. COVID was another great example. COVID seemed to people psychologically like the end of the world, and there was there was a lot of talk about the trauma of COVID. Turned out COVID wasn't really a traumatic experience per se in the way we think of trauma, you know, and the sort of definitions of trauma. It was a stressor.

It was a long stressor experience, and many people felt the stress. But the research on COVID showed the same thing we've seen for many other disasters and other large scale events. Most people were basically psychologically okay during COVID. We learned to adapt to it. We did that relatively quickly.

You know, and there's some common sense to it. The human race is thriving. Right? The human human beings are thriving on this planet. Our population keeps getting larger and we're running the show in a sense on this planet for better, for worse.

But that's because humans have adapted and continue to adapt. We're able to do that, and we just often forget that we can do that. So well, let's talk about adaptability. But before we do, I know you've talked about the relationship between grief and trauma. What do you see as the difference there or the relationship between?

Yeah. There are two different reactions or two different types of events and two different we react to them very differently. So grief, the loss of a loved one invokes intense sadness. And it it it the the process of getting past the death of love, which is not easy, even though most people are resilient in the sense that they continue to function well, there's a struggle, an internal struggle. We have to kinda recalibrate in our minds what the world is like.

And there's a lot of sadness that goes in that because we have to, in a sense, let go of the world we had with this person in it. And sadness is a functional emotion. So that's the dominant emotion. There's a kind of a slowing down of our bodies. The world slows down.

We're much more internal. The facial expressions that go with sadness are fascinating. The facial expressions communicate to other people that we're not that we need help. So facial expressions of sadness evoke sympathy from other people. Trauma reactions are very different.

Instead of slowing down, everything kind of speeds up. We get more anxious, more aroused, more on edge. We're looking externally, very much looking externally for the source of the danger where our minds are trying to figure out what happened, how did that happen, what went wrong. So the the event keeps repeating over and over in our mind. That's what flashbacks are, intrusions, nightmares.

It's our minds attempt to come to grips with the fact that something seriously dangerous just happened to us. And we wanna see. Our minds are trying in a sense to make sense of it, maybe to keep it from happening again. So that's the major difference. Grief, it's eternal turning inward, kind of withdrawing from the world a little bit and recalibrating our brains to the fact that the person in our mind is never coming back versus paying attention to the world, looking at looking for this danger, trying to make sense of it.

These two very different reactions. Interesting. So I know we started after World War one talking a lot about trauma and the lasting effects of trauma, but there does seem to be a modern explosion of the discussion of trauma and what effect it has had in our ability to work things through. How do you look at the modern explosion of, in the discussion of trauma that's taking place? That's a great question, and I wish I had a a fantastic answer.

I have a pretty good idea, I think, of what's happening, but there's there is a curious history to it. And if I may go even further back, the first time anyone ever used the word trauma as a is psychological trauma was in about eighteen eighty something. It took a hundred years before trauma was officially recognized. PTSD was officially recognized in the 1980s and that there's a lot of reasons for that. But then when it first appeared in 1980, it was kind of a welcome diagnosis because there were clearly people that were hurting, right?

So all these books appeared, these very draconian books, these clinical books about PTSD and the seriousness of PTSD that kind of PTSD is not fun having PTSD. It's not fun. It's a very debilitating kind of disorder that, you know, was very sobering for people to hear. And there was an aversiveness to it, but people gradually got to understand PTSD and what it is and the idea of trauma slowly seeped into the general public. But I think and in a sense, it was also an appreciation of for that human beings are strong and resilient on average as well.

The change seemed to have come. And I I agree that the world seems, I would say, almost obsessed with trauma now. And I think this goes this is correlated with inversely with age. So younger people are even more kind of focused on trauma and thinking about bad things in terms of trauma. Anything that's upsetting is traumatic, which is a very surprising and I think kind of strange trend.

I think it has a lot to do with the Internet, with the availability of information. You know, I I don't think the Internet is evil. I think we just have to grow up and understand the Internet as human beings. And we haven't done that yet. We are still completely enticed by the Internet.

We're on our computers, on our phones all the time, and we are we have become information junkies. And all the media outlets know this and they're all fighting for access to those information junkies. You know, stories, you don't see stories in the newspaper that say these bad things happened. Look what's happened in The Middle East and look at how resilient people are. You know, you you're not gonna see a story like that right now.

You're going to see stories about how tragic and horrible. None of these events, of course, are tragic and horrible, but people will endure them because that's what people always do. You know, not everybody, of course, but most people will. And then the research stories, the clickbait, if I can use that word, is there. And that's because we're wired for threat.

Our brains are wired for threat. We're we're wired to find threat in a world. We're not you know, we we also have all kinds of positive things and repetitive instincts and, you know, award based motivations for food and for things of pleasure, but threat trumps all those things. Threat is fast and quick. Our brains are looking for threat and responding to threat.

So the idea of trauma, of danger, that it's hard for us to look away from that. You know? So this is something that's that's being fed by twenty four hour Internet. And, you know, the youngest the youngest generations are enamored with TikTok and, TikTok has become an explosion of circular dialogue about mental health. Everybody's diagnosing everybody else and pointing out their diagnoses and their weaknesses and their traumas.

And this is, I think not a healthy thing. It's not healthy to be looking at these things all the time. And I think that has a has a very negative effect on us. So in your study, you talk about that we are resilient and we have these traumatic events, but we mostly get over them. And yet, at the same time, it sounds like you're talking about that there's a whole generation of people that almost seem to be in this constant state of trauma, potentially because of the Internet or other things they're being exposed to.

Yeah. How do you correlate the two? Well, I don't think that the younger generation per se, but we can stick with that. I don't think they're constantly traumatized. I think they're preoccupied with the concept.

I think a lot of what people think of as trauma is not actually trauma. K. Now, you know, nobody can control language. People can call an event whatever they want to, But it's very important to distinguish these different reactions so we can understand them and so we can help people. People who are generally traumatized can benefit from help.

One of the ways I've learned to think about it is I, you know, I teach classes of young people. Like, I'm around young people, thank God. But that people who are generally traumatized, they don't want to be traumatized. They want someone to help them get rid of it. They want it to be gone.

And they're willing to talk about it. I mean, I'm sorry. They don't really wanna talk about being traumatized. They just want they want help if I they can help it. People who are who are upset by something and and kind of I I hate to say this, but kind of in having an illusory trauma in a sense are very much want to talk about it.

And they they in a sense almost don't want it to go away. They want to keep the diagnosis. They wanna keep that moniker, that identity. I am traumatized. And I I I think that it serves a lot of functions.

One being it's an excuse. I know that sounds harsh, but I think it's a kind of an excuse for if I'm traumatized, then it's not my fault that I can't do certain things. And this has been a kind of a curious phenomenon in its own right. I've seen that people really seem to cling to these diagnoses now, even not just PTSD, but other kinds of diagnoses. Diagnoses are not life sentences.

They are categorical descriptions of a process that somebody is going through. And, they're, you know, they're not designed, they're not intended to be a part of your identity for the rest of your life, but it seems people cling to it that way. And they cling to the idea of trauma that way. Why do you think that the word trauma I mean, as you mentioned, words can be used in a lot of different ways, but why do you think that the use of the word trauma is becoming so prevalent? Well, a couple of reasons.

One, I mean, part of it is a misnomer. When the DSM, the the Bible of Mental Disorders, the official psychiatric diagnostic manual first began to talk about PTSD, they defined in order to have PTSD, you have to have a traumatic event. You can have all the symptoms with that, but if you don't have a traumatic event, it it's not PTSD. But, unfortunately, they called those events, and there's a initially, it was a very severe event, and then the criteria lacks over time to accommodate more subjective reactions. But I think it was a real mistake, well intended mistake, that they called these events, this sort of criteria that these are traumas.

You have to have a trauma. And in fact, a trauma is actually an event that causes an enduring trauma reaction. So I've, in my own work, forced myself to use the phrase potential trauma or a PTE, a potentially traumatic event, because no event is a traumatic event for everybody. It has never actually happened. The worst things that can happen, Hiroshima was not a traumatic event for everybody.

You know, it's just the way because human beings will always find some human beings will always survive psychologically. So the fact that these events are thought of as traumas means in our minds then that if you have one of these events in your life, then you've been traumatized. And the the epidemiological data though shows really clearly that the sort of large scale studies that almost everybody is exposed to at least one of these events in the course of their lives and often several. I think in my own life, I've been exposed at least five or six of these things because I was adventurous and really stupid when I was young. And I did a lot of dumb things, you know, and got myself into some real messes where I could have died.

But most people are, you know, car accidents, natural disasters, you know, medical emergencies. These are not uncommon events for most people. But if we call those traumas, then say, you know, if you want to find a trauma in your past, you can do it. If you think of it, those things as traumas. If we think of it as potential traumas, it's a different story.

And because most people don't suffer enduring reactions, we tend to forget about these events unless we look for them. And how do you from a treatment perspective, if you look at potential traumas versus trauma, how do we, from a modality perspective, approach them differently? Well, if a person has had a potential trauma in their past and they're not suffering from it, there's very little we need to do about it. Right. And I and I think there's a a real risk right now.

There's a tendency to to speak about trauma informed care. This is a buzzword, but it's become more than a buzzword lately. It's become an actually a prescriptive phrase, trauma informed care. And what that means is, and if you read the definitions coffered about, it's that when you're working with someone sort of in a clinical situation, you realize that they may have a traumatic event in the past that they don't wanna talk about or they're not fully aware of. And that, I think, is a very, very dangerous way to think about any kind of clinical interaction.

Because as I said, most people will have an event in their past that they're probably not, and many people have an events in their past that you could consider a trauma, but they're not even thinking about because it wasn't a trauma. Right? So I think that it gets very confusing clinically. But if a person is not suffering from a lot of symptoms of that look like PTSD and they're not in their minds directly linked to that event, then there's no reason to go there. And that makes sense.

On the other hand, when you look at the side effects or the way PTSD manifests itself, are there people that have had these, what we would not see as, you know, dramatic traumatic events, whether or not it's emotional abuse or things from their early childhood, that they take on this victimization and they feel like, Well, I can't do this because I was traumatized as a child, for instance. Do their symptoms overlap at all with somebody that has PTSD? I mean, what has created this sense that, you know, I can't function like a normal person because I was so traumatized as a child. I was a victim of my environment. Yeah.

Well, the the thing is that there was an idea of delayed PTSD for a long time. Like, you have an event and you're not upset by it or you're not you don't have any apparently enduring reactions. And then maybe years later, out of the blue, you have PTSD. That actually is kind of a myth. When we've looked at one of the things I do in my research and I've now done this, as I said for years and other people have started doing the same approach as we use different statistical tools to plot trajectories, different trajectories people show.

We don't ever really see this sort of out of the blue sudden surge of PTSD where there wasn't PTSD. What we do see are some people who are struggling after a highly aversive event, after a potentially traumatic event. They're struggling, but they're still getting by. They're we would call that, say, sub threshold. You know?

They don't have enough symptoms to qualify for PTSD but they're not doing that well either. And those people sometimes might go along for a year or two like that and then it starts getting worse and they don't get that much worse but they cross the line into full blown PTSD. And who it's usually because maybe they get upset that they're not getting better or they begin to be depressed or something else happens. Or maybe, you know, sometimes a person's injured in an accident and the injury is gradually taking a toll on them or the, you know, the the way it's impacted their life. So we do see that kind of slow emerging PTSD.

We call it worsening PTSD or, you know, something like that. But this out of the blue, you know, now I wasn't traumatized, but now I am. It's actually not. We don't see that in when we look at, you know, large populations of data. You can convince a person that what happened to them in the past is the cause of their symptoms in the present.

That's very easy to do, but I don't think that's actually a very realistic way to to work with people. So this may be a little off the wall, but in terms of people that have PTSD and you hear, let's say, Okay, I was in Iraq and an IUD went off and a friend of mine got killed or I was traumatized by that. And so every time I hear a car backfire, right, I get very anxious and a cold sweat and otherwise. Then you hear about people that, you know, every time they hear that somebody that they don't like on the other side of the political spectrum is gonna get elected president, they they start to panic and talk about how they're gonna leave the country and the world's gonna come to an end. And they defriend somebody in Facebook.

They have a fight with somebody, and they they start to shake. I mean, obviously, a bomb going off in Iraq is different than you finding out somebody may win the presidency. But the reactions in our world, you hear people saying that are getting anxious and triggered by social media and having these reactions. It seems to me it's downplaying PTSD, but do you see that come up in your work at all? Those reactions have nothing to do with PTSD.

Right? Because PTSD is a very clear kind of a problem. As I was saying earlier, when I was talking about grief, it's a kind of a you know, it's your mind replaying the situation that was usually a violent or life threatening situation. When people get upset at a political event, people get upset at a sports team losing, people get, I grew up in Chicago and, you know, where the Cubs perennially caused, you know, massive waves of depression in that city. You know?

Those are very different reactions. And we we know this too. We have there are other kinds of problems that are well identified, like anxiety, like depression. You know? Depression is about being, you know, a sense of the the depression is like a a kinda general sense of failure or some social ineptitude or loss of something, you know, and people do have those reactions.

And people get anxious about things when they're worried and on edge. Those are very different reactions. Those are not PTSD reactions. It's super important to keep all this clear when we're trying to understand somebody scientifically or clinically. But, you know, as we said before, people will use words and language as they wish.

And unfortunately, now people think of trauma as being upset. You know, I'm traumatized by this political event. I have to leave the country. I'm traumatized by this other thing that happened. I have to react that way.

But those are simply sort of sloppy ways of talking about things. And with PTSD, do you get into or how do you for people that really do have trauma, are there things that can be done to help these people? Oh, absolutely. There's been a lot of excellent research on in my profession, we refer to these things as empirically verified treatments. They're treatments that have shown, you know, through testing solid results.

The dominant approach is what's called exposure therapy, prolonged exposure. We're in a very controlled setting with a therapist who's well versed in the procedure. Somebody kind of goes through the what happened to them in tremendous detail and kind of with a therapist in a safe environment and gradually puts together in their mind what actually happened, which they hadn't done before. You know, when we when something's really aversive or minds race and we get little bits and pieces and we can't quite make sense of it. So they do this with a therapist and they gradually get used to with being with this event and realizing this thing happened to them and they're not it's not their fault.

They're not necessarily broken. They this thing happened to them. It's not easy. It's a lot of work. There are other kinds of therapy.

Meditation works for many people. There's bodily of approaches, relaxation techniques, lots of things that have been shown to work. That's not a a problem. And there are other treatments are being developed all the time. There's a lot of interest now in psychedelics, which seem to actually work quite well with PTSD.

And because of this modern explosion on the discussion of trauma, do you think that these treatments, like, again, with psychedelics or other modalities, did they have application in the general semen thing or do you think it's leading to over prescription and oversimplifying these less severe situations in PTSD? Well, I don't know if I if I can really answer that. I don't know if I have enough information to answer that. I would hope, and I I know this is not going to always be the case, but I would hope that, any kind of a therapist or psychiatrist or, you know, clinical psychologist or psychiatrist would do a full assessment on somebody before they left to the conclusion that they had PTSD and needed a PTSD treatment. And that should be fairly straightforward to sort of tease that apart.

Okay. This isn't necessarily PTSD. This is more anxiety or depression or something else that you're struggling with or even not at something that that would reach a level of a disorder. You know? So if that procedure is followed, you know, good assessment and then a good prescription of the right kind of treatment, there shouldn't be any problem.

If it's not followed, then we're getting into bit of trouble because then treatments don't work. And and I think that's kinda what's been as I understand it, I don't spend too much time on TikTok. First of all, I don't have too much time, and secondly, I it frightens me. But I I understand that that's what goes on on TikTok. The people are who knows who are diagnosing everybody without credentials, you know, and that's I think that's quite dangerous.

Interesting. And so when you talk about resilience and you talk about people that are overly diagnosing themselves as having kind of suffered from this trauma, are there ways that you think we can reframe this that would be more positive for people? That's a good question. I think that we could I mean, we'd have to start with the idea that knowing really what happened and getting a clear sense of what happened and what you're struggling with is the best way to toward health, you know, and we can provide people with tools. There are plenty of tools as I was saying that that we know about, you know, and there are tools for health in general, you know, and that we that people can learn about and use, tools for anxiety, you know, etcetera.

I mean, there in theory, the community on the Internet is potentially useful where people can support each other and provide a sense of, you know, there are other people with the same problem. It's just seemed to have gotten out of hand. But if we can reel it back a little bit to where there's a supportive community of people with a sort of a known problem, that can be useful. But I think the idea really needs to be planted in people that really have to get a sense of what actually the problem is if there is a real problem and where it's coming from. And then in a sense of respect for the idea that there is a body of literature out there, body of scientific and clinical literature that really can help distinguish these different kinds of problems and and sort of in a sense get it right.

It's not always easy to get it right, but to really nail, you know, what is it that this person is struggling with and then take it from there. As a society, how do you see discussions around developing grit versus, for instance, being more soft pulling into into our society? I don't know if I can answer that question. You know, grit is basically an idea of perseverance. I don't know that much about grit per se, but, you know, perseverance and goals and, you know, working towards things.

I think if I understand your question, maybe maybe I misunderstood for a moment there that there is a tendency to treat people these days as as very fragile. You know, I gave a talk. I did some work with firefighters. Firefighters work hard, you know, and they put 200 pounds on their back when they go out to a fire, and they they put themselves at risk. They're dedicated people.

And I gave a talk today at one of the firefighter conferences, and the moderator said, okay. Does anybody have a question for George? And I waited. There was a very unpleasant or uncomfortable silence for a few minutes there. And then finally, somebody raised their hand, and they said they wanted to know, what is it that makes young people such snowflakes?

And I didn't really know what to say at first, but I realized that that's kind of a perception that they had that what is wrong with young people? Why are they so fragile? And it was amusing in a sense, but I think that, you know, one of the things that happens in life is that well, here, let me think it put it this way. We are really wired to to adapt, and I I mentioned this, but we our brains are we have the most flexible brains in the animal kingdom. We have more neurons than any other creature, more cortical neurons.

We take longest to develop than any other creature on the planet to fully develop. It take twenty five years for our brains to mature. And all of that is in the service. It's an evolutionary strategy. And the strategy is that we can we're continually adapting.

We're born completely helpless, and eventually, we begin to be a little bit less helpless, but it takes a long time. But all that because our brains are large and we have a lot of development, but that also makes us enormously flexible. We can adapt and change, and we really have that skill as human beings. And that means that we can adapt to things. We can tolerate mistake.

We can tolerate failure. We can tolerate mistakes. We can learn from by trial and error. And there's all the research on how people learn. It's all about trial and error.

So it doesn't do anybody any good to protect them from mistakes. And I think that's kind of a a road we've gone down a little bit. And I know in the university life where I I teach at a university, there's a a real push or has been a real push to protect students from any discomfort at all. And I think that's a serious error because learning is about discomfort in a sense. Learning is about resolving information.

Learning is about growing, and there's pain in learning. I don't see how we can move forward without that. So I'm look I worry to some extent that as you put it soft, that we get a little bit soft about these things, you know, that that in an attempt to protect people, but I don't I think it's a disservice. So what I I hear you saying almost is that there is real trauma that can hit people. But even in that situation, because we're so adaptable, eighty five percent of us can get through it.

And that some of this is a perception that we've developed where when there is pain or anxiety, it overwhelms us because we almost feel like there's something wrong with us. And instead of realizing that we have the resilience to work it through, we kind of panic Yeah. And lean into it and think there's something wrong with us instead of, from an evolutionary perspective, understanding that pain, in a sense, is something that we can work through and that we should not be so afraid of it, but rather embrace the journey. Absolutely. I would agree with everything you said.

Yeah. 100%. So some of it is just changing I mean, again, it's interesting because as a as a society with so much success in terms of scientific's ability to deaden pain, you know, take a pill for this, take a pill for that, we almost see pain as a failure. But it sounds like what you're saying is that we have to be able to distinguish between real, real pain that we are stuck with versus what most of us can work through in a sense almost like you're saying with grief, right? That the mystics and and from a religious perspective have talked about the period of mourning, and that if you lean into the grief, you will get to the other side of it.

It's almost like you're saying that with trauma or these potentially traumatic events, if we don't panic and we lean into it and we embrace it, that we we have more capacity to work it through than we might understand. Absolutely. And I think that that's absolutely true that pain and struggle are the only way we get through some of these things. And I I think we're frightened of it, and we tend to try to push it away or avoid it because it hurts. It's uncomfortable.

But pain and struggle are are absolutely necessary, and they usually don't last very long once we sort of dig in and deal with them because and, you know, stress is essential. We have an incredibly good stress response system. It's conserved across evolution. We share a lot of the stress response system that animals have, but we have more. We have a cortex that helps us regulate.

We have we have a very a really solidly working stress system. If we're in a state of high stress for a long time, a month or more, then we start to break down a little bit. But usually, we don't need to go that long. Stress does its job pretty quickly. You know, when we're confronted with a major stressor, our bodies instigate a cascade of hormonal responses called the HPA axis that sends cortisol to our brain.

Cortisol reaches our brain and ramps it up right away, turns it up, turns up the heat in a sense for what we can do. We get more energy. We focus our brains. We think. We learn.

Then cortisol doesn't leave our system for a couple hours. It's just the way it works. Right? It reaches a peak after about twenty minutes and gradually decreases. It's designed that way.

We assume it's designed that way, but that's what we have. And it works really well. So instead of being afraid of that, afraid of feeling unhappy, uneasy for a little bit, we really do need to brace the idea that that's a normal response, and it's an adaptive response. It's hugely adaptive. So if it's a normal response, how would mindfulness, developing the third eye, meditation help people in these areas?

Those are all tools, I think. The daily practice of meditation teaches you things about yourself. It gives you a little bit of distance. It allows you to watch yourself a little bit more objectively. So you can actually see these things working in your body, in your mind.

You can actually see them. But nothing is a 100% effective all the time. So meditation and mindfulness are tools for certain kinds of circumstances. When you're in the midst of a seriously difficult event where your, you know, your emergency response equipment is is firing, you know, there's a major threat, you're not gonna sit down and meditate at that point. Right?

There's a little cartoon that's floating around the web of a woman being burned at the stake in the medieval time and another woman coming up to her and saying to her, have you tried yoga? And yoga is great, but you're not gonna use it in that situation. So mindfulness meditation is more for those quiet times that we can, you know, pull away from the world, and it might help us reflect. It might helps us helps us to see ourselves from a little more objectively and a little bit more, you know, remotely. But it's a tool for that time.

It's, you know, and it's a it's a useful tool. It's a very good tool. Guys, I always think the more tools we have, the better to get through our life's life's challenges. So we have these tools out there, as you said, that help us get through these life challenges. I also know you've talked about that you're not a big fan of psychiatric diagnosis.

What's your concern there? Well, psychiatric diagnosis the the way I put this, I think most often is psychiatric diagnosis are societal tools masquerading as scientific tools. Okay. They are designed to allow us to identify kind of a certain threshold where a person might need help. We use them even more often that we use them to determine who's going to pay for something.

They're, you know, they're for insurance purposes or for payment purposes and they're perfectly good for that reason. But they're not all that scientific And they're potentially dangerous because they suggest that these things exist in nature and they don't exist in nature. They suggest that PTSD is a thing that was sort of animals have PTSD in it when we came along and discovered it. Animals can feel can be traumatized. Humans can be traumatized, but there is no clear category where you're you are and not traumatized.

You know, it's all it's all a long continuum. But we don't need we don't want to continue. We want the category, and the categories are artificial. They also imply that everything is biological, and that's not true either. You know, there's no biological cause for PTSD.

There's no biological cause for depression. You can have a genetic disposition to something, but that explains a little bit of it. But I think there are a lot of myths and misunderstanding about diagnoses. And I used the word before life sentences, and they're not actually that's not what they are. They're descriptive, and they're descriptive of current states.

And they're useful in that regard as long as we keep it clear. They're also made up. You know, that diagnoses are the result of a bunch of people in a room arguing, and they really argue. You know, it's a kind of a shouting match. So they're useful if we keep a a clear head about it.

We're useful if we keep it clear that that's what they're for. They're they're these societal tools so we can categorize people in a way that says, okay, you probably really need help now with this. You meet this category. And we can study this category, but it doesn't actually happen that way in nature. When you talk about those people, have there been studies done or an understanding of, for instance, why certain people are more adversely affected by trauma?

That fifteen that really do end up with PTSD. I mean, do we understand why that's the case? To some extent. One of the I mean, it's the same thing with resilience. The people that are resilient, we also understand to some extent who those people are, but it's a lot more complicated than we generally believe.

So there's a as I mentioned, there's some genetics to it. You know, there's some genetic disposition that explains a little bit of it. People's life experiences, usually it's a serious history in the past of, you know, chronic caustic environments like chronic abuse or, you know, chronic exposure to violence or, you know, growing up in a civil war. You know, those kind of things can, in a sense, they create what what we call epigenetic changes. They're a little bit changes in the way genes are expressed that can make people more or less susceptible.

Again, it's a matter of degree. Right? There just gives people a little bit more of a of a vulnerability in that regard. And everything that we've ever identified is a little bit more of this or a little bit less of that. There is no one thing anybody's ever found.

It's, oh, you have this. Now you're going to get PTSD. You're you're really, you know, really at risk, and we just don't find that. So that's what we have. We have the sense of, you know, you're you're likely to be a little bit that way or or a little bit less that way.

So if people, you know, have more stable environments growing up. I mean, for instance, in the world of attachment therapy, John Bowlby and otherwise talked about the early childhood experiences and how important that was to develop a secure base and to feel that the world is a safe place. For people that come out of those environments where they are more securely, you know, attached as children, does that have any impact on how they deal with these traumatic events that happen later in life? I don't know. I don't have a great answer to that, but probably a little bit.

Yeah. It's probably a little bit. I mean, there have been some interesting insights into this over the years. So to take the thing that's studied most is say, chronic abuse for children, either chronic violence or chronic sexual abuse. It does change the way people function.

It does increase their risk, but people can also live fully happy, healthy lives if they find a way to be in the world that accommodates the way they are. So and that sounded more I didn't mean that to sound critical. What it means is that, you know, say here, here's a great example. Children who are raised, who are neglected as children, children who are either, not taken care of or there's nobody around or, you know, see this often in poverty where there's just simply nobody around or they're pushed away a lot as children, they develop a kind of precocious organization of the brain earlier. They learn to be self reliant earlier than other kids.

And that actually results in the brain being organized a little bit differently than other kids. Things that would get connected up in adolescence get connected up a little earlier, and they're sort of precocious self reliance. There's a cost to that, which they're a little bit less adaptable, a little bit less flexible in other contexts. They can grow up and have happy, healthy lives like anybody else. They simply live in a world where that it's not they're not demanded of adaptation to new things is not so demanded of them.

And that's common in many ways with people that, you know, the what we grow up with shapes who we are. And it's still possible that we might even you know, there's a lot of adaptability even in adulthood, and we can still change and adapt as adults if we wish. You know? So these are all, again, vulnerabilities. Even some of the more extreme situations are vulnerabilities.

You know? There's been a lot of research on on attachment, and when is it you know, when is there a sort of a point of no return? And it's a pretty severe point. There were the famous studies of these, orphans in Romania, and they were basically just left in these cribs almost as almost unattended. And, when the I think it was when the, when the Soviet Union fell and Romania was opened up, that a lot of those kids were brought to other countries and nurtured.

And there was a kind of a certain point when they could generally be kind of nurtured to the point where they would begin to develop more, like other children, more able to give and receive affection, etcetera. But the the point of no return was pretty old. I think four or five years, something like that. I don't remember off the top of my head. That's pretty severe.

I think for most people, they grow up in certain situations. They can always, you know, adapt as they get older. And, you know, the world is also, rich with different kinds of people. So we don't want everybody necessarily to have the exact same experience either. Even if we could, we can't do that, but we don't want that.

In speaking about different people, I mean, the longer lasting effects of trauma, as I understand it, usually do go away. On the other hand, when they don't go away, we get into that realm of PTSD. How do we chart those different journeys? The only way to chart them is to really just track it over time. And in doing that, we do find that there's some people again, most people get over, but there's this limited group that don't.

Yeah. And we're doing more and more to understand what the differences are in terms of why some people are able to get over and why some people aren't. Well, the in the work that I've been doing and other people have been doing, we actually do this kind of thing where we we chart people over many years. Right. And if we can, we chart them even before something happens.

And what we find is there are a couple of prototypical patterns that we see over and over and over. So some people develop this sort of chronically elevated symptoms, pathology, something like PTSD. Other people, the majority of people show a little bump after the event happens for, you know, maybe a week or two or a little longer. And then they return to a kind of what we call a stable trajectory of health. They're basically relatively few symptoms and no enduring cost of that event.

Then we see other people who who about sixty six percent, about two thirds on average show that resilient pattern. We see some people who show this dramatic increase in symptoms, we'll call it acute symptoms, and then they gradually return the kind of the normal health level again, the baseline. That takes a year or two for those people. So that's a pattern we call the recovery pattern, but those are people who struggled and then got over it. And then there's another pattern we talked about this before, not delayed, but a kind of a worsening pattern.

We sometimes see other other patterns as well for different types of events. So we know about these different patterns, and there isn't as much, I think, known about them as there should be. We're still trying to understand all that. Makes sense. The one thing that I would point out is that this is really what all of my work is focused on right now is what we're calling I call it regulatory flexibility or we call it self regulation flexibility.

But it seems to me that what most people are doing to get through these events, through aversive events, is they are kind of there's a series of steps we've been able to identify. But they're basically adapting. They're figuring out what's going to work for this situation. Because every situation, every challenge is different. You know?

And even if we take things that we would consider traumatic events or potentially traumatic events, they're all different. Being in a terrorist attack is different than being assaulted, which is different than being in a natural disaster or a loss or a disease pandemic or a medical emergency. You know, all of these things present different challenges to us. And even the same people in the same event will experience them differently and have a different challenge. Because of that, we kinda have to figure out what's going to help get me through this situation.

So we looked at the people vary in their ability to read situations, people vary in their kind of tools they have at their disposal, their repertoire of tools and people vary also in the third piece of this puzzle is that we correct as we go along. We pay attention to the consequences of what we've done and we decide, okay, this didn't work. I'll try something else. Some people don't pay as much attention to those things. Sometimes people will try something to get through an event and it doesn't work.

And instead of trying something else, they feel like they're failures and they give up. They tell themselves I can't do this. So this process, which I call regulatory flexibility, has these pieces we've been able to identify really clearly. We do a lot of research on this now. And these are all learnable in a sense.

And I think this is a really important this concept of flexibility is a very important way that we as a people, humans can can kinda get a grip on these things that happen and, let's say, enhance our ability to adapt even more than we do. The research shows pretty clearly that we most people are already able to do this pretty well, which makes sense. If most people are resilient, most people should be able to do this. But there are also tools that people can practice and and improve in their own lives. And finally, do you think that since we've had this resilience that's built up over the millennia and that people are flexible and more flexible than than they don't, Reminding them of that in terms of in the modern world where they are being triggered by social media and other things, do you think there's ways in which this new way of thinking can help people realize that there are, as you said, these tools and ways to get through these things and navigate and then not be so victimized by our current situation?

Oh, I think so. I mean, I think in part, we have to sit down and ask ourselves. We always have to ask ourselves, what is the problem? What's happening? And that takes a little bit of insight.

It takes the realization, say, with the news and social media and whatnot to realize there may be a bit of a problem, you know, not necessarily an individual problem, you know, where I'm not talking addiction to social media, but really just the idea that did this make me happy just now or did this make me feel worse going on the web for a half an hour? You know, and we all know what this is like. You go look up something on the web. You go to see about a program or look up a piece of information on the web, and you get sucked into these little pictures on the side, you know. And then before you know it, a half an hour's gone by and you're looking at stuff on the web that has nothing to do with anything and is making you feel lousy or getting bombarded with images that make you feel lousy.

And we just have to first I guess the first step is just realize that's not a good thing, And then maybe what can we do about it? And these tools are out there for anyone to use in their lives. The the things I described and all kinds of other tools that I mentioned, mindfulness and other things. They're all there, you know, at our disposal. And we just have to, I guess, decide to make that change.

Makes sense. George, this has been terrific, and I really, really appreciate your time, and and I urge our listeners to read your book and to dig into this. Are there other places that people can find you, for instance? I mean, I know you've got your book, but, for instance, do you do lectures? And I know you're a teacher, but are there other ways that people can find you?

I do lectures often in public, public lectures, somewhat, I should say, randomly and haphazardly, unfortunately. I do have a website. If somebody googles my name, my website comes up. The website at Columbia for my laboratory, but I also have a personal website that has lots of information on it. And there's a lot of resources on those sites and yeah.

Georgia, we really appreciate it. Enjoy this very, very much and hope the journey continues, and let's stay in touch. Thanks a lot. Very nice to talk to you too. Okay, George.

Thanks. Alright. The POC Venture Capital Beyond is produced by CMPG Advisors. If you enjoyed the conversation today and haven't yet subscribed to our show, you can find us on iTunes, Apple Podcasts, and SoundCloud. Feel free to leave a review while you are there and maybe even a five star rating.

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