Ifyou'vebeenlisteningtothispodcastforanyamountoftime, you'veheardmetalkabouttheISSTDandtheincredibleresearchers, clinicians, andadvocates I'vemetduringmytimeas a memberand a volunteerthere.
Thisorganizationhasbeendelvingintothescienceandbestpracticeoftreatingtraumaanddissociationforover 40 yearsnowandtheyhave a richcatalogofeducationalofferingsforbothprofessionalsandnon-professionalsontheirwebsite.
Dr. LeBloisisdeeplycommittedtousingheradvancesinneurobiology, behavior, andtreatmentstoreducestigmaandimprovecareforindividualslivingwithPTSDanddissociativeidentitydisorder.
So I havetoaskfirst, how's everythinggoingwiththebabes?
それで最初に聞きたいんだけど、ベイビーたちとはうまくいってるの?
Becauseyouand I hadkidsrightaroundthesametime, soit's kindof a miraclethatwe'rebothhere.
あなたと私はちょうど同じ時期に子供を授かったから、私たち2人がここにいるのは奇跡のようなものだわ。
It's beenquite a journey.
本当に長い旅だった。
Yes.
そうだ。
I feellikeyoucaptureditrightthere.
私は、あなたがそれを正しく捉えているように感じる。
Yeah, butthingsaregoingreallywell.
ああ、でもすごくうまくいっているよ。
Itdoesfeellike a lot, andit's prettyintense, butit's morejustliketheextremes, just a momentofjoy, andinstantly, threesecondslater, thepitsofdespairkickoff.
I'm alreadylike, ohmygoodnessgracious, it's a lot.
もう、ああ、大変だ。
Thisishowhumanitycontinues.
こうして人類は続いていくのだ。
Wow.
ワオ。
Okay.
オーケー。
There's a lotthatgoesintoit.
いろいろなことがあるんだ。
I thought I wasaware.
わかっているつもりだった。
I'm notthataware.
そこまで意識していない。
Now I'm learning.
今、私は学んでいる。
So I'm curious, justtostart, I alwayslovetojustgoto a littlebitofyourbackground.
まずは、あなたの経歴を少しお聞かせください。
Howdidyoucometolearnabouttraumaanddissociation?
トラウマや解離について知ったきっかけは?
Howdidthisbecomesuch a bigpartofyourworld?
なぜこのようなことがあなたの世界の大きな部分を占めるようになったのですか?
Yeah.
そうだね。
I guess I feellike I'velearnedthemostfromourresearchparticipants.
私は研究参加者から最も多くを学んだように思う。
They'vebeenthebestteachersforme.
彼らは僕にとって最高の先生だった。
Hearingthemtalkabouttheirexperiences, whatit's likeinsidetheirmind, hasbeensofascinating, andthen I thinkatthesametime, I hadthegreatfortuneofgettingconnectedwithDr. MelissaKaufman, who I nowjointlydirecttheDissociativeDisordersandTrauma
And I think I'm someonewho's alwaysbeenfascinatedeversince I waslittlebypeople's stories, andthatmomentwhereyou'reinconversationwithsomeoneandyoucanseeorfeelthattheyfeelseen, it's justsothrillingtome.
So I wanttotrytotranslate, and I knowwe'renotgoingtolikegothrough a PowerPointhere, but I, youknow, I'veseenyoupresentalso, I thinkitwasthegrandroundsatHarvard.
So I'm justwonderingifyoucanstarttospeaktosomeofthethingsyou'veseenasyou'vetakeninthisfMRIdata, asyou'veworkedwithpeoplearoundlikechangesinthebrainwithpost-traumaticstress, withPTSD, and I thinkwecankindofteasethatout.
I thinkitdoes, thecontextofitdependssomuchormatterssomuchrather.
そうだと思う。その文脈はとても大きく左右されるし、むしろ重要なんだ。
SowhatweasksomeonetodointhescannerwillreallydictatewhatlooksdifferentintheirbrainiftheyhavePTSDversusnot, orhave a morecomplexpost-traumaticadaptationlikeDID.
And I'm justgoingtorepeatthose, PTSD, post-traumaticstressdisorder, dissociativesubtypeofPTSD, andDIDordissociativeidentitydisorder.
PTSD(心的外傷後ストレス障害)、PTSDの解離性サブタイプ、DID(解離性同一性障害)。
Yeah.
そうだね。
And I, there's a woman, SachiNakajima, whohasthis, I lovehermetaphorof a rollercoasterforhowtodescribethedifferencesbetweenthosethreedifferentconditions.
So I guessfirst I shouldsaySachiis a nonprofitfounderandshe's a lecturerandanauthor, andshe's alsoopenaboutbeing a survivorofdomesticviolenceherself, butshetalksaboutforPTSD, imagineyou'reon a rollercoasterandyou'refeelingthatreallyintenseadrenalinerush, andit's a frighteningexperienceforyoutobeonthisrollercoasterversusthedissociativesubtypeofPTSD, whereimagineifsomehowinyourmind, youcanmakeitfeellikeyouwerestandingontheground, watchingyourselfbeontherollercoasterprovidesthatlevelofdetachment.
Sothesearefolkswhoreportfeelingsofdepersonalizationandderealizationwheretheyfeel a senseofdetachmentfromtheirbodyortheirsenseofselfortheirsurroundings, whereitfeelslikethey'rewatchingthemselvesfromaboveorthey'rein a movieorin a dream, somethinglikethat.
Sothat's whereyougetthisaddedlayerofdissociationwherepeoplelose a senseofagencyandownershipoversomefeelingsormemoriesoractionsorthesenseoftheirbodytothepointwheresometimesitcanfeellikeit's someoneelselivingintheirmind.
I thoughtyouweregoingtogotolikepassedoutontherollercoaster, right?
ジェットコースターで気絶したように行くんじゃなかったのか?
Likethat's like a meme, probablysomewhereyoucangetsomeonewhojustgotsoafraidontherollercoasterthattheyjustpassedout.
それはミームみたいなもので、おそらくジェットコースターで怖くなって気絶した人がどこかにいるはずだ。
Andthentheycometotheend.
そして、彼らは最後を迎える。
They'relike, arewestartingyet?
まだ始まらないの?
Andyou'relike, oh, italreadyhappened.
そして、ああ、もう起きたことなんだ、と。
Yeah.
そうだね。
Yeah.
そうだね。
I likethat, Lisa.
気に入ったよ、リサ。
I thinkmaybethatthatcouldbelikecertainexperiencesinDIDwhereitfeelslikeyouweren't therefor, um, oryou'relikehavethat, thatfullamnesiaof a fullydissociatedexperience.
So I thinksettingthestagewiththosedifferenttypesofpost-traumaticadaptation, andthenasfaraswhat's goingoninthebrain, whensomeone's feelingsymptomatic, um, thewayresearcherstypicallystudythis, they'recalledsymptomprovocationparadigms.
AndsotypicallywhathappensinthisparadigmforsomeonewithoutPTSD, uh, isthat, well, actually I shouldfirsttalkabouttwokeybrainregionsthatoftencomeupinthisparadigmandhavebeenstudied a lotinthetraumaliterature, theprefrontalcortexandtheamygdala.
Andsoforsomeoneinthissymptomprovocationparadigmwhodoesn't havePTSD, typicallywhatyou'd seeis a rapidactivationofamygdalatohelpmount a fullbodystressresponsetodealwiththisthreateninginformation.
AndthenforfolkswithDID, SimoneReindershasdone a lotofthisworkinthisparadigmwhereshehasfolks, sheandherteamhavefolkslistentothetraumanarrativeintwodifferentself-states.
Andthenalsohasthemlistentothetraumanarrativewhenthey'rein a differentstatewheretheyfeelmoredistanced, morenumbanddetached, andlessownershipoverthememorytothepointwheremaybeitfeelslikeithappenedtosomebodyelse.
I wouldgenerallysaythemoreseverethetraumais, themoreimportantitisthatyou'reworkingwiththosedissociativeparts.
私は一般的に、トラウマが深刻であればあるほど、解離部分と取り組むことが重要だと言っている。
Sowewanttobeinserviceoffolkswhohaveexperiencedthesereallysevereandongoingandcomplexanddevelopmentaltraumaandhavedevelopedwaystoadaptanddealwithit, likestandingontheground, watchingtherollercoasterorbeing a differentpersonontherollercoasterandlikereallyservingthosepeopleaswellasfolkswhoareintheabjectterror.
I thinkwe'renotquiteat a pointinthefieldwhereweknowifthedifferenceskindofpre-existedtheconditionorifthey're a resultofhavingthesesymptomsandlikeyousaid, youknow, becomingthishabitualresponseovertime, though I supposeto a certainextent, wearelesscertainaboutthatinthefunctionaldataaswell.
Butonefindingthatcomesuptimeandtimeagain, andthey'venowdonereallyhugeconsortiabasedstudieswithhundredsofpeoplewithPTSD, a commonfindingthathasbeenreplicatedisthatthehippocampusissmallerordifferentlyshapedforpeoplewithPTSD.
Andsothatkindofhas a lotoffacevalidityifyou'reconstantlyactivatingyourstresssystemthathasstructuralchangesintheimpactofstructuralchangesinyourbrain, especiallyinareasthatarereallysensitivetoit, likethehippocampus.
I'm not a neuroscientist, butlike I dounder, asfaras I understand, ourbrainisalwaystryingtodecidelike, whatdoweneedtokeepandwhat's justrecycleit, moveon.
Andsobinding, likesiftingthroughallofthatand, andlikeyouweresayingwiththebasalgangliaoflikeprioritizingorchoosing, that's what I heardfromwhatyouweresayingislike, there's thistaskswitchingandintegrativealmostfunctionthere, I wouldwonder.
Andhowit, howitspeakstoothernetworksinthebrain, I thinkwillbekeyto, especiallyinDIDeithertoallowthemtodoreallyamazingthingsintheirmindandwiththeirattention.
Ifyou'relisteningtothispodcastthinking, I wanttolearnmorebody-basedtoolstohelpsupporttraumarecovery, thenyoumightbetheperfectcandidatefortheYogaforTrauma
And I, aswe'retalkingaboutthesedifferentregions, I'm awareofjusthowcomplexanythingisandhowharditistoevenisolatedifferentareasandsay, thisiswhatthisdoesandthisiswhatthatdoes.
I thinkthere's a carefullinetowalkbetweenmakingsomethingreally, likeyousaid, liketangible, translatable, easytoexplainandstillholdinghowcomplexitreallyis.
Soyeah, I thinkit's reallycomplexandthatmakesitreallychallengingtobelike, okay, howcan I, whatcan I reallysayaboutthesefindingsthatdoesn't soundreallyabstractandhand-wavyandismoreexcitingthanjustlike, thereis a differenceinthisonetaskbecausethere's somuchmorewecansayfromit.
So I thinkourteamtriestobereallycarefulabouttryingtotranslateitsoit's accessiblebeyondexpertneuroscientists, butstillnotbeingsoreductivethatit's misleading.
Oneofthethings I thinkisreallyimportant a littlebitalreadyisjusttheir, theparadoxicalnatureoftheminthatthey'reboth, youknow, yourmind, yourbrain, yourbodyadapttotheenvironmentthatyou'reinreallybeautifullytohelpyousurviveitandmakeitthroughtotheotherside.
Andyou'relike, oh, I mean, I'vehadthatas a client.
そして、あなたは、ああ、つまり、私はクライアントとしてそのような経験をしたことがあるんだ。
Like, oh, that's notanissueanymore.
ああ、それはもう問題じゃないんだ。
Youknow, it's been 12 weeksandthatwasnoteven a thing.
もう12週間も経っているのに、そんなことはまったくなかった。
But I'm stillhereand I stillthinkthingsarerough.
でも、私はまだここにいるし、状況はまだ荒れていると思う。
Right?
そうだろう?
That's interestinghowweworkthatway.
僕らがそういう風に動くのは面白いね。
Yeah, thatisfascinating.
ああ、それは魅力的だね。
Itmakesmealsothinkof, I haven't lookedintoherworkin a longtime, butthere's a researcherinChicago, hername's SusanGoldenMeadow, andshelooks a lotatgestureandshe'llshowthatlikewhenyou'relearningsomethingneworyou'rejustabouttogettherewithsomenewconcept, you'llshowitsometimesinyourgestures, inyourbody, likethecorrectanswer.
Theexamplethat's comingtomindis, I thinkshe's didsomeworkwithchildrenlearning a newmathconcept, likemultiplicationordivisionorsomething, andthattheirhandwouldactuallypointtotherightanswerastheyweresayingthewrongone.
Sowe'reabletolookatthatanduseittopredictwhatfolkshadputdownon a selfreportoftheirlevelsofdissociationto a certainextent.
だから、それを見て、解離のレベルについて自己申告した内容をある程度予測することができる。
Weweren't abletopredictthewholekibbutz, butwe'reabletocarveout a pieceofitandpredictthat.
キブツ全体を予測することはできなかったが、その一部を切り出して予測することはできた。
Andso I feelexcitedaboutthatfindingbecauseit's thisproofofconceptfirstattemptat, canwetake a, quoteunquote, objectivemarkerofdissociationinsomeone's bodyorbrainandpredictwhattheywouldsayon a selfreport?
Andthensomethingthat's hotoffthepressesincollaborationwithDr. AnnShin, who's thisexpertinpsychoticdisordersandpsychosis, inoursamesample, so a lotoffolkswith
Soshefoundthat a lotofthesameregionsinthebrainthatareimplicatedinvoicehearingandschizophreniaareactive, butthey'recommunicatingdifferentlywitheachotherinPTSDandDIDcomparedtoschizophreniaandactuallyshowinganoppositepatternwhereinPTSDandDID, there's thisoverrecruitmentofdefaultmodenetwork, whichis a networkinthebrainrelatedtoself-relatedthinking.
So I thinkit's thispotentialuniquemechanismtodistinguishvoicehearinginPTSDandDIDfromvoicehearinginschizophrenia, thoughwehaven't donethedirectcomparisonwithpeoplewithschizophreniainthesamestudyunderthesameconditionsyet.
That's kindofthenextfrontier, but I feelreallyexcitedaboutthatbecause I'm sureasyouknow, Lisa, sooftenpeople, ifyou'rereportingsomesortofvoicehearing, youkindofautomaticallygetbucketedin a psychosiscategory.
So I'm alwayssadwhen I hear, andthissometimesisevenpersonally, like I get a lotofpeople, like I wenttoelementaryschoolwhoreachoutandthey'relike, help, mychildormypersonneeds a therapist.
だから、私が小学校の同級生だったような人たちが、私の子どもやその人にセラピストが必要なんです。
Andhere's threepoints.
そして、ここに3つのポイントがある。
Andsometimes I hearstoriesorclinicalreferralstoofpeoplewhoarehearing, reportingthatthey'rehearingvoicesandjustgettingthetidbitlike, oh, thereis a traumahistoryandthisishappeningandthey'rediagnosedwithschizophrenia.
Um, andso I feellikethis, I thinkaboutthis a lotas a parent, when I havethosemomentsoflike, uh, I didnotshowupinthewaythat I wantedormyemotionregulationwasnotwhat I wantedinthatscenario, butit's justlikesocalmingtokindofknowthat I cancomebacktoit, youknow, intheafternoon, reactivatethatmemoryforthem, openupthattraceagainand, uh, do a repairtalkabouthowitwasn't theirfault.
Andso I, a metaphor I wasthinkingaboutrelatedtothisisit's almostlike I'm a musician.
それに関連して考えていた比喩があるんだけど、僕はほとんどミュージシャンみたいなものなんだ。
So I likethinkingaboutitinthisway, butthememoryisliketheoriginalsongthatgotlaiddownandyoucangobackandadd a harmonythatbrightensitup a littlebitandthenhelpsthemfeelnotasalone.
I sing a littlebit, lovesingingharmoniesand I playthefiddle.
ハーモニーを歌うのが大好きで、バイオリンも弾くんだ。
Awesome.
素晴らしい。
That's fun.
楽しいね。
Thatsoundsfun.
それは楽しそうだ。
Doyougettoplaymuchthesedays?
最近はあまりプレーできないのですか?
I feellikeyourlifeissofull.
あなたの人生はとても充実しているように感じる。
Yeah.
そうだね。
Muchlessthan I didbeforekids, butmorerecently I'vekindofclawedmywaybacktoit a littlebittocarveoutsometimebecause I findit, um, I lovebeinginthatheadspaceand I missit a lot.
Cause I usedtolovethelittlemermaidwhen I wasyounger.
リトル・マーメイドが大好きだったんだ。
Amazing.
驚いたよ。
It's mymusicstory.
私の音楽物語だ。
I loveit.
とても気に入っている。
Well, it's alwaysthere.
まあ、いつもそこにある。
It's alwaysthereforyoutoreturnto.
いつでも戻ることができる。
Right.
そうだね。
I canbuildsomeharmoniesinthere.
そこでハーモニーを作ることもできる。
So I feellikeyourworkissorich, hassomuchdepth.
だから、あなたの作品はとても豊かで、深みがあるように感じる。
Ifsomeone's justlearningaboutyourwork, youandMelissaKaufmanandalltheresearchteamsthatyou'veworkedwith, wherewouldyousendthemtogettojustnextstep, get a littlebitmoreandstartexposingthemselvesmoretowhatyou'vedone?
Andsothatwillreallytakeyou, I think, tothenextlevel, a deeperdiveintoDID.
そうすることで、次のレベル、つまりDIDをより深く掘り下げることができる。
And I feelreallyexcitedaboutthiscoursebecauseasyouknow, LisaDIDissounderstudiedandmisunderstoodoften, andit's not a partofpeople's trainingprogramsinhealthormentalhealthprofessions, butitsprevalenceissohigh.
ローレン・ルボワ博士と学ぶトラウマと解離の神経科学 - How We Can Heal Podcast S4 E9 (The Neuroscience of Trauma & Dissociation with Dr. Lauren Lebois – How We Can Heal Podcast S4 E9)