I know enough to follow my heart to
follow my passion and I hope all of you
will do that and accomplish great things
so for me my heart and my passion lead
me to working with people and working
with science and I brought them together
and followed the call to become a
psychologist for my first job I worked
at a residential treatment center for
severely emotionally impaver lis
disturbed kids and almost all of them
had been severely physically or sexually
abused I learned so much from these
young kids who had seen more in their
short life than I’ve seen in my gentle
many decades and they became the reason
why I was fascinated in PTSD to be
honest their minds were so resilient and
adaptive and found unique ways of
protecting themselves from the horrors
they’d known I needed to know more and I
just studied decided that I wanted to
study post-traumatic stress disorder
called PTSD so I should teach you a
little bit about this if you don’t know
yet PTSD focuses on trauma trauma
requires a life-threatening situation or
injury or a sexual assault this isn’t a
minor bad event this is a
life-threatening or sexually traumatic
event people with PTSD have nightmares
they react speery n’t
they think about this when they don’t
want to they might have flashbacks they
avoid people places things that remind
them of traumatic events they have
negative moods cognitions if you’ll
depress they feel guilty and they have
physiological arousal they’re always
ready for the next shoe to drop
they’re always ready and on guard and
watching against the next bad thing so
they don’t sleep well and they might be
angry and they’re always on guard but
bottom line
PTSD is the only major psychological
disorder that the cause is in the list
of symptoms PTSD is caused by trauma and
doesn’t matter what kind of trauma you
experienced physical abuse sexual
assault combat terrorism natural
disaster all of these traumas results in
the same set symptoms and the traumas
are experienced they’re re-experience
they’re avoided they’re guarded against
they swirl and they push and they pull
in this constant dialectic of attending
to danger and avoiding danger there are
great current treatments available for
reducing PTSD talk therapy is one of
those gold standard interventions and
all of them share in common a quality of
exposure therapy that means you go to
counseling for PTSD and you’ll talk to
your counselor in depth in detail in
horrifying detail about the worst day
the worst moment the worst second of
your life and you’ll do it again and
again and again until it doesn’t bother
you so much this is not fun therapy it’s
hard it’s unpleasant it’s expensive the
other major gold standard treatment for
PTSD is medication however there are no
curative medications in PTSD meds only
target associated symptoms like
depression or sleep disturbance or maybe
some anxiety so what do I know well
something is missing in the current
treatments for PTSD medications are
heavily prescribed however they don’t
target specific symptoms of PTSD gold
standard talk therapy is emotionally
draining for patient and provider and
clients drop out of talk therapy because
it’s too difficult to continue so I
decided that we didn’t just need to
build on existing interventions but we
so simplify take out Occam’s razor and
move from a focus on symptoms down to
the very core of PTSD and that very core
of PTSD is trauma so instead of talking
about all
the memories meanings interpretations
recollections that swirl at the top of
the funnel and usually is where talk
therapy works I want to shift and I want
to pay attention to the lowest narrowest
tip of the funnel and this is the way
people pay attention how people pay
attention to cues in the world that
might trigger a warning sign what do we
need to look at then we need to think
about how people experience trauma and
worry about re-experiencing trauma so
let’s think people are social people
people are very important to others one
of the greatest forms of threat is other
people so it’s important for us to be
able to recognize what kind of mood and
intention other people have and we tend
to know that via their facial expression
simple first gut reaction
what do you see a face I think most of
you gonna tell me it’s a face if you
look closely
well it’s fruits and vegetables or a
famous painting by Archibald oh but
really the first thing everybody sees is
the face the major message here is that
our brains are primed to see faces and
that means that faces must have an
important and major significance look
threatening faces pull our attention
immediately
it’s really important for you guys to
understand brain spaces high-end real
estate our heads are only so big so if
we’ve got a brain space particularly
designed to do a task we know that task
is important and one such brain space is
called the fusiform face area this is
the underbelly of your brain so looking
at your brain from the underside and
marked in red you’ll notice that this is
the fusiform face area and it’s engaged
when viewing faces a really cool thing
about our own facial recognition device
in the overlay here is it’s right next
door to our threat processing areas so
look the area here in red is going to be
called our amygdala part of our limbic
system and it’s the part of our brain
that reads threat
it reads danger
isn’t it handy that our own innate alarm
system is right next door in terms of
geography to our facial recognition area
this isn’t by accident this is by design
we look at the human brain and what you
can see here is that all of the major
tracks for all the different cognitive
processes we have they all intersect at
the limbic system which contains the
amygdala and the amygdala alerts us to
fear so what do we see here Dorothy and
her group of friends are going to go on
a walk through the haunted forest and
they chant lions and tigers and bears oh
my
wait let’s try that again no they chant
lions and tigers and bears oh my
the job of the amygdala is to read do we
have a threatening signal and what
you’re seeing on the board here is
research we’ve done locally looking at
combat veterans with PTSD against
healthy combat veterans top row the guys
who are doing well don’t have any
psychological symptoms their brains are
pretty quiet at rest their eyes are shut
they’re resting maybe daydreaming the
row underneath for the veterans with
PTSD same task eyes closed at rest and
their emotional processing areas are
busy they’re daydreaming they’re having
visual images and they have a lot of
activity in there threat alarm system
even though they’re in a room by
themselves and it’s quiet and it’s safe
so let’s think about this from a more
experienced you’ll point of view if
you’re somebody with PTSD the yellow
door here on this picture it gets all of
your attention this is like threat okay
you worry about this door you think
about this door you worry about what
might happen behind this door and you
avoid the other doors or maybe you’re
trying to look at another door and not
look at the yellow door but you’re hung
up on the yellow door at end avoid
attend avoid attend avoid so in my
intervention it’s so simple
people see two faces at the same time on
a computer screen ones normal one
angry if they see an angry face and they
have PTSD the brain sounds an alarm
that’s a big deal because people without
PTSD don’t have this amygdala response
people with PTSD who see neutral faces
don’t have this alarm either this
happens only in PTSD and it tells us
that the brain responds to threat
immediately and quickly this is a
bottom-up basic processing difference we
don’t have time to think about it so
here’s what happens over and over again
in the treatment I’ll show you a face
pair it’s there for half a second it
goes away the amygdala response is ten
times faster than that the amygdala
response that tells us one of those
faces is angry happens in 50
milliseconds let’s see it ready let’s
see it again how easy is it to even tell
what you’re seeing we aren’t looking at
a higher order cognitive process here
that requires the upper divisions of our
brain really all we’re looking for is
that bottom-up immediate evolutionary
response push let’s try that here you
guys take a look at the screen I only
want you to look for ours find the
letter R only look for ours where the
ours where the ours don’t look at the
other letters don’t see the other
letters find the ours
okay let’s try it again
quit looking at the ours the ours are
bad you don’t need to think about them
they’re threatening they’re gonna remind
you of your bad experience now I’d like
you to look for the e’s give it a shot
don’t look at the artists whatever you
do only find the e’s don’t think about
these r’s they’re gonna get you in
trouble
EEE okay bottom line I hope you see a
few more ease I’m sure you’re still
seeing ours and you’re probably noticing
very little else
so in PTSD we need to refocus attention
and take the overly threatening nature
out of normal everyday cues like a piece
of garbage on the side of the road that
reminds the Iraq veteran of the
potential explosive device so in my
intervention we
can now deliver this via computer people
see two faces they leave the screen an
arrow comes back in place they press
right or left and they do this so 150 or
so times and that’s it no sweat no tears
no crying in our research we find that
if we take the special meaning of threat
away they don’t have to attend or avoid
we get dramatic reductions in PTSD
symptoms and we get them so much
improved that almost all of them are
beneath the diagnostic threshold for
this condition which is really exciting
we also know what causes it with a
reduction in attend avoid attend avoid
we get a reduction in PTSD symptoms so
we know the causal modality here as well
and we can see it in the brain in the
top row you’re seeing brain differences
in activation or deactivation between
healthy and combat veterans after
treatment those differences are
essentially reversed meaning these
brains now look like healthy people
without PTSD and again the bottom of the
brain the amygdala is quiet and also
interesting in the picture next to that
the prefrontal cortex that normally we
try to activate in talk therapy it’s
also quiet
well why because it’s job is to tone
down the amygdala from a top-down model
my treatment tones it down from the
bottom up model makes seeing it simple
and easy a tiny intervention in a tiny
process can make a great difference so
in visual let’s revisit this again
after completing treatment people with
PTSD are not stuck only viewing the
yellow door
now all the doors are available all the
doors are interesting all the doors are
full of potential and they can be opened
for a healthy happy life so that
potential trauma cue that had bothered
them and thrown them into full-blown
symptoms prior to treatment it’s just a
drop and treatment allows them to see
the whole world to focus on what some
Fortin to them and this is a great joy
for me to be able to contribute to this
we’re currently finishing clinical
trials in hopes of being able to call
this treatment and treatment that’s web
deliverable easily accessible and almost
free
in science we usually end our talks by
talking about the people who contributed
to our DEA’s people who came before us
the Giants who stole shoulders we have
stood upon well I thank them and I thank
my collaborators but I want you all to
know that the greatest Giants the
strongest Giants that I have known are
the people who’ve had traumatic events
happened to them have shared their
stories with me
and allowed me to learn from them I
thank them and I thank you for your
attention today [Applause]
follow my passion and I hope all of you
will do that and accomplish great things
so for me my heart and my passion lead
me to working with people and working
with science and I brought them together
and followed the call to become a
psychologist for my first job I worked
at a residential treatment center for
severely emotionally impaver lis
disturbed kids and almost all of them
had been severely physically or sexually
abused I learned so much from these
young kids who had seen more in their
short life than I’ve seen in my gentle
many decades and they became the reason
why I was fascinated in PTSD to be
honest their minds were so resilient and
adaptive and found unique ways of
protecting themselves from the horrors
they’d known I needed to know more and I
just studied decided that I wanted to
study post-traumatic stress disorder
called PTSD so I should teach you a
little bit about this if you don’t know
yet PTSD focuses on trauma trauma
requires a life-threatening situation or
injury or a sexual assault this isn’t a
minor bad event this is a
life-threatening or sexually traumatic
event people with PTSD have nightmares
they react speery n’t
they think about this when they don’t
want to they might have flashbacks they
avoid people places things that remind
them of traumatic events they have
negative moods cognitions if you’ll
depress they feel guilty and they have
physiological arousal they’re always
ready for the next shoe to drop
they’re always ready and on guard and
watching against the next bad thing so
they don’t sleep well and they might be
angry and they’re always on guard but
bottom line
PTSD is the only major psychological
disorder that the cause is in the list
of symptoms PTSD is caused by trauma and
doesn’t matter what kind of trauma you
experienced physical abuse sexual
assault combat terrorism natural
disaster all of these traumas results in
the same set symptoms and the traumas
are experienced they’re re-experience
they’re avoided they’re guarded against
they swirl and they push and they pull
in this constant dialectic of attending
to danger and avoiding danger there are
great current treatments available for
reducing PTSD talk therapy is one of
those gold standard interventions and
all of them share in common a quality of
exposure therapy that means you go to
counseling for PTSD and you’ll talk to
your counselor in depth in detail in
horrifying detail about the worst day
the worst moment the worst second of
your life and you’ll do it again and
again and again until it doesn’t bother
you so much this is not fun therapy it’s
hard it’s unpleasant it’s expensive the
other major gold standard treatment for
PTSD is medication however there are no
curative medications in PTSD meds only
target associated symptoms like
depression or sleep disturbance or maybe
some anxiety so what do I know well
something is missing in the current
treatments for PTSD medications are
heavily prescribed however they don’t
target specific symptoms of PTSD gold
standard talk therapy is emotionally
draining for patient and provider and
clients drop out of talk therapy because
it’s too difficult to continue so I
decided that we didn’t just need to
build on existing interventions but we
so simplify take out Occam’s razor and
move from a focus on symptoms down to
the very core of PTSD and that very core
of PTSD is trauma so instead of talking
about all
the memories meanings interpretations
recollections that swirl at the top of
the funnel and usually is where talk
therapy works I want to shift and I want
to pay attention to the lowest narrowest
tip of the funnel and this is the way
people pay attention how people pay
attention to cues in the world that
might trigger a warning sign what do we
need to look at then we need to think
about how people experience trauma and
worry about re-experiencing trauma so
let’s think people are social people
people are very important to others one
of the greatest forms of threat is other
people so it’s important for us to be
able to recognize what kind of mood and
intention other people have and we tend
to know that via their facial expression
simple first gut reaction
what do you see a face I think most of
you gonna tell me it’s a face if you
look closely
well it’s fruits and vegetables or a
famous painting by Archibald oh but
really the first thing everybody sees is
the face the major message here is that
our brains are primed to see faces and
that means that faces must have an
important and major significance look
threatening faces pull our attention
immediately
it’s really important for you guys to
understand brain spaces high-end real
estate our heads are only so big so if
we’ve got a brain space particularly
designed to do a task we know that task
is important and one such brain space is
called the fusiform face area this is
the underbelly of your brain so looking
at your brain from the underside and
marked in red you’ll notice that this is
the fusiform face area and it’s engaged
when viewing faces a really cool thing
about our own facial recognition device
in the overlay here is it’s right next
door to our threat processing areas so
look the area here in red is going to be
called our amygdala part of our limbic
system and it’s the part of our brain
that reads threat
it reads danger
isn’t it handy that our own innate alarm
system is right next door in terms of
geography to our facial recognition area
this isn’t by accident this is by design
we look at the human brain and what you
can see here is that all of the major
tracks for all the different cognitive
processes we have they all intersect at
the limbic system which contains the
amygdala and the amygdala alerts us to
fear so what do we see here Dorothy and
her group of friends are going to go on
a walk through the haunted forest and
they chant lions and tigers and bears oh
my
wait let’s try that again no they chant
lions and tigers and bears oh my
the job of the amygdala is to read do we
have a threatening signal and what
you’re seeing on the board here is
research we’ve done locally looking at
combat veterans with PTSD against
healthy combat veterans top row the guys
who are doing well don’t have any
psychological symptoms their brains are
pretty quiet at rest their eyes are shut
they’re resting maybe daydreaming the
row underneath for the veterans with
PTSD same task eyes closed at rest and
their emotional processing areas are
busy they’re daydreaming they’re having
visual images and they have a lot of
activity in there threat alarm system
even though they’re in a room by
themselves and it’s quiet and it’s safe
so let’s think about this from a more
experienced you’ll point of view if
you’re somebody with PTSD the yellow
door here on this picture it gets all of
your attention this is like threat okay
you worry about this door you think
about this door you worry about what
might happen behind this door and you
avoid the other doors or maybe you’re
trying to look at another door and not
look at the yellow door but you’re hung
up on the yellow door at end avoid
attend avoid attend avoid so in my
intervention it’s so simple
people see two faces at the same time on
a computer screen ones normal one
angry if they see an angry face and they
have PTSD the brain sounds an alarm
that’s a big deal because people without
PTSD don’t have this amygdala response
people with PTSD who see neutral faces
don’t have this alarm either this
happens only in PTSD and it tells us
that the brain responds to threat
immediately and quickly this is a
bottom-up basic processing difference we
don’t have time to think about it so
here’s what happens over and over again
in the treatment I’ll show you a face
pair it’s there for half a second it
goes away the amygdala response is ten
times faster than that the amygdala
response that tells us one of those
faces is angry happens in 50
milliseconds let’s see it ready let’s
see it again how easy is it to even tell
what you’re seeing we aren’t looking at
a higher order cognitive process here
that requires the upper divisions of our
brain really all we’re looking for is
that bottom-up immediate evolutionary
response push let’s try that here you
guys take a look at the screen I only
want you to look for ours find the
letter R only look for ours where the
ours where the ours don’t look at the
other letters don’t see the other
letters find the ours
okay let’s try it again
quit looking at the ours the ours are
bad you don’t need to think about them
they’re threatening they’re gonna remind
you of your bad experience now I’d like
you to look for the e’s give it a shot
don’t look at the artists whatever you
do only find the e’s don’t think about
these r’s they’re gonna get you in
trouble
EEE okay bottom line I hope you see a
few more ease I’m sure you’re still
seeing ours and you’re probably noticing
very little else
so in PTSD we need to refocus attention
and take the overly threatening nature
out of normal everyday cues like a piece
of garbage on the side of the road that
reminds the Iraq veteran of the
potential explosive device so in my
intervention we
can now deliver this via computer people
see two faces they leave the screen an
arrow comes back in place they press
right or left and they do this so 150 or
so times and that’s it no sweat no tears
no crying in our research we find that
if we take the special meaning of threat
away they don’t have to attend or avoid
we get dramatic reductions in PTSD
symptoms and we get them so much
improved that almost all of them are
beneath the diagnostic threshold for
this condition which is really exciting
we also know what causes it with a
reduction in attend avoid attend avoid
we get a reduction in PTSD symptoms so
we know the causal modality here as well
and we can see it in the brain in the
top row you’re seeing brain differences
in activation or deactivation between
healthy and combat veterans after
treatment those differences are
essentially reversed meaning these
brains now look like healthy people
without PTSD and again the bottom of the
brain the amygdala is quiet and also
interesting in the picture next to that
the prefrontal cortex that normally we
try to activate in talk therapy it’s
also quiet
well why because it’s job is to tone
down the amygdala from a top-down model
my treatment tones it down from the
bottom up model makes seeing it simple
and easy a tiny intervention in a tiny
process can make a great difference so
in visual let’s revisit this again
after completing treatment people with
PTSD are not stuck only viewing the
yellow door
now all the doors are available all the
doors are interesting all the doors are
full of potential and they can be opened
for a healthy happy life so that
potential trauma cue that had bothered
them and thrown them into full-blown
symptoms prior to treatment it’s just a
drop and treatment allows them to see
the whole world to focus on what some
Fortin to them and this is a great joy
for me to be able to contribute to this
we’re currently finishing clinical
trials in hopes of being able to call
this treatment and treatment that’s web
deliverable easily accessible and almost
free
in science we usually end our talks by
talking about the people who contributed
to our DEA’s people who came before us
the Giants who stole shoulders we have
stood upon well I thank them and I thank
my collaborators but I want you all to
know that the greatest Giants the
strongest Giants that I have known are
the people who’ve had traumatic events
happened to them have shared their
stories with me
and allowed me to learn from them I
thank them and I thank you for your
attention today [Applause]
Please follow and like us: