November 29, 2025 • 12 mins
This episode maps the biology of fear and trauma and explains why the brain can lock in threat after just a single experience—then shows how real healing requires replacing, not erasing, old associations. We break down the physiology of stress, the circuitry of fear learning, and the cognitive stories that shape how we interpret danger, safety, and meaning. The goal: a clear, evidence-based path to recovery using tools that reshape both body and brain.
We start by distinguishing stress, anxiety, and fear, then trace the HPA axis, adrenaline, cortisol, and gene-expression shifts that keep the body on high alert. You’ll learn how the amygdala acts as the threat hub, how it links to dopamine-driven salience, and how the prefrontal cortex becomes the storyteller that either amplifies or dissolves fear. We explain one-trial learning, maladaptive generalization, and why the gold-standard rule is extinction plus replacement—building a new association strong enough to override the old one.
The episode covers evidence-based therapies including prolonged exposure, CPT, CBT, and repetition-based relearning. We discuss the role of ketamine as a buffer that softens defensive responses and MDMA-assisted therapy for trust-driven emotional relearning. Finally, we highlight foundational supports—social connection, sleep, nutrition—along with cautions around cyclic hyperventilation and the stabilizing effects of saffron and inositol.
High-volume keywords used: trauma recovery, fear learning, anxiety, HPA axis, amygdala, exposure therapy, ketamine, MDMA-assisted therapy
Listener Takeaways
- How stress, anxiety, and fear differ in biology and experience
- Why one-trial learning locks in threat and drives generalization
- The rule of extinction + replacement for true trauma healing
- How exposure, CBT, ketamine, and MDMA assist relearning
- Foundational tools: sleep, connection, nutrition, saffron, inositol
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_01 (00:00):
Welcome to the deep dive.
Today we're embarking on ajourney into, I think, one of
the most foundational parts ofour experience.
SPEAKER_00 (00:07):
And maybe one of the most frustrating.
SPEAKER_01 (00:09):
Exactly.
We're talking about theneuroscience of fear, of trauma,
and really the actionable stuff,how we can scientifically turn
down the volume on all that.
SPEAKER_00 (00:18):
Right.
And that's our mission here.
We're going to unpack the actualbiological circuits, the
chemicals, you know, the wholesystem that creates a fear
response.
SPEAKER_01 (00:26):
But the focus is on the tools.
SPEAKER_00 (00:28):
The focus is absolutely on the modern
science-based tools.
And we're going to keep comingback to this one key idea.
SPEAKER_01 (00:34):
Yeah.
SPEAKER_00 (00:35):
You don't just delete fear, you have to replace
it.
SPEAKER_01 (00:38):
That's a huge point.
But before we get into thebrain, we have to clear up some
terms, right?
Because people use stress,anxiety, and fear almost
interchangeably.
SPEAKER_00 (00:46):
Aaron Ross Powell They do, and that really
complicates things.
SPEAKER_01 (00:48):
Yeah.
SPEAKER_00 (00:48):
Biologically, they are not the same at all.
So let's think of them as uhlike layers in a cake.
SPEAKER_01 (00:53):
Okay.
SPEAKER_00 (00:54):
The bottom layer is stress.
It's just a ph physiologicalresponse, purely physical.
Your heart rate goes up, yourpupils dilate, that kind of
thing.
SPEAKER_01 (01:01):
So you need stress for fear, but you can be
stressed without being afraid,like after a good workout.
SPEAKER_00 (01:06):
Exactly.
Now the next layer up, that'sanxiety.
You can think of that as stressthat's aimed at the future.
It's that worry, thatanticipation about something
that might happen.
SPEAKER_01 (01:16):
And again, you can be anxious without it tipping
into full-blown fear.
SPEAKER_00 (01:19):
That's it.
And then at the top, you havefear.
That's the whole emotion.
It's built on the stress and theanxiety.
But now you add the cognitiveparts, the thoughts, the
specific memories, the story youtell yourself about the physical
feeling.
SPEAKER_01 (01:32):
The whole package.
And when that package gets stuckon a loop?
SPEAKER_00 (01:35):
That's when we call it trauma.
It's that fear response showingup when it doesn't help you,
when it's actually maladaptiveand limits your life.
Knowing these layers helps ustarget the right biological
route.
SPEAKER_01 (01:47):
Okay, so let's dig into those roots.
That reflexive biology, thestuff that happens before you're
even consciously aware of it.
Where does that alert start?
SPEAKER_00 (01:56):
It all begins in the autonomic nervous system, the
ANS.
It's uh pretty much outside ofyour conscious control.
SPEAKER_01 (02:03):
And it has those two branches.
SPEAKER_00 (02:04):
Right, the sympathetic and the
parasympathetic.
Think of them as a seesaw.
The sympathetic is theaccelerator, it amps you up for
action.
The parasympathetic is thebreak, it calms you down.
Fear is basically thesympathetic branch slamming that
accelerator to the floor.
SPEAKER_01 (02:19):
And that accelerator pedal is connected to the most
famous alarm system in the body,the HPA axis.
SPEAKER_00 (02:25):
Yes, the hypothalamus pituitary adrenal
axis.
A really elegant three-partsystem.
The hypothalamus in your brainspots a threat, tells the
pituitary gland, which thensends hormones down to the
adrenal glands on your kidneys.
SPEAKER_01 (02:39):
Which then dump all those stress hormones we've
heard of.
SPEAKER_00 (02:41):
Exactly.
You get adrenaline orepinephrine for that immediate
burst, and then you get cortisolfor more sustained alertness.
But here's where it gets reallyfascinating for trauma.
SPEAKER_01 (02:51):
Okay.
SPEAKER_00 (02:51):
This isn't just a one-off alarm bell.
These chemicals, they have afast component, sure, but they
also have a longer-lasting part.
They can actually go back up tothe brain and influence what's
called gene expression.
SPEAKER_01 (03:01):
Whoa, hang on.
Gene expression.
What does that actually mean forsomeone trying to understand why
a single scary moment can lastfor years?
SPEAKER_00 (03:09):
I mean, think of it this way
cortisol are like a chemicalconstruction crew.
They don't just send an alert,they start physically remodeling
your brain's wiring.
SPEAKER_01 (03:18):
They're changing the connections between neurons.
SPEAKER_00 (03:21):
Literally changing them, building new, more durable
circuits for that fear.
That's how a trauma canphysically embed itself over
days and weeks.
It's a biological memory beingbuilt.
SPEAKER_01 (03:32):
So the HPA axis is the messenger sending the
construction crew.
But where is the actual panicbutton?
Where does the threat reflexitself flow through?
SPEAKER_00 (03:41):
Aaron Powell That all flows through the amygdala.
It's this uh littlealmond-shaped structure deep in
the brain.
SPEAKER_01 (03:46):
The central hub.
SPEAKER_00 (03:47):
It's the final common pathway.
It takes in all the data, whatyou're seeing, what you're
hearing, memories coming fromthe hippocampus, and integrates
it into that immediate threatresponse.
Fast heart rate, hypervigilance,all of it.
SPEAKER_01 (03:59):
Aaron Powell And once it decides threat, it sends
out the instructions.
One path goes to thehypothalamus to keep that HPAX
firing.
But our source material pointedto a second pathway that was
really surprising.
SPEAKER_00 (04:10):
Aaron Powell Yeah, this is the incredible part.
The second major pathway goesdirectly from the amygdala to
the dopamine system.
SPEAKER_01 (04:17):
Aaron Powell Okay, let's just pause on that.
That is a massive insight.
SPEAKER_00 (04:20):
It is.
SPEAKER_01 (04:21):
The fear center of the brain is talking directly to
the craving and motivationcenter.
What are the implications there?
SPEAKER_00 (04:27):
Aaron Powell Well, the implication is leverage.
Dopamine is what makes us wantthings, pursue things.
So the fact that the threatsystem can light up the reward
system, it means we're not justdealing with a defensive memory.
SPEAKER_01 (04:41):
Aaron Powell It can almost get you stuck in a loop
of pursuing the feeling orcompulsively thinking about it.
SPEAKER_00 (04:46):
Aaron Powell It can, but more importantly, it gives
us an entry point, a way to usethat same system for
replacement, which we'll get to.
SPEAKER_01 (04:53):
Incredible.
But of course, we're not just abundle of reflexes.
There's top-down control.
Trevor Burrus, Jr.
SPEAKER_00 (04:57):
Right.
And that's your prefrontalcortex, the PFC, right behind
your forehead.
It's the CEO, the rational mind.
SPEAKER_01 (05:03):
It's what lets you suppress a reflex.
SPEAKER_00 (05:05):
Suppress a reflex, attach a narrative, give meaning
to what is otherwise just ageneric physical feeling.
When your heart is pounding,your PFC is what decides am I
excited or am I terrified?
It's the storyteller.
SPEAKER_01 (05:18):
And that idea of story brings us perfectly to the
next point.
That this whole fear system isreally, at its core, a memory
system.
SPEAKER_00 (05:27):
It is.
It's designed for one thinganticipation and safety.
It creates memories to keep youfrom getting hurt again.
Some are protective, you know,touch a hot stove once you
learn.
SPEAKER_01 (05:37):
But others become maladaptive.
They limit you.
SPEAKER_00 (05:39):
Exactly.
And the learning mechanism isbasically Pavlovian
conditioning, but on steroids.
SPEAKER_01 (05:44):
Right.
It's super efficient.
SPEAKER_00 (05:45):
It's set up for what we call one trial learning.
You don't need a hundredpairings of a bell in food.
One single powerful traumaticevent is often enough to create
a very strong, very lastingassociation instantly.
SPEAKER_01 (05:56):
Aaron Powell And can you give an example of how that
sort of bleeds out, how that onetrial can color everything else?
SPEAKER_00 (06:02):
Aaron Powell Sure.
Think of the story from theresearch about the person whose
car gets broken into just oncewhile visiting a big city.
That single event, that onetrial, can then generalize.
It can color their entire viewof all cities, leading them to
make decisions years later aboutwhere they won't live, where
they won't travel.
That specific fear just wicksout everywhere.
SPEAKER_01 (06:22):
Which brings us back to the core mission here.
Since you can't just deletethese memories.
SPEAKER_00 (06:27):
You can't.
That circuit is paved.
So the rule, the absolutemandate is this it's not enough
to just extinguish the fear.
You have to extinguish the fearA and D, replace it with
something else.
SPEAKER_01 (06:38):
A new positive memory or idea?
SPEAKER_00 (06:40):
A new competing response.
You're essentially building anew, better road right over the
old, scary one.
SPEAKER_01 (06:47):
And this replacement process has to rely on the
circuits we just mapped out.
SPEAKER_00 (06:50):
It relies completely on them.
It uses the prefrontal cortex tocreate the new meaning, the new
story.
And it uses that wild connectionfrom the amygdala to the
dopamine system to reward andlock in the new positive
association.
SPEAKER_01 (07:03):
Aaron Powell Okay, this is where we get really
practical.
If the goal is extinction andreplacement, what are the tools?
Let's start with the behavioraltherapies, the ones that use
language.
SPEAKER_00 (07:11):
Right.
So there are three main oneswith a ton of evidence.
There's prolonged exposuretherapy, or PE, where you
confront the memories.
There's cognitive processingtherapy, CPT, which is more
about challenging the beliefsaround the trauma.
SPEAKER_01 (07:22):
And then the broader ones, CBT.
SPEAKER_00 (07:24):
And cognitive behavioral therapy, yes.
But they all share one criticalmechanism.
SPEAKER_01 (07:29):
The repeated telling of the story.
SPEAKER_00 (07:31):
Exactly.
The repeated, very detailedrecounting of the event.
In complete sentences,describing your internal
feelings.
And the first time you do it,the physiological response is
enormous.
Heart rate spikes, you sweat,the whole HPA alarm goes off.
SPEAKER_01 (07:48):
That sounds just awful, but necessary.
SPEAKER_00 (07:51):
It's necessary because the magic is in the
repetition.
When they measure the responseon the second, third, and fourth
retelling, the amplitude of thatraw physical feeling goes down.
SPEAKER_01 (08:01):
It gets smaller each time.
SPEAKER_00 (08:02):
It progressively diminishes.
You are literally teaching youramygdala, see, we just relive
that and we're safe.
You have to lower thatphysiological volume to create
space for the PFC to write a newstory.
SPEAKER_01 (08:12):
Which is a perfect lead-in to the pharmacological
tools because they seem designedto chemically fast-track that
process, like ketamine-assistedpsychotherapy.
SPEAKER_00 (08:21):
Right.
Ketamine is a dissociative.
What it does in therapy iscreate a kind of temporary
emotional distance.
It lets you tell the story whilefeeling a very different, much
more muted emotional response.
SPEAKER_01 (08:34):
So it acts like a buffer against that intense pain
of the first retelling.
SPEAKER_00 (08:38):
That's a great way to put it.
It's a buffer.
It helps achieve thatextinction, that lowering of the
intensity very quickly, and ithelps you remap new, calmer
feelings onto that old story.
SPEAKER_01 (08:48):
And then you have the really unique chemistry of
MDMA assisted therapy.
SPEAKER_00 (08:52):
Yeah, MDMA creates a brain state that is just
profound for this work.
It causes a huge simultaneousincrease in both dopamine and
serotonin.
SPEAKER_01 (09:02):
So dopamine for motivation and pursuit and
serotonin for pleasure andcontentment at the same time.
SPEAKER_00 (09:08):
At the exact same time.
It's what produces thosesubjective feelings of immense
connection, resonance, andsafety.
SPEAKER_01 (09:14):
And that state must make the relearning process
incredibly fast.
SPEAKER_00 (09:17):
Incredibly fast.
You are accelerating the tackingon of positive trusting feelings
directly onto the traumaticmemory.
It's maybe the most efficienttool we have for the replacement
side of the equation.
SPEAKER_01 (09:32):
Aaron Powell So stepping back from the clinic,
what about the foundationalself-directed things people can
do that support this wholesystem?
SPEAKER_00 (09:39):
Well, you start with the absolute basics.
Social connection.
Regular trusting connection is ahuge regulator for the HPA axis.
And of course, quality nutritionand good sleep.
I mean, those are non-negotiablefor a healthy nervous system.
SPEAKER_01 (09:52):
I want to talk about the one that seems
counterintuitive (09:53):
the cyclic hyperventilation, the zero-cost
tool that deliberately makes youfeel stressed.
SPEAKER_00 (09:59):
It does, and that's why it works.
The protocol is designed to letyou voluntarily induce your own
stress response for just a fewminutes a day.
It's a series of deep inhalesthrough the nose, exhales
through the mouth, and then along breath hole.
SPEAKER_01 (10:12):
And you feel it, you feel the adrenaline kick in.
SPEAKER_00 (10:14):
You feel the tingling, the heat, the
agitation.
Yeah.
And you're doing it on purpose.
SPEAKER_01 (10:18):
So why on earth would you do that if you're
trying to heal from trauma?
SPEAKER_00 (10:22):
Because you are practicing voluntary control
over the physical feeling ofarousal.
You're teaching your brain thaterasing heart and adrenaline
don't have to equal danger.
You are leaning into it in acontrolled way and extinguishing
the panic that's normallyattached to it.
SPEAKER_01 (10:38):
And we have to put a huge warning here.
Anyone with a history of panicdisorder or severe anxiety
should be extremely careful withthat and ideally get clinical
support.
SPEAKER_00 (10:47):
Absolutely.
100%.
And finally, a couple ofwell-researched supplements for
just bringing the system back tobaseline anxiety levels.
First is saffron.
SPEAKER_01 (10:57):
Saffron, really.
SPEAKER_00 (10:58):
Yep.
A consistent dose, about 30milligrams, has been shown in
multiple meta-analyses toreliably reduce anxiety.
SPEAKER_01 (11:05):
That's amazing.
SPEAKER_00 (11:05):
And the second one is inositol.
It needs a higher dose, maybe 18grams a day for a month.
But the studies show its effectis on par with some prescription
antidepressants for anxiety.
But remember, these are forstabilization.
You wouldn't take them rightbefore a therapy session where
you actually want to access thestress response to work with it.
SPEAKER_01 (11:22):
This has been such a comprehensive deep dive.
We mapped the biology, the HPAaxis, the amygdala's link to
reward, the PFC as thestoryteller.
SPEAKER_00 (11:32):
Then we looked at fear as this one-trial learning
memory system.
SPEAKER_01 (11:35):
And finally, we covered the three paths to
recalibration behavioraltherapy, pharmacological tools,
and self-directed approaches.
SPEAKER_00 (11:42):
And the core takeaway really has to be the
logic of it all.
You have to safely re-engagewith the old memory to
physically turn down its volume.
That's what creates the spacefor your prefrontal cortex to
come in and build the new,stronger replacement memory.
SPEAKER_01 (11:57):
Which leads us to our final thought for you.
Since the feeling of fear isjust a generic biological
reflex, a blast of adrenalineand cortisol, the real power
isn't in the chemicals.
It's in your prefrontal cortex'samazing ability to create
meaning, to attach a new storyto what feels like
uncontrollable biology.
So if the old story was definedby threat, what new purpose,
(12:18):
what new meaning can you assignto that memory now?
Welcome to the deep dive.
Today we're embarking on ajourney into, I think, one of
the most foundational parts ofour experience.
SPEAKER_00 (00:07):
And maybe one of the most frustrating.
SPEAKER_01 (00:09):
Exactly.
We're talking about theneuroscience of fear, of trauma,
and really the actionable stuff,how we can scientifically turn
down the volume on all that.
SPEAKER_00 (00:18):
Right.
And that's our mission here.
We're going to unpack the actualbiological circuits, the
chemicals, you know, the wholesystem that creates a fear
response.
SPEAKER_01 (00:26):
But the focus is on the tools.
SPEAKER_00 (00:28):
The focus is absolutely on the modern
science-based tools.
And we're going to keep comingback to this one key idea.
SPEAKER_01 (00:34):
Yeah.
SPEAKER_00 (00:35):
You don't just delete fear, you have to replace
it.
SPEAKER_01 (00:38):
That's a huge point.
But before we get into thebrain, we have to clear up some
terms, right?
Because people use stress,anxiety, and fear almost
interchangeably.
SPEAKER_00 (00:46):
Aaron Ross Powell They do, and that really
complicates things.
SPEAKER_01 (00:48):
Yeah.
SPEAKER_00 (00:48):
Biologically, they are not the same at all.
So let's think of them as uhlike layers in a cake.
SPEAKER_01 (00:53):
Okay.
SPEAKER_00 (00:54):
The bottom layer is stress.
It's just a ph physiologicalresponse, purely physical.
Your heart rate goes up, yourpupils dilate, that kind of
thing.
SPEAKER_01 (01:01):
So you need stress for fear, but you can be
stressed without being afraid,like after a good workout.
SPEAKER_00 (01:06):
Exactly.
Now the next layer up, that'sanxiety.
You can think of that as stressthat's aimed at the future.
It's that worry, thatanticipation about something
that might happen.
SPEAKER_01 (01:16):
And again, you can be anxious without it tipping
into full-blown fear.
SPEAKER_00 (01:19):
That's it.
And then at the top, you havefear.
That's the whole emotion.
It's built on the stress and theanxiety.
But now you add the cognitiveparts, the thoughts, the
specific memories, the story youtell yourself about the physical
feeling.
SPEAKER_01 (01:32):
The whole package.
And when that package gets stuckon a loop?
SPEAKER_00 (01:35):
That's when we call it trauma.
It's that fear response showingup when it doesn't help you,
when it's actually maladaptiveand limits your life.
Knowing these layers helps ustarget the right biological
route.
SPEAKER_01 (01:47):
Okay, so let's dig into those roots.
That reflexive biology, thestuff that happens before you're
even consciously aware of it.
Where does that alert start?
SPEAKER_00 (01:56):
It all begins in the autonomic nervous system, the
ANS.
It's uh pretty much outside ofyour conscious control.
SPEAKER_01 (02:03):
And it has those two branches.
SPEAKER_00 (02:04):
Right, the sympathetic and the
parasympathetic.
Think of them as a seesaw.
The sympathetic is theaccelerator, it amps you up for
action.
The parasympathetic is thebreak, it calms you down.
Fear is basically thesympathetic branch slamming that
accelerator to the floor.
SPEAKER_01 (02:19):
And that accelerator pedal is connected to the most
famous alarm system in the body,the HPA axis.
SPEAKER_00 (02:25):
Yes, the hypothalamus pituitary adrenal
axis.
A really elegant three-partsystem.
The hypothalamus in your brainspots a threat, tells the
pituitary gland, which thensends hormones down to the
adrenal glands on your kidneys.
SPEAKER_01 (02:39):
Which then dump all those stress hormones we've
heard of.
SPEAKER_00 (02:41):
Exactly.
You get adrenaline orepinephrine for that immediate
burst, and then you get cortisolfor more sustained alertness.
But here's where it gets reallyfascinating for trauma.
SPEAKER_01 (02:51):
Okay.
SPEAKER_00 (02:51):
This isn't just a one-off alarm bell.
These chemicals, they have afast component, sure, but they
also have a longer-lasting part.
They can actually go back up tothe brain and influence what's
called gene expression.
SPEAKER_01 (03:01):
Whoa, hang on.
Gene expression.
What does that actually mean forsomeone trying to understand why
a single scary moment can lastfor years?
SPEAKER_00 (03:09):
I mean, think of it this way
cortisol are like a chemicalconstruction crew.
They don't just send an alert,they start physically remodeling
your brain's wiring.
SPEAKER_01 (03:18):
They're changing the connections between neurons.
SPEAKER_00 (03:21):
Literally changing them, building new, more durable
circuits for that fear.
That's how a trauma canphysically embed itself over
days and weeks.
It's a biological memory beingbuilt.
SPEAKER_01 (03:32):
So the HPA axis is the messenger sending the
construction crew.
But where is the actual panicbutton?
Where does the threat reflexitself flow through?
SPEAKER_00 (03:41):
Aaron Powell That all flows through the amygdala.
It's this uh littlealmond-shaped structure deep in
the brain.
SPEAKER_01 (03:46):
The central hub.
SPEAKER_00 (03:47):
It's the final common pathway.
It takes in all the data, whatyou're seeing, what you're
hearing, memories coming fromthe hippocampus, and integrates
it into that immediate threatresponse.
Fast heart rate, hypervigilance,all of it.
SPEAKER_01 (03:59):
Aaron Powell And once it decides threat, it sends
out the instructions.
One path goes to thehypothalamus to keep that HPAX
firing.
But our source material pointedto a second pathway that was
really surprising.
SPEAKER_00 (04:10):
Aaron Powell Yeah, this is the incredible part.
The second major pathway goesdirectly from the amygdala to
the dopamine system.
SPEAKER_01 (04:17):
Aaron Powell Okay, let's just pause on that.
That is a massive insight.
SPEAKER_00 (04:20):
It is.
SPEAKER_01 (04:21):
The fear center of the brain is talking directly to
the craving and motivationcenter.
What are the implications there?
SPEAKER_00 (04:27):
Aaron Powell Well, the implication is leverage.
Dopamine is what makes us wantthings, pursue things.
So the fact that the threatsystem can light up the reward
system, it means we're not justdealing with a defensive memory.
SPEAKER_01 (04:41):
Aaron Powell It can almost get you stuck in a loop
of pursuing the feeling orcompulsively thinking about it.
SPEAKER_00 (04:46):
Aaron Powell It can, but more importantly, it gives
us an entry point, a way to usethat same system for
replacement, which we'll get to.
SPEAKER_01 (04:53):
Incredible.
But of course, we're not just abundle of reflexes.
There's top-down control.
Trevor Burrus, Jr.
SPEAKER_00 (04:57):
Right.
And that's your prefrontalcortex, the PFC, right behind
your forehead.
It's the CEO, the rational mind.
SPEAKER_01 (05:03):
It's what lets you suppress a reflex.
SPEAKER_00 (05:05):
Suppress a reflex, attach a narrative, give meaning
to what is otherwise just ageneric physical feeling.
When your heart is pounding,your PFC is what decides am I
excited or am I terrified?
It's the storyteller.
SPEAKER_01 (05:18):
And that idea of story brings us perfectly to the
next point.
That this whole fear system isreally, at its core, a memory
system.
SPEAKER_00 (05:27):
It is.
It's designed for one thinganticipation and safety.
It creates memories to keep youfrom getting hurt again.
Some are protective, you know,touch a hot stove once you
learn.
SPEAKER_01 (05:37):
But others become maladaptive.
They limit you.
SPEAKER_00 (05:39):
Exactly.
And the learning mechanism isbasically Pavlovian
conditioning, but on steroids.
SPEAKER_01 (05:44):
Right.
It's super efficient.
SPEAKER_00 (05:45):
It's set up for what we call one trial learning.
You don't need a hundredpairings of a bell in food.
One single powerful traumaticevent is often enough to create
a very strong, very lastingassociation instantly.
SPEAKER_01 (05:56):
Aaron Powell And can you give an example of how that
sort of bleeds out, how that onetrial can color everything else?
SPEAKER_00 (06:02):
Aaron Powell Sure.
Think of the story from theresearch about the person whose
car gets broken into just oncewhile visiting a big city.
That single event, that onetrial, can then generalize.
It can color their entire viewof all cities, leading them to
make decisions years later aboutwhere they won't live, where
they won't travel.
That specific fear just wicksout everywhere.
SPEAKER_01 (06:22):
Which brings us back to the core mission here.
Since you can't just deletethese memories.
SPEAKER_00 (06:27):
You can't.
That circuit is paved.
So the rule, the absolutemandate is this it's not enough
to just extinguish the fear.
You have to extinguish the fearA and D, replace it with
something else.
SPEAKER_01 (06:38):
A new positive memory or idea?
SPEAKER_00 (06:40):
A new competing response.
You're essentially building anew, better road right over the
old, scary one.
SPEAKER_01 (06:47):
And this replacement process has to rely on the
circuits we just mapped out.
SPEAKER_00 (06:50):
It relies completely on them.
It uses the prefrontal cortex tocreate the new meaning, the new
story.
And it uses that wild connectionfrom the amygdala to the
dopamine system to reward andlock in the new positive
association.
SPEAKER_01 (07:03):
Aaron Powell Okay, this is where we get really
practical.
If the goal is extinction andreplacement, what are the tools?
Let's start with the behavioraltherapies, the ones that use
language.
SPEAKER_00 (07:11):
Right.
So there are three main oneswith a ton of evidence.
There's prolonged exposuretherapy, or PE, where you
confront the memories.
There's cognitive processingtherapy, CPT, which is more
about challenging the beliefsaround the trauma.
SPEAKER_01 (07:22):
And then the broader ones, CBT.
SPEAKER_00 (07:24):
And cognitive behavioral therapy, yes.
But they all share one criticalmechanism.
SPEAKER_01 (07:29):
The repeated telling of the story.
SPEAKER_00 (07:31):
Exactly.
The repeated, very detailedrecounting of the event.
In complete sentences,describing your internal
feelings.
And the first time you do it,the physiological response is
enormous.
Heart rate spikes, you sweat,the whole HPA alarm goes off.
SPEAKER_01 (07:48):
That sounds just awful, but necessary.
SPEAKER_00 (07:51):
It's necessary because the magic is in the
repetition.
When they measure the responseon the second, third, and fourth
retelling, the amplitude of thatraw physical feeling goes down.
SPEAKER_01 (08:01):
It gets smaller each time.
SPEAKER_00 (08:02):
It progressively diminishes.
You are literally teaching youramygdala, see, we just relive
that and we're safe.
You have to lower thatphysiological volume to create
space for the PFC to write a newstory.
SPEAKER_01 (08:12):
Which is a perfect lead-in to the pharmacological
tools because they seem designedto chemically fast-track that
process, like ketamine-assistedpsychotherapy.
SPEAKER_00 (08:21):
Right.
Ketamine is a dissociative.
What it does in therapy iscreate a kind of temporary
emotional distance.
It lets you tell the story whilefeeling a very different, much
more muted emotional response.
SPEAKER_01 (08:34):
So it acts like a buffer against that intense pain
of the first retelling.
SPEAKER_00 (08:38):
That's a great way to put it.
It's a buffer.
It helps achieve thatextinction, that lowering of the
intensity very quickly, and ithelps you remap new, calmer
feelings onto that old story.
SPEAKER_01 (08:48):
And then you have the really unique chemistry of
MDMA assisted therapy.
SPEAKER_00 (08:52):
Yeah, MDMA creates a brain state that is just
profound for this work.
It causes a huge simultaneousincrease in both dopamine and
serotonin.
SPEAKER_01 (09:02):
So dopamine for motivation and pursuit and
serotonin for pleasure andcontentment at the same time.
SPEAKER_00 (09:08):
At the exact same time.
It's what produces thosesubjective feelings of immense
connection, resonance, andsafety.
SPEAKER_01 (09:14):
And that state must make the relearning process
incredibly fast.
SPEAKER_00 (09:17):
Incredibly fast.
You are accelerating the tackingon of positive trusting feelings
directly onto the traumaticmemory.
It's maybe the most efficienttool we have for the replacement
side of the equation.
SPEAKER_01 (09:32):
Aaron Powell So stepping back from the clinic,
what about the foundationalself-directed things people can
do that support this wholesystem?
SPEAKER_00 (09:39):
Well, you start with the absolute basics.
Social connection.
Regular trusting connection is ahuge regulator for the HPA axis.
And of course, quality nutritionand good sleep.
I mean, those are non-negotiablefor a healthy nervous system.
SPEAKER_01 (09:52):
I want to talk about the one that seems
counterintuitive (09:53):
the cyclic hyperventilation, the zero-cost
tool that deliberately makes youfeel stressed.
SPEAKER_00 (09:59):
It does, and that's why it works.
The protocol is designed to letyou voluntarily induce your own
stress response for just a fewminutes a day.
It's a series of deep inhalesthrough the nose, exhales
through the mouth, and then along breath hole.
SPEAKER_01 (10:12):
And you feel it, you feel the adrenaline kick in.
SPEAKER_00 (10:14):
You feel the tingling, the heat, the
agitation.
Yeah.
And you're doing it on purpose.
SPEAKER_01 (10:18):
So why on earth would you do that if you're
trying to heal from trauma?
SPEAKER_00 (10:22):
Because you are practicing voluntary control
over the physical feeling ofarousal.
You're teaching your brain thaterasing heart and adrenaline
don't have to equal danger.
You are leaning into it in acontrolled way and extinguishing
the panic that's normallyattached to it.
SPEAKER_01 (10:38):
And we have to put a huge warning here.
Anyone with a history of panicdisorder or severe anxiety
should be extremely careful withthat and ideally get clinical
support.
SPEAKER_00 (10:47):
Absolutely.
100%.
And finally, a couple ofwell-researched supplements for
just bringing the system back tobaseline anxiety levels.
First is saffron.
SPEAKER_01 (10:57):
Saffron, really.
SPEAKER_00 (10:58):
Yep.
A consistent dose, about 30milligrams, has been shown in
multiple meta-analyses toreliably reduce anxiety.
SPEAKER_01 (11:05):
That's amazing.
SPEAKER_00 (11:05):
And the second one is inositol.
It needs a higher dose, maybe 18grams a day for a month.
But the studies show its effectis on par with some prescription
antidepressants for anxiety.
But remember, these are forstabilization.
You wouldn't take them rightbefore a therapy session where
you actually want to access thestress response to work with it.
SPEAKER_01 (11:22):
This has been such a comprehensive deep dive.
We mapped the biology, the HPAaxis, the amygdala's link to
reward, the PFC as thestoryteller.
SPEAKER_00 (11:32):
Then we looked at fear as this one-trial learning
memory system.
SPEAKER_01 (11:35):
And finally, we covered the three paths to
recalibration behavioraltherapy, pharmacological tools,
and self-directed approaches.
SPEAKER_00 (11:42):
And the core takeaway really has to be the
logic of it all.
You have to safely re-engagewith the old memory to
physically turn down its volume.
That's what creates the spacefor your prefrontal cortex to
come in and build the new,stronger replacement memory.
SPEAKER_01 (11:57):
Which leads us to our final thought for you.
Since the feeling of fear isjust a generic biological
reflex, a blast of adrenalineand cortisol, the real power
isn't in the chemicals.
It's in your prefrontal cortex'samazing ability to create
meaning, to attach a new storyto what feels like
uncontrollable biology.
So if the old story was definedby threat, what new purpose,
(12:18):
what new meaning can you assignto that memory now?
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