Heal Trauma & Boost Your Energy Levels

Episode 78:

Ep 78 Heal Trauma & Boost Your Energy Levels with Dr. Aimie Apigian & Evan H.

Hirsch, MD

Evan H. Hirsch, MD 00:08

Hey everybody, welcome back to another episode of the Energy MD Podcast super

excited that you're here with us today. Because as you know, we help people with

chronic fatigue MECFS and long COVID get their lives back by going after the root root

causes. So these are heavy metals, chemicals, molds, infections and trauma. And I'm so

excited today because we're going to be talking with our one of my good friends who's

also a trauma expert, Dr. Aimie opinion. So let's learn a little bit about Dr. Aimie. So she

is a former foster mom, adoptive mom and general surgery resident. She's a board

certified double board certified physician in preventive medicine and addiction medicine,

with a double Master's in biochemistry and public health. That's a lot of doubles. She

now bridges the world of functional medicine, neuroscience and trauma work to create

online educational and experiential programs for individuals around the world to

accelerate their trauma healing journey, and teach professionals through her search for

certificate training program how to do the same for their patients and clients. You can

find her on YouTube, Instagram and her website trauma healing accelerated.com for

free educational content around how to know if you have stored trauma in the body. Dr.

Aimie, thanks so much for joining me today.

Dr. Aimie Apigian 01:27

Absolutely. Dr. Evan, it's my pleasure. It's always good to see you always good to spend

time with you, and happy to share with your audience.

Evan H. Hirsch, MD 01:33

Yeah, I'm so excited about learning from you. So let's just dive right into it. Let's talk

about the difference. A lot of people get confused about the difference between stress

and trauma. How do you differentiate those two?

Dr. Aimie Apigian 01:47

Yeah, and when I was going through medical school, and maybe hopefully you were

taught differently, but when I was going through medical school, I was taught like fight

flight or freeze and it was just kind of all lumped in together as this was your this was

your stress responses was your survival response. And actually, there is more to that.

And as I begin to have to learn this with my own body, because of my health issues at

the time, I started to realize no, like there's a big difference between the fight and flight.

And this thing called freeze that I was still figuring out like, What even is this, what

seems to just take over my body in the moment, my mind gets frustrated, because it's

like my body shuts down and my mind didn't want my body to shut down my by my body

seems to be doing something, it feels like there's this internal. And I'm kind of twisting

my hands. For those who can't see me this internal sensation of like paralysis, that then

takes me into this place that I'm overwhelmed all of a sudden, and I am not even

listening to the other person anymore. I can't even hear what they're saying anymore.

Like I'm in my own world. I'm in my own thoughts. And what what is this? And so as I

was figuring this all out, that's when I started going into different trauma therapy

trainings. So I went into Somatic Experiencing neuro affective tach started doing an

instinctual trauma response model, trying to figure out what was happening in my body,

and really what I needed to do in order to get it back into a place of health since it was

already starting to affect my health. And the what I came to find was that the stress

response is this adrenaline generated response in the body. And we're all familiar with

that adrenaline, we're all familiar with cortisol being our stress hormone. And that stress

response is always something that the body senses is a potential danger doesn't even

need to be real. Dr. Evan doesn't mean to be real, which is a scary thing. But it's anything

that is potential danger, potential threat. And it's just this my body and I can even sense

it right now. Like it goes like we're like it says, Hi higher alert. And the intention of the

stress response is to lean in and figure out what the problem is. Is this a problem? Is

this a threat? Is this a danger? And if so, what do I need to do in response, so that if I

were a firefighter, my response would be like, Alright, I'm throwing on my gear, and I'm

driving towards the fire, and I'm going to put this fire out. And that is a response so that

the body has this response. That is a very active response, like, that's why it's the fight or

flight, right? Like I'm running in, I'm either running towards something or I'm running

away from something, or I'm, I'm fighting and whatever that means, but it's a very active

high energy process. But that freeze moment, Dr. Evan, that freeze moment, where I

stopped being in movement, I actually stopped being able to respond to whatever is

happening in the moment. That's the moment and it is a moment in time that our bodies

switches from Oh, I guess this is too big for us. And instead, we need to shut down and

conserve it. Energy, and it goes into the trauma response. So the stress response is

something that's really high energy. And I'm, I'm actively working to solve this problem,

I'm leaning into it, I think of hiking, because I've spent a lot of years in my life hiking. So I

think of like this big mountain, right? Like big mountain, Mount Kilimanjaro is always one

that I've wanted to hike, and I haven't yet, but if I were looking at the mountain be like,

alright, this is a big mountain, and I've got it, like, Let me Let me tackle this mountain, let

me figure out how I need to scale this mountain or scale the problems in our life, let me

figure it out. And there's an energy to that there's a movement to that there's a flow to

that there's a response to that. But the moment that our body like looks at the mountain

and says, Oh, I can't do that, that's, that's too big. That moment is when our body goes

into this other response, it's very different than the stress response, it's a low energy

response. It feels heavy, it feels overwhelming. And that is the trauma response. And it

has a very different physiology, the completely different operating system for our body,

because it does go into this immobilization, stress responses, mobilization, movement,

action. trauma response is immobilization. It starts with that freeze moment. And then it

goes into just this heaviness and internal collapse and kind of shutting down that some

people may be familiar with.

Evan H. Hirsch, MD 06:30

And in both ways, the body is trying to protect itself. It's trying to help itself. Right. It's a

compensatory mechanism that's generally that the body is trying to do for the

betterment,

Dr. Aimie Apigian 06:41

right? Absolutely. And we have this thing called the autonomic nervous system. And

that's what actually controls which of these states, are we in? Are we going to be in the

stress response? Are we going to be in the trauma response? Hopefully, we'll have

moments of neither and be in the parasympathetic state, at least sometimes. But the

operating system is always doing what it thinks is best for our survival, always. And it

takes everything into consideration, which is actually rather remarkable when you think

of it and our autonomic nervous system, which is the unconscious, you can think of it as

the unconscious mind, the unconscious mind, that's actually nerves in your body that

are picking up gathering information about everything, Dr. Evan, everything, not only

from your external environment, but your internal environment. So how much ATP do I

have? How much magnesium do I have? How much zinc do I have? How much of these

cellular resources do I have? Because it depends on my resources in that moment of

whether I can actually respond to a problem in my life, or if I'm going to get

overwhelmed, because I don't feel like I have enough, or I'm not enough for whatever

those stories are that we create. But that autonomic nervous system is actually

gathering all of this information from our body itself. And that's why it very much is this

adaptive mechanism that is very fluid, moment by moment, it can decide, no, I don't, we

need to go into the trauma response, based on the minute second by second

information that is getting from the cells from the tissues, from the organs that tell it

we're being stretched beyond what we can sustain, we need to actually shut down

because this level of energy, this level of response, this level of danger, is unsustainable

for us. And we might lose our what we call a medicine homeostasis, or this ability to

keep my systems, my physiology, even down to my blood pressure, my blood sugar

levels, my heart rate, my oxygen levels, my co2 levels, I might not be able to keep those

at a healthy level. And so in order to keep those at a healthy level and keep my my actual

human body alive, I'm making the decision to shut everything down. It's it's, it's amazing

how much goes on on the unconscious level that that we're not aware of.

Evan H. Hirsch, MD 09:03

Yeah, it seems like a more. A more dramatic response is is like passing out. Right? It

sounds like because you were talking about maintaining homeostasis is that

sometimes, if something happens, sometimes the body will just pass out in order to

recalibrate.

Dr. Aimie Apigian 09:19

Yes, and that's actually what it's trying to protect us from. So when our body goes into

that freeze moment, it's actually trying to protect us from passing out. Now some

people still pass out. But that's actually what it's trying to protect us from, which is

fascinating to think that, you know, if I and I remember, I go back to a moment maybe in

my general surgery residency where I'm standing in front of, you know, this surgeon and

I'm just the resident, and maybe I forgot to do something, and he's looking down at me

and he's pretty stern and he's pretty upset. And I go into that moment of like, oh, just like

I freeze inside, right? I freeze inside. And in that moment, it's actually protecting me from

passing out. It's actually protecting me from this other bigger transition or shift in my

body that would, that would compromise my heart rate, like we're protecting you from a

heart attack, we're protecting you from all of these other things that could happen if our

body didn't have the capacity to go into this other response state and say, No, we're

gonna, we're going to kind of shove that aside, we're going to make that feel distant. And

we're just going to kind of hunker down and go into our little cave, and protect ourselves.

Evan H. Hirsch, MD 10:37

And so normal stress response would be kind of the first thing of what you're talking

about, where you're get flooded with a bunch of these different hormones, and you can

take action, you can run, you can fight whatever it is you need to. Right. So that's like

normal response. And then your body comes back to equilibrium. But this is this is the

trauma response, which is the immune system's inability, essentially, to manage that

stress response. Is that accurate?

Dr. Aimie Apigian 11:01

Yes, and I and I don't usually go this deep into a conversation with someone. So I love

that we are able to do this, that trauma response only happens when our body feels like

it could not have a complete stress response. And so if it feels like, No, this, this

problem is too big for me, then it's going to shut down to conserve energy. And so it's it's

the shutting down. It's the immobilization that actually brings on the trauma response.

So that as long as we are able to stay in response, yes, and our bodies are flooded with

these hormones. But what if in that moment, we're still flooded with all these hormones,

but we go into a moment of that paralysis that freeze, and then the trauma response, we

still have all those hormones, they didn't magically go away anywhere. And that's where

we really start to see this connection between trauma and symptoms, trauma and

chronic conditions, trauma and disease, because it's all of those hormones, especially

the adrenaline. Adrenaline does a lot of damage to our tissues when we don't

metabolize it when we don't actually use it up. And yet, when we go into that trauma

response, we're not using it up. And so you can think of it as if you're driving a car. And

that stress response is if your foot is all the way down on the gas pedal, like metal down,

like we are speeding in this car, we're stressed out, maybe we are late for a meeting. So

we're stressed out, right, like we're, we're driving fast. That's our stress response. And so

there's all these hormones that are getting released as long as that foot is on the gas

pedal. But the trauma response would be the equivalent of throwing on the emergency

brake, your foot may still be on the gas pedal, Dr. Evan, that may not have changed. But

what is stronger? Well, the emergency brake is actually stronger than the gas pedal. And

so the true damage, like the most damage to our physical health comes from when our

emergency brake is on when our trauma response is on. But yet our foot is still on the

gas pedal. And it's unleashing all of these hormones, the adrenaline, the cortisol, that

we're not able to actually metabolize and use up. And so they're just sitting there, and

they start to cause damage to our tissues. This is a big driving force for fibromyalgia, or

chronic, chronic pain, or any of these like syndromes that can happen, there's such a

strong correlation with those with the trauma response, because of this factor, were not

able to actually be in the movement that would be in or the stress response to complete

it. And so our body goes into the trauma response, but yet all of these hormones are still

there, and causing their damage.

Evan H. Hirsch, MD 13:52

Yeah, that's a great explanation. I love that visual of the the brake versus the gas. And so

in nature, animals would animals shake at this point, right? Don't they shake out trauma?

Dr. Aimie Apigian 14:06

They do. Yeah. So it let's take you know, and there's a great video on on YouTube for

anyone who wants to find like the polar bear Somatic Experiencing Peter Levine video.

And is this video of this polar bear that's being chased by a helicopter, they're needing to

tag it for some reason. Right? So the helicopters flying low. Here's this polar bear. He's

running because he's in the stress response. Right? And that's what animals do like they

they run when I look at my dog, and when she hears a sound like she leans into it, she

doesn't paralyze actually leans into it, she, she goes for it. So they're in the stress

response, and then they throw this you know, like Darth of anesthesia. Now that causes

the immobilization. And that's a really important point that I just want to pause right

there and mention is that it doesn't matter the cause of the immobilization for us us,

whether it's something physiological, like anesthesia, or like toxins, or like mitochondrial

inefficiencies, or if it's something emotional, or psychological, like someone relationship

stress, for example, it doesn't matter the cause of the immobilization, because the end

result is still the same, my body goes into a trauma response, it's no longer able to stay

in the stress response. So for this polar bear, they throw a dart of anesthesia, and it falls

asleep. But again, like what I was just saying, Where did all that adrenaline go, like it

didn't magically disappear, it's still there waiting to be discharged. And it has to be

discharged for us to complete a stress response. And this is where I see most people

going wrong, is that they're not aware and don't know how to complete a stress

response. And so they start to just accumulate more and more and more. And then

eventually, the body is like, I can't hold anymore, I have to go into the trauma response.

And so that adrenaline, that's right now in the polar bear, it's still waiting. And as he

wakes up from the anesthesia, you start to see his movements come out, and his paws

start to move. And actually, what you see is him going back to the movement of running

that he was doing before the immobilization. And there's this, then this massive

discharge and, and he trembles and he shakes. But it's in this movement of, I'm still

completing what I started back there. And now I'm completing it. And that's what

actually allows us to come out of that trauma response, and discharge all of it and

actually come back to a baseline of health. Since most people are not aware or don't

know how to actually discharge and complete either a trauma response or a stress

response. It just accumulates in our body. Until one day perhaps like my body, like it just

it just shuts down and it won't, it won't get out of bed that morning. And so there's this

accumulated effect that happens that is underneath the surface, if we were actually

listening to our bodies, we wouldn't be able to feel it building. But most of us are also

not listening to our bodies until one day it won't do what we want it to do. And and we're

forced to pay attention to it.

Evan H. Hirsch, MD 17:19

Thank you. So So then how do you complete a stress response? What's the right way to

do it? Yeah,

Dr. Aimie Apigian 17:27

I've got a whole six week module that I'm teaching on it right now, Dr. Evans. So it's more

than just like this, this simple answer that I'm going to give you. Because here's what

complicates it, we have patterns. And the body establishes patterns that you could

interchange that with habits, the body has habits, and the body develops habits in order

to make things easy, and not have to think about what I'm going to do every single time

because, oh, we've done this before. And I know what to do next. And so the body has

these habits of doing things. Well, for most people, they started experiencing moments

of overwhelm in their early childhood, long before they have conscious memory. Maybe

their parents read the books about having you cry it out at night, and you cried it out at

sleep, and you actually fell asleep in a trauma response out of exhaustion, rather than

feeling safe and secure. That's just a an example of the moments of overwhelm that we

can experience in early early life. But because it happened early, and the earlier in life

that it happens, the more that these become a habit for how our body operates. And we

can have the habit of learned helplessness. So that even though our mind tells us that it

wants to do something different, even though our mind may tell us like, yeah, we can

tackle this problem, we've got this, our body is in the habit, it has had a habit for

decades of No, we just we just know that we're not big enough, we just know that we're

not strong enough, we just know that we're not smart enough. Everything feels like it's

too much everything feels like it's unmanageable. And so it complicates all of us now as

adults to be able to say, Oh, well, let me just start completing my stress responses. You

actually may need to work with your body first to work with that habit of learned

helplessness that makes your body immediately go into a freeze response or a trauma

response. without you even having the choice to be able to make do I want to do this or

do I not want to do this right? Do I actually want to complete the stress response? The

idea like how to complete a stress response is that discharge of all of the adrenaline. So

the ideal stress would be something that's short term. That's the ideal. The ideal is

something that's short term, not something that's chronic, short term and something

happens And in that moment, I take action. And we can look at the timeframe even of

these different hormones, the adrenaline hits our system within 15 seconds. Which is

interesting because we can tell that when there's a sound when there's a noise, when

there's something that we see our system lights up faster than 15 seconds. What is that,

then that's our sympathetic nervous system. That's, again, our autonomic nervous

system. And it kicks in even before adrenaline is there to come in. But the adrenaline

has a purpose. And that adrenaline is to move us like, the only intention of adrenaline is

to get us to take action. And so it literally goes to our tissues, it starts to move blood

around to our muscles, so that we will take action and have the energy to do so. It's

actually when people feel the most alive. And that's why some people will intentionally

stress themselves out, or maybe they become adrenaline junkies, because that is when

they feel most alive is when they've got this adrenaline, because that's what it makes

you feel it makes you feel powerful, it makes you feel strong, it makes you feel capable.

And that's when moms can lift cars off of their children who are pinned underneath, like

it's this superhuman effect with adrenaline, but we only have it for 15 minutes. So there's

this wave of adrenaline, and it's out of our system by 15 minutes. So that means the

peak is earlier than that. And that's when we need to be using the adrenaline to take

action so that if in that moment, I'm like, Oh, well, I'm busy right now, let me finish this

call. Let me finish doing this, let me finish doing that, we lost our window of opportunity

to actually take action to complete the stress response. And so we actually need to just

align ourselves with the rhythm of our hormones adrenaline hormone in this example,

and align ourselves with know like, when I feel that stress, when I feel that response, like

I need to let my body have the response that it needs to have, so that I can be in

movement and do something about it. And then once we do something about it, if we

feel complete with what we've done, and that would be the other important piece, Dr.

Evan, is, am I complete with what I've done? Or is there still something unfinished? If

there's still something unfinished, you haven't completed the stress response? And

you're not going to get that effect? When we feel like no, like, I've completed what I

needed to do, I have done everything that I can do at this time, then we come back to a

sense of safety. And we have to do that intentionally. When you look at the animal

kingdom, there's orienting meaning looking around in my environment. What's going on

right here right now? Am I Am I safe right now? Or is there another threat? Is there

another monster? Is there another danger and this orienting and yet in our world, we're

so much into our cell phones, we're so much into our screens, right? Like we're, our

focus is inward, and we're not like out like scanning our environment and getting that

sense of, okay, like right now, right here, I'm good. Like, I'm safe. I'm secure right here

right now. And that would be the final resolution that we have to have in order to

complete a stress response, and let our body have that full resolution. So it's this

combination of responding and responding to the degree of the adrenaline levels that

your body produced. If I don't respond to the degree that my adrenaline levels were in

my body, I'm there's going to be a mismatch. And I'm either going to still have adrenaline

leftover that I didn't discharge, or I'm going to have overextended myself, and be pushing

myself into fatigue into these areas where I only needed to respond this much, because

I only had this much adrenaline, but I chose to respond this much. And now I've

overextended myself. So it's matching ourselves up with what does my body need right

now? What is the response that my body needs to do? Let me take that response in this

window of time that I have. And then let me come out and let me orient let me ground

let me have that reestablishing of a sense of safety, so that I'm not carrying it around all

day, and still thinking about that thing that happened this morning, because I didn't

actually resolve it.

Evan H. Hirsch, MD 24:27

Thank you for that explanation. So it sounds like you're is it out yet or you're working on

this new programs?

Dr. Aimie Apigian 24:33

No, this is out like this is one of my biology of trauma modules. So I have six modules in

my biology of trauma. And I walk people through all the different aspects of the trauma

response that they need to work on. And so I encourage people to start with the first

module which is the freeze and overwhelm module. But here's the thing, Dr. Evan, that

when the body starts to come out of a chronic freeze response, meaning like this is just

kind of where I live chronically i i wake up and over I'm I'm overwhelmed all day I go to

bed in overwhelm. So that's a chronic trauma response. And when the body starts to

come out of that, and it needs very specific things to start to come out of that, when it

comes out of that it goes back into the stress response. It actually doesn't go back into

the parasympathetic, oh, all as well, no, like, we went into the trauma response from the

stress response, like that was the path into that trauma response. And so that's our path

back out. And so many people will start to experience like this, this energy that feels like

it's anger that feels like it things it and they don't know what to do with it, and they think

they're doing something wrong. And it's like, no, like, this is great. Like, your body is now

ready to start to digest and discharge all of that adrenaline that it's been holding on to

that charge. And that's what's been causing a lot of their their health issues as well. So

it's a good sign, when they're actually able to start to feel a lot of that heat, and flushing

and energy, even though it can feel very uncomfortable, especially for people who have

felt uncomfortable feeling angry in the past. That can be a very, I mean, that's the next

stage that we need to work on is okay, like, we've got this. And this is what we do with it,

we actually learn how to move through it and move it like we've got to be and movement

to discharge all of the adrenaline. But it also can't just be random movement, Dr. Evan,

because I see a lot of people being like, Oh, well, I exercise a lot. Doesn't that count?

Like? No, no, it doesn't. And here's why. It, the stress response is in response to

something that feels like a danger. And so if I have a danger coming over, at me from

this direction, maybe from my left side, if I do exercise, it's directed toward my right side,

my body is still like, but there's danger over on the left side, like we haven't addressed

the danger. And so the movement that we do needs to be specific to the type of danger

that we're experiencing. So we can't just do like general shaking, and expect that to

discharge adrenaline and to complete a stress response, it needs to be specific to the

threat and the danger that the body feels in that moment.

Evan H. Hirsch, MD 27:15

Sounds like a great coarse grid module. So So let's, let's go back a little bit on trauma.

And maybe you can define for us what trauma is. So we can all make sure we're on the

same page. Yeah,

Dr. Aimie Apigian 27:31

and you know, when you asked me that, it takes me back to my days when I thought I

knew what trauma was. And that was when I became a foster parent, I had just finished

my master's in biochemistry had a few months of space before I jump back into the

third year of medical school rotations at Loma Linda University. And I was like, Ah, let

me use this time to become a foster parent. Again, I had my own trauma to work with, I

know. But at the time, I thought this was a great idea. And I thought that I knew what

foster children needed, I thought that they needed love and stability, I could provide that.

And so this seemed like the perfect time to do that. And so when Miguel came into my

life, and my home and my heart, I knew what he needed. And I started to give my love

and support and stability to him. And what I had to learn the hard way was that it was

actually my love that was triggering him. So I had to unlearn everything that I knew

about trauma, and really come down to Okay, so what is what is trauma, especially then

when I started to have my own health issues that I knew from my studies that were

related to trauma in childhood, like the adverse childhood experiences, and yet I looked

at my childhood, and I was like, Ah, no, like, I don't see trauma, especially when I

compared my childhood to Miguel's childhood, did not see trauma. And so this forced

me required me to say like, I don't think that I really understand trauma then, because

why would I have what I now call like a trauma body, when I don't think that I had

trauma. And as I started to study the body and the nervous system and these reactions

that were happening in my body, I realized that trauma is anything that for any reason, at

that time in our life, overwhelmed us. And overwhelmed. Our ability to respond in the

moment to the stress overwhelmed our ability to understand and process what was

happening. And when I thought of it in that way, I could look back at my childhood and

be like, Were there times when I didn't understand what was happening when I felt alone

when I felt lost. Yeah, there were times in my childhood, quite a few in fact, and so that's

when I was started to seem like oh, so those for me from my body were moments of

trauma that anything anything, for any reason at that time in our life overwhelmed us.

And those experiences are then what are stored in our autonomic nervous system and

create these habits, these patterns of going into the trauma response in, in response to

things that maybe are stressors that other people can handle. But we're not able to stay

with that stress anymore, because now we have the habit, we've had this pattern of

going into the trauma response since childhood, perhaps because we were we were

overwhelmed with a lot of things. And that was just we became to note, we came to

know that, that we get overwhelmed with everything. Like everything, everything. And so

that's my definition of trauma now is, is I'm not looking for an event, right? And people

who come through my biology, trauma, health coaching, like that's, that's one of the

things that they're always confused on is they look at our assessment forms, and they're

like, but where, where's the assessment form where I get to tell you everything that's

ever happened to me? I'm like, like, actually, we're not looking for events, we're looking

for, what are the habits? What are the patterns that we see in your nervous system? And

that's how we know, back somewhere in the past, and along the way, you your body has

been going into the trauma response quite a bit.

Evan H. Hirsch, MD 31:22

Yeah, for me this, this is really clarifying. And it allows me to have a lot more acceptance

for myself. In that the, we all have trauma. And it's really just a question of kind of like,

more about our response and less about the thing that actually happened, because my

understanding is that there are people who have really serious trauma, and they'll have

the same response as somebody who has something that would necessarily be

considered more mild, right. So we all have trauma. And consequently, we all need to

work on our trauma. This is true. No. So let's talk a little bit about unresolved stored

trauma, how does somebody know if they have it?

Dr. Aimie Apigian 32:11

There are three ways that we can easily know if we have unresolved stored trauma in

the body. And we're really looking for these habits that I've been talking about. And we

can look at our thoughts. And there are certain thoughts that are what I call trauma

thoughts, when you have this thought, you are always in a trauma response. And that

thought would be, I can't do this anymore. Just that moment of feeling overwhelmed

with it all. And you have the thought, I can't do this, that is only a thought that we have

when our body is in a trauma response. If our body is in a stress response, our thought

is holy. This is a lot, what do I need to do? That's a thought from the stress response, but

from a thought from the trauma response is going to be I can't like I just can't, I can't I

can't do this, I can't. That thought will only come only only only come when our body is in

a trauma response. So when I learned that, because I for the longest time just always

saw it as the top down approach where my thoughts were directing my body. And when

I realized that, no, actually my body is what drives my thoughts, then I could take those

thoughts and be like, Oh, this thought is just giving me information. I don't need to judge

the thought I don't need to try to change my thought. This thought is giving me

information that my body has gone into a trauma response. And I get to use my tools

that I know how to support my body while it is in a trauma response. Now, the body

sensations would be another way to know if we have some unresolved stored trauma.

So anytime that our body is in a trauma response, it will feel heavy, it will feel just like

everything is hard to do. Maybe there will be like a glass of water, but it's just two feet

away. And it feels hard to reach for a glass of water that's two feet away. And you're like

it's only two feet away. Like why is this so hard? Why? Why do I not want to bend down

and pick this thing up off the floor? Why do I not want to do this? Whereas yesterday, I

seem to have no problem. Like it wasn't even a thought of? Yeah, let me just take two

steps and grab this glass of water and drink a glass of water. It's like it's not even an

issue that we think about but all of a sudden when our body goes into that trauma

response, everything feels harder, we may notice that our thoughts are slower and we

may walk slower. We don't usually notice our breath but if we were to notice our breath

we would notice it was a lot shallower, slower and more shallow. So anytime that our

body just feels heavy and for a lot of people with chronic conditions, this is their

constant reality right like the fatigue and the pain just that AIX, the heaviness that is a

body in a trauma response so that our body can be in a trauma response in association

with our physical health. And that would be the last way to tell that we have unresolved

stored trauma is our physical health. Do we have one of these conditions autoimmunity,

the chronic pain, chronic fatigue, fibromyalgia, anxiety, depression, do we have these

things that indicate that there is imbalance in our autonomic nervous system and it's

gotten stuck, it's gotten stuck either in the stress mode, or it's gotten stuck in trauma, or

we just go back and forth all day long between stress and overwhelm, and stress, and

then overwhelm. That is all the signs of the unresolved stored trauma.

Evan H. Hirsch, MD 35:47

Thank you for that. And so then, for all of us who have this store trauma, how is it

showing up? So it sounds like with a lot of these different health conditions? Is that

correct? Is it showing up in any different ways that we need to talk about?

Dr. Aimie Apigian 36:04

I mean, it's gonna show up in every area of our life, because just like the emergency

brake on in our car, it just becomes our operating system. So it becomes how we

interact in relationships. And when we're in the trauma response, like we really don't like

to be interacting with people, because we don't feel like we have the energy, if

relationships feel hard, right? Like communicating feels hard. And people may even tell

you, right, like, are you upset? And you're like, No, and they're like, Oh, your face just

looks like it, because that's what happens to our facial muscles, like our facial muscles

actually lose their tone when we are in the trauma response, because that's part of the

the dorsal vagal response, shutting down the ventral vagal response. And so there's all

these changes that happen that just make everything harder, we start to cut more

corners, take more shortcuts, because we're looking for the easy way, like we don't have

a lot of energy. So we start being very selective about what am I going to use my energy

for? How am I going to use my energy? Because I don't have energy for everything. And

whatever we don't want to have energy for then like, it just it either doesn't happen, or

we're taking shortcuts to get it happen. And then at the end of the day, what do we find

ourselves doing? We find ourselves just kind of sitting there, maybe drinking an extra

glass of alcohol or wine or like, are we just mindlessly doing things mindlessly watching

the movie Mindlessly scrolling through social media, mindlessly doing things is another

way to know that our bodies in that pattern of like I just I just don't have the energy, I

don't have the energy to the present, I don't have the energy to be thoughtful about what

I'm doing. And then another way is to look at if if we are struggling with our energy

levels, what are we needing to do throughout the day to push ourselves to get through

our work, for example, or get through our day? Or get through getting the kids to school

and do their soccer games? What are we what are we relying on, and those will be the

coping mechanisms. So we can look at coping mechanisms. And there's all kinds of

coping mechanisms that come out, when we are either in in completed stress

responses and stuck in that anxiety of the stress response, or stuck in the heaviness of

a trauma response is that in order to just to get things done, we've got to make some of

those feelings go away, we can't be that tired. And so we reach for caffeine, and maybe

a second cup of coffee. Or maybe we're finding that we crave foods that are actually a

food sensitivity for us because they're giving us that energy with the histamine release.

There's so many things that start to just crop up into our life that we use to manage our

symptoms. And to not feel that in this moment. Because I want to try to get this done, or

I want to try to feel this way. And a lot of coping mechanisms start to come out.

Evan H. Hirsch, MD 38:57

So it seems like we're mainly talking about emotional causes of trauma. But what about

like some of the toxins, the heavy metals, the chemicals, the molds, the infections? It

seems like they also cause trauma in the bottom. They also, you know, negatively affect

the autonomic nervous system. How do you see that interplay between those those

toxins and trauma?

Dr. Aimie Apigian 39:21

Yeah, so let me go back to my definition of trauma, Dr. Eben, which is anything any

toxins, parasites, biochemical imbalances, anything that for any reason, at that time,

overwhelmed our body. And so the more toxins that we have, for example, the more our

body's already holding all of this stress, I see that as a stress, and then it doesn't take

much more stress to just overwhelm our body. Or maybe we already have all of this

other stress and maybe it's mold stress. Maybe it's a combination of work stress. Maybe

it's The combination of these different things, but then we get an infection. And that's

what then puts us over the edge into that, okay, now my body really cannot respond. It's

too much. And I feel like that's one of the one of the things that I really want to bring into

medicine is this idea that no, like trauma is not just emotional trauma is not. It's not just

psychological. There are these kinds of things that actually put the body into a trauma

response. When I had mold toxicity, it put my body into a trauma response. It would that

was not emotional trauma. But that was still a trauma response. And so for me, that's

been really helpful to distinguish a trauma, which again, most people would think of

trauma as being an event versus a trauma response. Because my body can have a

trauma response to anything, it's not going to differentiate something chemical from

something viral from something emotional, like it's just, my body is doing the best it can

at all times. And it can only hold so much. And so anything, anything that for any reason

overwhelms our body is going to generate a trauma response. And for so many people,

it generates a chronic condition, or that chronic condition creates the trauma response.

By the time a person has a chronic condition. They have stored trauma, because you

can't have a chronic condition and not have the body go into a trauma response. That's a

package deal.

Evan H. Hirsch, MD 41:35

Yeah, I'm glad you made that clarification, because it was I who was thinking about the

emotional health in here. But you had said everything. So I appreciate the clarification.

And so you have a free gift for our audience, the roadmap to

Dr. Aimie Apigian 41:51

identify unhealed trauma. Mm hmm. Awesome. Yeah. In that I actually have an

assessment that people can take so that if they're confused, and not sure, I don't know if

I've had trauma. I hear what Dr. Aimie's saying it doesn't really need to be an event. I

don't know, they can go in there and they can look at okay, is this something that I

experienced? Is this something that I feel? How often do I have this, and it will give them

a helpful assessment of if they have stored trauma in their body. And that's something

that their body is currently carrying and holding.

Evan H. Hirsch, MD 42:24

And then the solution is to go to your website, right trauma healing accelerated. In tell us

what happens next.

Dr. Aimie Apigian 42:35

Yeah, so in the big picture, the solution for store trauma is to is there's different steps.

And we have to start with this connection with the body but in a safe way. So we have to

learn how to safely open up because a lot of people are trying to open up yet before it's

safe. And so that's where I've started my people through programs. And even though

they're they were coming to me for health issues or a substance use issue, I started to

realize, ah, like, I've still got to get them into this basic understanding and connection

with their body so that their body can start to complete some of these responses, and

not accumulate more stress and trauma over time. And so that's where I developed my

21 day journey, I lead everyone through that, like that is the starting place. And it's the

starting place that Dr. Steve Porges talks about with his polyvagal theory, we have to

start with safety. We hear from somatic experiencing, and some of these other

programs and people where they talk about like, we have to set the container, we have to

set the foundation, we have to set this regulation and peace, all chronic disease is being

driven by dysregulation of our autonomic nervous system. So bringing in that regulation

piece is essential, or else we'll still just be always putting band aids on our symptoms.

And so that's what people start to experience in that 21 day journey is just this sense of

like, ah, like I'm I'm holding things together, like things are contained. I'm not spiraling

out of control with my emotions, or my reactions and triggers, etc. And it's been

fascinating to see that people, how much their physiology, how much their physical

health, their symptoms change, just doing these 21 days of very basic somatic exercise,

connecting with their body and learning how to create that felt sense of safety create

that felt sense of support in the moment. So that's, and for me, like when I started to see

those numbers that for me, was this validation of Yes, like this is exactly where we need

to start, even in medicine, being able to start with this sense of regulating the autonomic

nervous system, because it's also what changes the biology, not just the diet and

supplements, though that is also an essential piece.

Evan H. Hirsch, MD 44:51

Yeah, I'm glad that you said that because I can't tell you, the more that I've learned and

the better. I kind of get at my job, the more I realize how important trauma is Is and

dealing with resetting the autonomic nervous system. And if you don't do that, you're

just not going to have success and whatever you're trying to treat.

Dr. Aimie Apigian 45:09

Yep. You can't you can't out supplement trauma.

Evan H. Hirsch, MD 45:15

That's a good bumper sticker.

Dr. Aimie Apigian 45:17

My new tagline.

Evan H. Hirsch, MD 45:19

I love it. Awesome. So anything else you want people to know about you what you're

doing any last words you want to leave us with today?

Dr. Aimie Apigian 45:29

I would. I always like to leave people just with this hope that like no matter how old you

are, there's, there's as long as you're still breathing, as long as your body is still keeping

you alive. We can work with the operating system of your body and make things better.

And then I do have a free online event coming up that people are welcome to join.

August one starts August one is my annual biology of trauma Summit. So this is my

third annual. And this year's topic is the trauma disease connection, and have almost 50

speakers on this year's summit. Going into the details like actually looking at, okay, how

does trauma become a disease not just keeping it in theory, but the actual practical, this

is what happens. And this is what we can do about it.

Evan H. Hirsch, MD 46:13

Yeah, I always love what you do on your Summit. It's it seems like it's different from

other summits that I've seen where you're really, you're getting to brass tacks, and you're

really getting some of these experts to share their real secrets. So thank you for the

work you're doing.

Dr. Aimie Apigian 46:26

And thank you, Dr. Evan, thank you for the work that you do.

Evan H. Hirsch, MD 46:29

Thank you. So thanks so much for coming on today. Dr. Aimie, I really appreciate you

educating us answering all of my questions, and I look forward to seeing you soon.

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and have an amazing day.