From: hubermanlab
In the latest episode of the Huberman Lab Podcast, Professor Andrew Huberman offers an in-depth exploration of the neuroscience underlying fear, trauma, and post-traumatic stress disorder (PTSD). A significant portion of the discussion is dedicated to understanding the effectiveness of various behavioral therapies for treating PTSD. Here, we will delve into the key therapeutic approaches discussed and their mechanisms of action as they relate to fear and trauma.
Prolonged Exposure Therapy, Cognitive Processing Therapy, and Cognitive Behavioral Therapy
These three forms of therapy utilize language as a primary tool to reduce fear and trauma:
-
Prolonged Exposure Therapy involves the repeated retelling of the traumatic event in rich detail, which initially evokes a physiological anxiety response. Over successive retellings, this anxiety response diminishes significantly, decreasing the association between the narrative and the threat reflex [00:51:56].
-
Cognitive Processing Therapy is designed to help patients challenge unhelpful and distorted thoughts related to the trauma, facilitating a change in how they perceive the traumatic event [00:51:56].
-
Cognitive Behavioral Therapy (CBT) leverages the same principles of identifying and altering negative thought patterns and behaviors to change the patient’s response to trauma triggers [00:51:56].
These therapies build on the concept of extinction, whereby the traumatic memory becomes less emotionally charged and more of a “boring bad story” than a life-impairing experience. Through narrative rewriting, patients attach new, positive memories to the previously feared stimulus, effectively suppressing the threat reflex associated with the trauma [01:04:00].
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR stands out as an innovative technique that combines eye movements with cognitive recall of traumatic events. Initially met with skepticism, more recent data suggests that lateral eye movements during the recounting of trauma can significantly inhibit the threat reflex. This is potentially related to the suppression of amygdala activation, which is part of the fear circuitry [01:11:18]. However, EMDR appears more effective for acute, single-event traumas rather than long-term or repeated traumatic experiences [01:10:02].
Social Connection and Tachykinin
Another critical aspect discussed in the podcast is the role of social connection in modulating the biology of fear and trauma. Neuropeptides like Tachykinin, which increase in response to social isolation, can amplify fear and anxiety. Meaningful social interactions, conversely, help suppress these detrimental neurochemicals, thus facilitating the reduction of traumatic symptoms [01:15:01].
Conclusion
Behavioral therapies offer a scientifically grounded approach to addressing PTSD and trauma, focusing on altering the physiological and cognitive associations tied to traumatic memories. Through extinguishing these connections and reinforcing new, positive ones, as well as leveraging social support, these methodologies provide a potent and often non-invasive means to heal trauma. While additional emerging therapies may complement or enhance these treatments, the discussed therapies continue to form the cornerstone of successful PTSD management strategies.
For more detailed discussions and insights on treating PTSD and other neuroscience-based strategies for mental well-being, listen to the full episode of the Huberman Lab Podcast with timestamp references provided above.