This episode of "The Fourth Wave in Therapy" featured a conversation between Peta and Dr. Aimie Apigian, a double board-certified physician in preventative and addiction medicine and leading voice in trauma biology. 

Dr. Apigian shared how her personal experience with grief and chronic fatigue syndrome in 2014 led her to discover the connection between trauma and physical health, prompting her to develop a body-based approach to healing trauma. She explained her three-energy levels theory (calm and alive, high energy, and low energy) and how the nervous system shifts between these states in response to perceived danger, using the metaphor of a turtle retreating into its shell during overwhelming situations. 

Dr. Apigian discussed the importance of allowing time for physiological recovery and challenged the cultural emphasis on resilience, defining true strength as the ability to feel and process emotions rather than pushing through difficulties. She outlined her approach of "precision nervous system healing" which integrates mind, body, and biology assessment to create personalized healing plans, and expressed frustration with the medical field's slow adoption of trauma-informed care despite early research on adverse childhood experiences.

Takeaways

• Chronic illness and autoimmunity can be rooted in unresolved emotional trauma.
• The nervous system operates in three states: calm, high-energy stress, and low-energy shutdown.
• Recovering from shutdown requires felt safety, not logical reasoning, and takes time.
• Cultural pressure to stay busy and composed often overrides the body's need to heal.
• "Bounce back" resilience messaging in schools can be misleading without teaching real coping skills.
• True resilience means flexibly moving through life while staying attuned to the body.
• Chronic survival-state activation can slow metabolism and block weight loss.
• Effective trauma healing requires precision work across mind, body, and biology together.

Note: this is unedited.

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Welcome back, everybody, to another episode of The Fourth Wave in Therapy. Now, with me today, we're both having a moment here of, fangirling, so I'm sure it will become very evident as I read Amy's bio to you. With me today is Dr. Amy Apigian.

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She is a double board-certified physician in preventative and addiction medicine, and a leading voice in the emerging field of trauma biology.

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Amy is the founder of Biology of Trauma and Trauma Healing Accelerated, where she trains practitioners and guides individuals in healing trauma through a body-based, systems-oriented approach, our absolute favourite here.

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Dr. Apigian is the author of The Biology of Trauma, and you can see it if you're watching the video, everybody, in the background there, and I have a copy right here on my desk as well, and the host of a widely followed podcast. Now, that is below too, so absolutely, please listen in, where she shares practical tools for rewiring the body's trauma responses and accelerating healing at a cellular level.

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Now, the reason why Amy and I are having a little bit of a fangirl, because we have mutual colleagues, is her work represents a powerful shift in a new paradigm of therapy, which is what we're all about. One that integrates biology, attachment, and embodied healing.

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Amy, thank you so much for your time today.

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It's truly an honor to be here. I'm really excited for our conversation. Thank you so much, and I think, you know, anyone listening in, kind of listening to your bio, and kind of going, wow, you're the real deal here, so you actually have all the medical degrees and all the certifications. What was it in your journey that perhaps, you know, because we're talking about

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fourth wave approaches here, and we're talking about embracing the body in therapy, which still is not mainstream, if we're totally honest. So, where on earth did that diversion in your traditional training path happen?

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You know, what you're speaking to is the truth in that we can have all the education in the world, and that still does not land us in our own body. Something has to happen in our own life that makes it be a lived experience, not just our educational background.

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And for me, that was experiencing the biggest loss and grief of my life in 2014.

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And one month later, developing chronic fatigue syndrome and autoimmunity. I was so clear on the connection between

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that, and one month later, and I also had worked with enough adopted children and leaned into attachment

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that I knew the strong connection between adverse childhood experiences and those two conditions that I just got diagnosed with.

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And yet… I never would have said that I had trauma.

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And that is what… Both confused me, but then made me very curious, and made me…

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realize there is so much more to trauma that I clearly do not understand.

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Because if I have what I now call a trauma body, a body that the nervous system has all of the patterns of stored trauma, but yet I don't think that I've had trauma, then there's something I don't understand about trauma, and let me go figure that out.

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Primarily for me to get my life back, for me to get my health back. It was so significant, I couldn't get out of bed for a period of time.

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And so, that's where it started, and realizing that even as a physician.

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I did not have a map.

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for the healing journey. I did what…

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I'd always told my patients to do, which was, you should go to therapy and talk to someone about stuff. And I did that, and I actually found my symptoms flaring up.

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And that was very frustrating, because here I thought I was doing exactly what I was supposed to do, and yet I am definitely not getting better. And I don't have a map. I don't know what I need to do differently.

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And that is what started me on my journey. There's so many things there I want to unpack, and I've got to remember all of them. I should be taking notes. One, you mentioned quite a fast time frame between, obviously, a fairly traumatic event

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and the presentation in your body of a physical symptom. Do you think that was quick as far as a month, when sometimes we might be looking and working with patients with chronic health issues.

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But when you dig back, and maybe you're doing formulation, you're kind of like, actually, maybe that was really brewing from, you know, something that happened at 15, but now you're 45, and it took that long for the body. Like, do you think that month was quick, or is that typical? What's your thoughts on that?

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My thoughts are that it really depends on each person's current capacity.

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And for me, I had never done any inner work, nervous system work. I had only known how to live life by pushing through.

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By numbing my feelings with food and exercise and work. And so, by the time that grief hit in 2014,

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My stress capacity was already so full that it…

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quickly develop symptoms. Whereas for someone else, they may not have

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gotten that far in their dysregulation, and in the manifestation in their biology.

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And so for them, and I even start my book, Chapter 1, with the story of my patient, Elena. She had a car accident. For her, that was her triggering event, but it was still a year before she developed the diagnosis of autoimmunity. So for me, one month

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is now very quickly, given all the patients that I've seen, and I also am so grateful for that, because if it hadn't have been so close, I probably, like everyone else, would have never connected the two. Yeah.

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Yeah, I agree. I think, sometimes if it's years and years, kind of buried in the past, it is really hard. We've done a lot of work in research in the chronic pain space, and sometimes, you know, it's decades.

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where the precipitating event was back in the… yeah, and it's hard to make that connection, I totally agree. So, tell us, what… what happened then? You've made this connection, obviously,

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truly, I'm having a laugh, because I identify, you know, overachievers like to do things hard and fast and quick, and get it and things like that, but what happened then? Like, you make the connection.

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do you take a step back and kind of go, what… like, I'm missing a body map here, what tools do I… or does it send you down a path to try to create something new?

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Truly, at first, it really was me just trying to get my health back, and at first, it was, how do I get back into my residency training program? I was in third-year surgery training, and how do I get back? Because that's my livelihood. If I can't work, what do I have?

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There never was any intention at that time for, well, let me learn this to help other people as well. Let me leave surgery and go into trauma in the body. There was no such thought. It was purely survival. How do I get out of bed and feel well enough to get back into work?

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And where that started me then was looking at my energy levels, which I think that you will find very interesting, because of how much you work with energy. And I even remember

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Noticing how quickly my energy could shift.

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And I even remember my therapist teaching me a few of the EFT tapping mechanisms, and being able to feel the energy shift in the moment. And I thought, well, that's weird. Like, why…

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how? What's the mechanism, right? Like, I'm a biochemist at heart, so I want to understand the mechanism. What exactly is happening inside my body? This must be that mindset shift that people tell me about. Okay, so if I just

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shift my mindset, my energy will follow. But then I would notice later on, no, it has nothing to do with my thoughts and my mindset. Something seems to be happening inside of my body, and it generates the thoughts.

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Well, that's interesting, and I could notice that when I had a trigger, and I remember a very specific trigger moment.

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And the first time that I was able to observe myself having a freeze response.

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I'd never been in the observer's seat before. And so, for the first time, I'm watching myself have this reaction, and then… and while I'm having the reaction, be able to say, like, wow, isn't this so interesting? And it was a moment when a tall male figure with blue eyes

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Like, every way representing my father, was looking down at me with anger and disappointment.

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And I crumbled inside. And I immediately could feel my whole energy drain, as if someone had literally unplugged

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the electrical cord from my nervous system into the wall. Like, it just… it… I don't know where it went, it just disappeared in a… in a second.

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And I thought, how interesting, because it's not like…

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what we were taught, what I was taught in medical school, which was you get your energy from your mitochondria, and you have to eat food in order to have energy. This had nothing to do with any of that. It was an immediate shift in energy, and that's what got me curious, and I started mapping out my energy states.

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And that's how I discovered the three states of the nervous system. And then when I found the polyvagal theory, it matched that perfectly, and I was like, oh, like, this is what I've been experiencing. I haven't had the language for it, but now I can know

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The operating system that my body has, based on its perception of danger versus safety.

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And it is changing my energy in the moment based on my environment.

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How interesting. I love that you… the phrase, it's interesting, and being that observer, and taking that curiosity, it kind of, you know, less kind of personal attachment, isn't it, to kind of be able to see connections that might be there.

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Can you tell us a little bit about those three levels, then, of energy that you're talking about that maybe overlay with, you know, polyvagal theory?

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So, in simple words, the three energy levels are a medium level, I call that calm and alive. So, I'm calm.

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But I'm also very alive. I'm not calm because I'm zoned out, I'm numbed out, I'm checked out. I'm calm and very alive, kind of like how I am now with you. Yep. And then, that is the energy level

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that the nervous system will put me in when I feel safe. I feel safe enough to be alive. I feel safe enough to be connecting with you.

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And when there is a sense of danger, my nervous system will upregulate its energy, because I need to figure out, am I really in danger?

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I need to respond if I am in danger. And so the first step of that trauma response is an upregulation of our energy, and we will feel anxious, could be one word.

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But stress is not bad, and so this is where sometimes this is a great thing, this is a challenge. You're running a marathon, you're lifting weights, there's no real danger, but it's still a challenge, and you will feel an increase in energy. This is where people can get addicted to adrenaline, because we like to have energy.

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This is where people can become a little dependent on caffeine, because caffeine gives us that adrenaline that drives us into this specific energy state of up-regulated energy production and utilization. So there's a higher energy level

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So we've got medium energy, we've got high energy, and now we're gonna dive bomb, and we're gonna go from that high energy to really low energy.

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It's almost like being on that roller coaster.

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And you know the roller coaster was like, they slam on the brakes, and you were just going really fast. And now, like, whoa! Like, it's almost a whiplash effect, that's why they have the seatbelts on so tight on those roller coasters. And it's like, you go from high energy to really low energy, and you can do that very quickly. So what would create that transition?

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When the perception of the size of the danger is now more than what you can respond to.

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as long as I sense that I have the capacity

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to respond to this amount of problems, demands, responsibilities. I'm going to be in that higher energy state to respond to those problems, demands, challenges. But the moment that it feels like it's too much.

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my nervous system says, it's not safe for you to even keep trying. It's better for us to shut down and to save our energy.

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And so this is the freeze and the shutdown steps of the nervous system, and in the polyvagal world, that's called the dorsal vagal response, and it's literally where your whole operating system shifts.

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It's like driving a car, and all of a sudden you shift from where you were in 6th gear all the way down to 1st gear.

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Or maybe even you throw on the emergency brake, and you're not moving at all.

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It's that dramatic of a shift when the size of the danger in our life all of a sudden feels like it's…

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Just too much for us.

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So if someone's listening in and might be familiar, you just mentioned the dorsal vagal kind of response, and then, you know, the ventral vagus, my understanding would be, is some of the, you know, higher level, above-medium kind of response. Someone's listening in and kind of thinking.

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I can identify with that. I've been pacing along, life's happening, and then something, bang, happens that may shock the nervous system into that dorsal vagal kind of, you know, shut-down-freeze response.

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what does one do in that? And I'm guessing when you're talking about that father figure-like kind of situation where something reminded your body of

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your dad, that's what happened to you. Like, what… what can one do if suddenly you find yourself in that response?

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Yeah.

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there's… Different ways to approach it based on the situation.

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But I liken it to, if we were a turtle, I've just completely pulled into my shell.

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It does not feel safe to be out in the world right now. It does not feel safe to have my heart open. It does not feel safe to be seen.

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It only feels safe to hide, to be quiet.

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Or to people please, so this is where some of the fawning can come out.

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And so at that point, the only way for us to shift our physiology

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And shift the operating state of our entire physiology is to reset back to safety.

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How do I make a turtle?

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who has been so overwhelmed with danger that it is completely pulled in, its legs, its head, everything is inside. How do I convince that turtle

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You can come out of your shell now.

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The only way to convince that turtle is to make it safe.

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And that doesn't happen with a lecture, that doesn't happen with education, that doesn't happen with…

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all of the intellectual, logical reasoning in the world. It only happens with a felt sense.

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Now, the physiology of that takes some time.

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And so, when the mitochondria, when those factory houses in our cells that make energy, when they have experienced this kind of a shock.

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they actually go into shutdown mode as well. It's called the cell danger response.

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And so that's not an immediate switch that can be flipped and have them be like, oh, okay, never mind, that was no longer necessary, and I'm back online now. It takes time to reset our physiology.

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And I would want people to think of the example we have in nature. When an animal, an opossum, for example, goes into that freeze.

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they don't come out of it immediately. It's on a time frame.

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It literally is on a timer.

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And the body, the physiology, needs a time to be able to, in essence, like, catch its breath.

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And people are like, oh, that was awful. That was so scary. I thought I was gonna die.

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And I didn't die, and wow, okay, I am safe, all my limbs are still in place, and now I've regained my energy to be able to run away, walk away, come back out of my freeze.

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Now, that's the ideal. The ideal would be for someone to be able to curl up into a ball, let themselves have that time to just…

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shut down.

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Except, in our busy culture.

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We don't know how to do that, and if someone were to do that, we would probably make fun of them for having done that.

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And so, just our entire culture that's based on busyness and rushing, and maintaining your composure

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Really sets us up for then just pushing through and faking it.

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Rather than being able to tend to our physiology and give it what it needs in the moment, so that we don't carry that experience into the future.

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It creates a biology of trauma, and makes us sick.

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And I guess anyone listening that may relate because they know someone in their life who has this response, it's really good for us to kind of take that message, too, that if we do have someone in our life, that could be a child, it could be a partner, a parent.

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And they have that response that they will need that time as well, and that for us not to rush them, or, you know, like you say, you know, make a judgement of that, that, yeah, that's a really good kind of moment for us to go, oh, okay, this is actually the body needing time, and…

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that's something that we kind of forget sometimes, that truly we need… like, if we were… I always use the analogy that if you cut yourself, you do need time for your body to heal that cut. So, same thing… I'm guessing the same thing goes here with this type of thing.

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Exactly, and this is where I get really sad, because I think of all of the children

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Whose parents, with all the love and care in the world, with all the good intentions in the world, will give their children messages like.

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No, honey, don't cry. Be strong.

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This is a time to be brave. Your grandmother wouldn't want you to cry. She would want you to be happy. You know, these type of messages that are so wrong.

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In that it puts us already against our body and our physiology, rather than allowing us to maintain that nurture and connection of what does my body need right now? My body is sitting with this

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Shock, perhaps?

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Heaviness, perhaps? Sadness, perhaps?

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And it needs a moment.

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And that moment can look like, I'm going to cry. And to, from very early on, get the message that crying is somehow being weak.

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It ruffles my feathers still. I'm sure it does you as well. Oh, I've got plenty that ruffle my feathers, Amy. I wonder, too, what you think. This is my soapbox moment when I'm teaching. I'm like.

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I wonder if the word resilience

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Are you with me? You're with me, right. So, everyone just listen in to our, soapbox for a moment. That, you know, the messaging, particularly here in Australia, it's been quite big for the last decade in schools.

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Literally to the point where there's posters around the schools, how fast can you bounce back? And I just cringe as a parent, but also, obviously, a therapist, and go.

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Is that the right message? And I always think there's a missing bridge of a lot of children aren't taught. How? How do you bounce back?

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But there's a really strong, I wonder if it's in the States too, emphasis on resilience, and how… and I'm like, well, you can't be resilient unless you've had adversity, and so if your child hasn't had adversity, is that a bad thing? But we're also giving this message of.

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Tell me what you think, Amy, because I'm just… I could just go on. Like, resilience, and you're saying, well, we need time, and it's like…

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How do they go together?

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Ugh.

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I gave a keynote about a week and a half ago, and it was to a group of high-functioning women.

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And I stood in front of them, and I said, look, the most important thing that you can ever do for your physical health

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is learn how to feel your feelings.

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Is learn how to not push through because you're trying to be resilient, but actually allow yourself to feel the

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That.

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Thing that you don't want to feel.

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That's my definition of what it means to be strong.

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Strength is not avoiding Numbing. Distracting.

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in order to be resilient. That's not true resilience.

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And then you're gonna get to a place like where I was in 2014, thinking that you're so resilient because you've pushed through everything, and then…

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Something happens, and it ends up being the straw that breaks the camel's back, because everything has been piled on.

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And that's what you had thought was resilience.

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So, I define resilience as the flexibility To move through life's experiences.

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Not needing to neglect yourself, not needing to disconnect from reality, from others, from yourself.

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But knowing how to tend to your body, to your biology, and move with flexibility through all of these different states, through all of the different life's experiences.

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And in fact, one of the ways in which I can tell that someone is storing trauma in their body is that they have a decreased capacity to feel joy.

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You've seen this. I know that you've seen this. Yeah, yeah. Yeah, it's almost like the…

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yeah, the damp, flat affect, the kind of, like a heavy-weighted blanket sometimes on someone's, sort of, whole person and personality. Yeah. Exactly. It's… if I'm holding things in because, I don't want them to come to the surface, it's not safe to

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have that deep breath and expansion and joy, because that thing is going to surface. And so we walk around with, like, this inner bubble that we're trying not to bump, because it could break and spill over, and we end up blocking a lot of the joy and connection and happiness.

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That we could have in life.

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Oh, so glad. I'm so glad we bonded over resilience. That's great. That's just like… someone else who's, like, all up in arms about it. I know. When I… when I start in my lectures, my students just roll their eyes and go, here she goes. Oh, good. I'm… I'm with you, strength. Yes, I like that. That's really good.

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So…

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We haven't asked any of the questions I said I was going to ask, but this is fabulous. The biology bit. I'm really curious, and we've just talked about joy, and obviously lack of, but also…

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you know, what… allowing yourself to feel these feelings. I mean, what is happening? I guess the opposite, where…

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if we're not allowing ourselves to process feelings, my rudimentary understanding of the biology with emotions, Candace Pert's kind of work, is that

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I understand most emotions will have a neurobiological kind of signature at some level of a neurohormone, and perhaps if you've spent, I don't know, your default emotion might be anger or resentment for decades of your life, like, what is that doing to the cells of our body? It's not just, I…

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I'm repressing a feeling, is it? You literally are wearing and tearing the cells. Am I right, Amy, in understanding that?

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Yes, and there's so many layers to this.

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Which gets me excited, because then there's layers to the repair as well. It gives us more leverage for how can I change this, given that there's so many layers to this. So, one layer is that

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the adaptations that I'm going to develop in order to help me avoid

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numb or distract are going to change my biology. If I'm eating carbs and chocolate and breads in order to numb my feelings, well, there's the consequence to my biology and to my gut just on that. And there's a whole science about why those are the foods we reach for. That will maybe need to be a different conversation at a different time.

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But even bigger than that is this whole state shift.

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And so, going back to the idea that this is an operating system that our nervous system orchestrates.

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And we are either in 6th gear, or we're in first gear, but I can't have my cardiovascular system be in 6th gear, and my immune system be in third gear.

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They're all either in 6th gear, or they're all in 1st gear. That's the integration.

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And the connection between these different systems. And so when we look at, then, the nervous system, then that's the system that is responding in real time

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to how safe or how endangered do I feel that I am, knowing that there's the stress level of danger, and then there's the overwhelm level of danger. Two very different survival states, even though they are both survival states.

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Those are different operating states.

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Now, in neither one of them is repair and…

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health and detoxification the priority, because they are both survival states. However, if I had to pick one, I'm going to put myself in the stress survival state, because at least my biology is engaged with life.

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There is more… Damage?

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that happens in the overwhelm state, or if you want to call it the trauma physiology. Is that the bottom state that you talked about? Exactly, that's that dorsal…

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level, and what's happened is that, literally, my nervous system has come in and said.

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It's not safe for us to use up energy.

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And so, it is dimming down my metabolism.

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It is dimming down my thyroid, my mitochondria, my… I mean, it's dimming down my whole metabolism. And so here someone comes along, and they've been gaining weight, and now they're, you know, middle age, and they want to start losing weight, and so they come in, and maybe they want to get on a GLP-1.

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And so now they're gonna take a GLP-1.

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And they're trying to figure out, like, why isn't this working? Well, it's because

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Your body is in this operating state of overwhelm.

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And the problem isn't the GLP-1, the problem is the nervous system is still perceiving so much danger in your life.

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That it is dimming down your metabolism.

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So is it literally slowing everything down in order to conserve energy? Because we're talking about the turtle coming into the shell. Is it… is that biologic happening here? Yes, it is… it is, it is… exactly. And so… What drug's going to ramp that up? No, exactly, like, no…

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Diet, supplement, medication is going to be stronger than your own nervous system that has decided we need to be in survival mode.

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Wow, that's fantastic to know. I think… I think we just need to re-go over that again. So, we're in that need, need for…

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almost, like, rest and digest sort of situation, where you really need to rest. Everything is slowed right down, and that could be, like you said, middle age, everyone's talking about, you know, the menopause kind of belly and all the rest, that's all out there, only because I'm in that age group. And…

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you go, oh, I'm gonna go off and take my Azempic, or whatever it might be, and it's not working.

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And it's because the body is stronger overrules. The need of the physical and immunity and everything altogether is stronger. Is that right?

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Yes, exactly. That's insane!

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Very clever. Very clever. It's very clever of our body to be able to guide us through life, again, based on its assessment of

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how safe is your world right now? And one of the aspects around the biology of trauma that would be important for people to know is that the more stored trauma they have.

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The more that that biology that it has created, the low energy, and now the nutrient deficiencies, and now the immune imbalances.

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All of those things now create a signal of danger for our nervous system. So it's not that our nervous system is only perceiving our environment and our home or our work and saying, oh, these people are awful. It's also sensing our own biology, and it's saying, look.

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you don't have enough magnesium. You don't have enough zinc. We have so much inflammation here, like, we are in a war zone down here. And so, no, we don't have the energy to

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lose weight. Like, that… what are you thinking? Like, that's not the priority right now. We are in a war, and we're… we're not realizing that

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The source of all of these danger signals are coming from outside of us, but also from within.

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And so then that's where the repair starts, is finding out what are all the danger signals coming into my nervous system, because when I can shift those and make them be more signals of safety, that's when I'm going to shift the whole operating state of my body.

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So, you talked about, you know, there's layers that are occurring in our biology, but therefore there's layers then that occur in the repair phase. What you just said, does that mean

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someone finds themselves relating to this conversation and kind of going, yeah, I've tried a few things, you know, white-knuckled it with diets, or whatever it might be.

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Addiction, you know, the whole works.

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It hasn't… or it's worked for a little bit, but then obviously…

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reverts back to baseline. Is it important, then, to have your biology tested as to your magnesium levels, your, I don't know, B12 levels, your iron levels, the full works? They're my rudimentary understandings.

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Is that part of the repair process? You really need to know what's going on in your body?

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This is what I'm calling precision nervous system healing.

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Where we can guess about where the danger signals are coming, but until we actually test, We don't know.

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And we can spend a lot of time not knowing and trying different things, or we can do a fairly good assessment, both of the biological aspects, but we also want to test somatic implicit memories, and also the thoughts that we have, and some of the parts that have

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developed over the years to help us survive. So it's this full-spectrum assessment.

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That then allows us to say, okay, here's the levels of repair. You're deficient in B6 and selenium, and you've got some toxins in your mitochondria. That's going to be the focus on the biology level to repair that.

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On the somatic level, this seems to be a trigger.

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Every time that you walk into this room, you have these

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body sensations that are recreating a sense of danger. This is how we're going to work with that. We have these thoughts and these beliefs about yourself that

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are impacting your cells and put you back into that overwhelmed state. So there's always these three levels of repair, mind, body, and biology, but it is true that we cannot neglect the biology

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And the more precise that we can be about how we are doing that repair, what needs repair, the faster we can do the healing journey. And this is where I'm finding, like, we can actually accelerate

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the healing journey, and do it safely. Not accelerate because we're trying to cut corners. We're accelerating because we're able to be more precise.

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personalized, and then pace at that capacity. That's fantastic. I love that. What was the phrase again? Precision…

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Precision Nervous System Healing.

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Oh, I love it. Precision… I know, I love it. Like, I'm just… I'm so geeking out. I've been doing that for the last 6 months with those in my programs, and I just, like, going into their biology and their labs and giving them these insights that show, like, this is what's happening in your body because of your nervous system.

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And the state that it's in, and the signals of danger and safety that it's receiving. So here's how we can be more precise.

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about shifting those. I love that, and if I can briefly share, just listening, listeners out there, you know, sometimes I think in life.

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depending on age of life, we talked about menopause before, and I'm obviously, menopausal, post-menopausal, and often things are just… symptoms are attributed to, oh, it's just that, or whatever. So, you know, I had some, you know, I don't know, aches and pains and bits and pieces, and, you know, GPs are…

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oh, no, it's just because of your age, or whatever, and I'm like, rude. No, I think I'll just have a full blood workout. Turns out.

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my B12 level, mine was normal, but my B12 was literally Nothing. Zero.

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they then tested, and my daughter as well. We have pernicious anemia. I'm like, I've gone through five decades of my life here not knowing, attributing symptoms to a biological… and now I get my, my golden needle, and it's fantastic, and I feel great. And all the… guess what? All the aches and pains, and all the stuff's gone away, and it's like…

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my body can't manufacture the protein part of it, or keep it in my body. And I'm like, are you serious?

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So, luckily, my 18-year-old got onto this early, genetically, she's inherited, that's great, but…

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At least you know, but it's interesting that sometimes the lens that's applied to these things

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isn't accurate, and truly, there may be some biology that is informing that. So I'm so glad that you've kind of shone a light on that in this conversation, that it's three-pronged here, so mind, body, and biology, and it is important, I would think, to get that right.

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Yeah, I mean, I think of how many people present with anxiety. If they present to their GP, well, they're given a prescription for Lexapro, or a different SSRI. You know, if they present to a therapist, they may get somatic work or tapping. And so, I'm coming at it from the lens of.

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The somatic work and the tapping, yes, please do those. And let's also evaluate your neurotransmitters.

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and your gut, and your mitochondria. Let's actually test these aspects of your biology that could be signaling to your nervous system, we need to be anxious because we don't have enough B12.

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Yeah. And so, never neglect the tapping. Don't… don't ever stop the tapping.

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But let's also include this biology aspect, because, like, your condition, right? Like, it's… it…

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Can so much be a part of our biology, and if we don't test, we don't know, and we're then literally fighting our own biology.

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Yeah, flying blind. Amy, this has been a fantastic conversation, and I know people listening in might be like, where do I get that precision nervous system regulation program? Tell us a little bit about what you are offering in some of your work.

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Yeah, so what I do is I say, look, what we need to do is be able to open up to life again.

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Get out of the overwhelm, many people call it chronic functional freeze, this kind of chronic

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state of just surviving our life, and really become calm and alive again. That's how we can be the most healthy, in our best state, our best health.

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But how do we do that, right? Like, I know we all want that, but how do we do that? And for many people, like me, they might find that they're trying to do so many things, and their body just isn't responding. So this is especially for those who have

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any form of health symptoms, health conditions, doesn't need to be a diagnosis, but in some way, it's already showing up in your biology and in your physical health. That's where this precision nervous system healing really shines. And we start with

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Creating one's sense of inner safety.

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Just like the turtle, that's where we have to start. We have to start with having it feel safe.

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as I'm sure you know from the people that you've worked with, people don't feel safe in their own bodies. They walk around, and they don't even know that they don't feel safe, because this is how they've always felt.

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It's not until they have that first sense of, like.

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that spontaneous deep breath, that they realize, I've never felt safe.

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in my own body before. So that's where we start. So I start with the, I mean, that's really the… the phases of the healing journey that we start with, and then we layer in the… how do we sustain that?

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We can create it in the moment, but if our biology is pulling us back into overwhelm, if our thoughts are pulling us back into overwhelm, if our somatic body implicit memories are pulling us back into overwhelm, we're not going to be able to sustain that. We need that to be sustained.

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I can't live on my meditation pillow all day long. So, that's then the next layer of work after those first 6 weeks, is layering in this aspect of mind, body, and biology

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Doing precision on each of those layers, testing, assessing.

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And working through that as we go through all the aspects of the nervous system and what it will need for healing. So we work on the freeze response, we work on grief, we work on attachment and our neurodevelopment, we work on our stress response.

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We work on letting go and detoxing. We work on neuroplasticity. These are all the aspects, and we… we work on it at the mind, body, and biology level.

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Fantastic, and links are below, everyone. If you're driving and listening, but want to come back to it later, we have all of those details, so you can connect with Amy. And Amy, if you don't mind me asking, as we start to wrap up, how have you found your field in its openness or embracing of these messages that we've talked about today?

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Oh, this is another area that makes me… that makes me sad.

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And it's… I mean, medicine is just not… not open yet. They don't know what to do with this. Again, I… I believe that everyone in the world has good intentions.

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And I look back on history and see some of the milestones that we had in medicine, even the adverse childhood experiences studies that were first published in 1992, and how long has it taken for them to even be acknowledged, and they still haven't even been integrated.

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So… Yes, I mean, medicine has kind of siloed itself into these

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fields and these specialties in order to try to wrap their hands around something that's very complex, the human body. Yeah. And so, no fault of their own, but

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I think that still at this point in time in the world's history, a person cannot expect their medical physician to understand

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trauma, trauma stored in the body, these states of the nervous system. I think that they can use them as a resource for some of the biology work, but a person needs to go in having that knowledge and knowing what they need, knowing what to ask.

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And that's where I think it's just so helpful to have that

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guidance and that kind of coaching somewhere else, so that you don't get lost in a system that is operating on a…

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on a model that serves them. Yeah, absolutely, and we all hold hope for change to occur, but it is people like yourself as, you know, pioneers who are leading, but from within, and I truly see that in chatting to many, kind of, you know, people in the medical world who are doing work like yourself.

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you are inside the system, and that is where lots of this change. So, thank you from, you know, my small corner to yours for sharing this in this kind of forum as well, to sort of let people know there are integrative options out there, and they are working. And certainly, if people are interested in

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reading, I absolutely recommend your book. You've got wonderful case studies in there of patients and what they achieved in these processes, so thank you so much. Dr. Amy Apiggian, everybody, it has been an absolute joy, Amy. Thank you so much for your time today and sharing all of your wisdom.

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Well, thank you for you and leading the way and paving the road for other female leaders in the space.

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Thank you so much, Amy, and everyone, we look forward to seeing you again in another episode of The Fourth Wave in Therapy. If you know someone who might enjoy listening to this episode, please share, and of course, you know, let us know what you think on all of the platforms. Thanks, everyone, we'll see you again soon.

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