How the Body Holds Fear, Pain and Overwhelm and How to Heal It with Aimie Apigian, MD, MS, MPH

This week on the Less Stressed Life, we’re unpacking The Biology of Trauma with Dr. Aimie Apigian to reveal how your cells, not just your mind, hold stress and why your body can’t heal when it doesn’t feel safe.

Dr. Aimie shares her personal crash-and-rebuild story and explains how stress becomes biology through the “cell danger response.” We talk about high achiever burnout, unconscious stress, and simple ways to create a sense of safety so your body can finally repair.

If you’ve ever pushed through exhaustion or wondered why your symptoms linger even after doing everything right, this episode gives you language, awareness, and practical tools to help your body exhale.

📖Check out Dr. Aimie's book here: https://www.biologyoftrauma.com/book

KEY TAKEAWAYS:
• Stress grows you; trauma overwhelms you
• The cell danger response is your body’s emergency brake
• You can’t outthink a body that doesn’t feel safe
• Healing happens in layers, not all at once
• Start by micro dosing safety—breathe, feel, soften

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ABOUT GUEST:
Dr. Aimie Apigian, double board-certified physician (Preventive/Addiction Medicine) with master's degrees in biochemistry and public health, revolutionizes trauma healing by revealing how our cells—not just our minds—store trauma. Her book "The Biology of Trauma" (foreword by Gabor Maté) transforms our understanding of how the body experiences and holds trauma. After adopting a child during medical school sparked her journey, she developed an integrative science-based sequence for the healing journey. Through her practitioner training, podcast, YouTube channel, and international speaking, she bridges functional medicine, attachment and trauma therapy, proving that repairing trauma's impact on the mind, body and biology is possible.

WHERE TO FIND GUEST:
Website: https://biologyoftrauma.com/
Instagram: https://www.instagram.com/draimie/
Podcast: https://biologyoftrauma.com/biology-of-trauma-podcast/ 
YouTube: https://www.youtube.com/c/DrAimieApigian

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Podcast Instagram: @lessstressedlife
YouTube: https://www.youtube.com/@lessstressedlife

SPONSOR:
Thanks to Jigsaw Health for sponsoring this episode! Looking for a clean, tasty way to stay hydrated? Their Electrolyte Supreme is a go-to for energy, minerals, and daily hydration support. Use code LESSSTRESSED10 at JigsawHealth.com for 10% off—unlimited use!

I’m opening up applications for a 90 Day high touch mentorship that will run Nov 1- Jan 31 for online 1:1 service providers. If you’re ready for mentorship that’s both strategic and supportive, apply here → christabiegler.com/mentorship

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TRANSCRIPT:

[00:00:00] Dr. Aimie Apigian: it lingers because the body's still waiting for its true sense of safety that it never gets staying in that place. Then it creates more damage to our biology, the more that it's in that state, and that's then why years later we're struggling with disease and wondering, why is this happening?

Why me?

[00:00:24] Christa Biegler, RD: I'm your host Christa Biegler, and I'm going to guess we have at least one thing in common that we're both in pursuit of a less stressed life. On the show, I'll be interviewing experts and sharing clinical pearls from my years of practice to support high performing health savvy women in pursuit of abundance and a less stressed life.

One of my beliefs is that we always have options for getting the results we want. So let's see what's out there together.

 All right. Today on the Less Stress life I have Dr. Amy Apigian. Which, thank God she told me how to pronounce her name. She is a double board certified physician in preventative and addiction medicine with a master's degree in biochemistry and public health, who is revolutionizing trauma healing by revealing how our cells, not just our minds store trauma.

She has a recent book that has come out called The Biology of Trauma with a Forward by the kind of the. Biggest name in body trauma, which is Gaber Matte, I think is how we say his name, which transforms our understanding of how the body experiences and holds trauma. After adopting a child during medical school sparked her journey, she developed an integrative science-based SQL for the Healing Journey through her practitioner training podcast, YouTube channel.

In international speaking, she bridges functional medicine, attachment and trauma therapy, proving that repairing traumas impact on the mind, body, and biology as possible. So, big topic. Welcome to the show, Dr. Amy. 

[00:02:13] Dr. Aimie Apigian: Well, thank you. I'm really excited for this conversation. 

[00:02:16] Christa Biegler, RD: Yeah, I am too. I think anything we can do to kind of open our brain up, I mean, we've been talking on the show for a long time, how trauma is a.

Piece of kind of the autoimmune triad and all these things, and most practitioners would say that a lot of times people walk in and it's rare that there wasn't a stressful event before, but we go even back farther than that. I'm excited to go back to some of this like childhood stuff and then of course talk about some tangible tools, but.

I think origin stories are mo the most fun, right? They provide humanity to why we're doing the work that we're doing. So tell us a little bit about this story that kind of, helped you become interested in this topic. You said you adopted a child, which, exposed you to some new things that got you kind of interested in this topic overall, especially, and I think you were in medical school at that time, is that right?

[00:03:02] Dr. Aimie Apigian: Yes. So you and I were just talking briefly before we hit record around how. We can get involved in projects and we think like, oh, this isn't gonna be that hard, and then it turns out to be so much harder than what we thought. That's what I did in medical school with foster parenting. I was just finishing my master's in biochemistry and I was like, I've got some time.

I wanna make my life meaningful. What can I do to make a difference? I can be a foster parent, and between all of the things that needed to happen in my home and just the timing. They called me once. I was already back in medical school, but he's, what happened? They told me about him and they said, we have this 4-year-old boy and he needs a home.

And honestly, that was all they had to say. And I was like, yes, yes, yes. Now, as I learned more of his history and his past, I realized how much I was actually taking on, but that wasn't my initial response. As I'm seeing this unfold and I'm seeing what he's bringing in to my home with him, he's bringing his whole past, and his past was very traumatic, and I thought that with time, since we know that time heals all right, thought with time and that with love, because love is the other thing that heals everything.

Between time and love, he would adjust and he'd be able to rise above his childhood, and that is not what was happening. It was not.

[00:04:40] Christa Biegler, RD: Well, first of 

all, congrats to you. I always think foster parents are the real MVPs in the world, or anyone who's like really setting themself aside to care for someone else.

I just have always held that belief very close to my heart. So I think that's pretty incredible. And I think it says a lot about you as a human. If you were thinking, wow, I got a little time after I finished my biochem degree, before I go to medical school, how can I change the world? So that science brain.

Probably had you wondering and questioning what was going on. So tell us about how you started to kind of unwrap some of the research and what was going on at a cellular level, because we tend to seek deeper wisdom or seek something else if what we're doing isn't working right because we're moved to change through inspiration.

Desperations usually desperations. So tell us how the next step unfolded, how you kind of started to learn how the biology is really impacted by trauma. 

[00:05:34] Dr. Aimie Apigian: Yes. I start my book with a story with Miguel, and we're in a rocking chair and he says something that puts me into that desperation place. And so from that moment I realized that trauma is deeper than what I thought.

It's not just in his mind, it's so much deeper and how do I access that? So that's what I started researching. I started studying attachment because of course he's four. This must be all attachment. And studying how that actually shapes our brain, how that shapes what we believe. I, at this point, am still not thinking biology.

Actually, it wasn't until I got sick six years later. That I'm like, wait a second. This has become my biology for kids. We often may not see the biology piece right away because the biology piece is one that accumulates over time. Mm-hmm. So this is why we often are developing autoimmunity in our thirties, our forties.

Women going through menopause are noticing that their body is having so many more symptoms, the more trauma they've had, that's remained unresolved. Mm. Yeah. And so for me, like working with his body, it was clear that his body was still being held hostage by the past. But the biology piece really didn't come into play until I got sick myself in 2014.

[00:07:08] Christa Biegler, RD: Well, let's unwrap that story. So. Tell us what happened with you. 

[00:07:13] Dr. Aimie Apigian: One morning I could not get outta bed. Now this is coming from someone who had, by that point, run five marathons. I was all the time biking, running, hiking. I was very active and I was one who pushed myself a lot. So it wasn't just that I'd go out for a jog if I was gonna go out like we are gonna beat our past best time.

And this idea then that, how did my life go from that to literally not having the energy to be able to get out of bed? The fatigue was so severe when had this become my life, when had this become me. I don't even recognize myself anymore. And I am so thankful now that happened because it was the moment in which my body gave me a very clear message that.

No, we cannot do this anymore. What has been working has worked in the past, but it can no longer continue to work, and that's what I saw a lot of things happening to my patients as well, is that they developed these strategies to function and those strategies worked until they didn't. And now I was at that place.

And my turning point though was to read the book When the Body Says No by Gober Mate, and realize that my autoimmunity that we had just discovered my autoimmunity was a sign of trauma, not just my immune system being imbalanced, which meant to me that whether I liked it or not, whether I understood why or not.

I also needed to bring in trauma work to my plan moving forward in order for me to have my best life and to be in my best health. 

[00:09:06] Christa Biegler, RD: Well, you're a woman after my own heart, because I always think this clinical picture is the one that kind of breaks my heart the most. The one that's unconscious stress, that's I'm performing.

Like we have a very high achievers, which is essentially, you use different words to describe Right. Very good. Going out doing the thing. They tend to have kind of this high tolerance for pain or just sort of pushing through. Yep. And I've been trying to put my finger on, you know, describing it, but as the person who.

Also was that and has done a lot of healing around that. Right. There's, I, there's layers. I don't have necessarily a map. I think you've got a little bit more of a process than a map that, than I really have around this, but it's. It's someone after my own heart because I see these physiologic responses to the stress at that time, right?

Like we're blowing through nutrients, under stress, and when you don't have nutrients, then the body can't function properly. Those are the workers at the body. And I'm curious because even one of my first health crises, I'm sure there was some signs and symptoms before, and so it's a matter of learning and recognizing that earlier.

Do you think you had signs before the day you couldn't get outta bed? 

[00:10:13] Dr. Aimie Apigian: There were so many signs, Krista, and this is how disconnected I was from my own body. Now to give your audience context, I didn't even know that I was disconnected from my body. That's how disconnected I was from my body.

[00:10:28] Christa Biegler, RD: Yeah, I understand completely.

[00:10:32] Dr. Aimie Apigian: And here I am, feeling so proud of myself because I'm a physician. So that means that I really know the body. I know how to fix and heal people. I, I am a surgeon at that point, so I am inside the body. I have been working on the vagus nerve and cutting the vagus nerve.

Like if there's anybody that knows the body, it's me. So what a shock for me then to have this experience where I realize. I have been so disconnected from my body. It's been yelling at me for years. I've been turning a deaf ear. I've been pushing myself more into my work when the loneliness and the sadness and the grief become a little too much, I just reach for a tub of ice cream and I can numb it and make it go away, and I can keep going because everything for me hinged on being able to perform, being able to accomplish, being able to study, being able to do well, being able to be my best.

So anything that felt like it was holding me back. At that time, I needed to numb it, avoid it, distract myself from it, stuff it, and I had gotten so good at that, I didn't even know that I was doing it.

[00:11:50] Christa Biegler, RD: Yeah, I wasn't sure if you were talking about yourself or about me there for a second. So, but this is the conundrum to me and I kind of coined it unconscious stress.

Yes. Yeah. And we'll talk about kind of unlayering and decoupling it maybe from stress versus trauma. But I think, the thing I wanna just kind of piggyback on is what do you think is one of the options opportunities for helping people reconnect to the body? Because when you are this overachiever who is pushing yourself, performing, et cetera, you don't necessarily resonate with reconnecting to my body.

[00:12:22] Dr. Aimie Apigian: Right? And I look at it as repression or suppression. Suppression is where I am consciously suppressing something. I know that, oh, I'm feeling this sadness. I don't want to feel sadness, so I'm going to go do this instead. Or I'm going to go eat this. I'm going to lose myself in movies right now because I don't want to feel this.

And there are many people who live. Suppressing their emotions rather than being able to move through them. Mm-hmm. But the greatest danger, like you say, is repression. You don't even know that you're stuffing that down. 

[00:13:10] Christa Biegler, RD: Yeah. I really like this delineation between the two because I think we can probably relate to suppressing, and I think every medical provider should be able to, I can't necessarily speak for every.

Every discipline, but I can say for medical providers, there is some crazy things you see. And so the way you survive is you dissociate, right? Yes. And you sort of suppress what would be naturally sad because you are required to be professional in that place. I remember some, I can bring myself back to, I'm sure you have these as well.

Where you're working with patients in a conventional setting and it's like, no, we're not gonna talk about your potassium and phosphorus today because your child like burned their house down with your grandchildren in it. It's just like beyond comprehension sadness. Right? And a lot of times in these medical professions, this is real life.

This is like the everyday crazy things that you see. So I think to myself, no wonder we get into suppress scene. Not only if we look at our. Family history? Did anyone talk about their feelings? Was that allowed? Right. I think it's pretty easy to go immediately into suppressing when it's like, Hey, don't cry.

Everything's gonna be fine. Right? When you're told those things.

[00:14:16] Dr. Aimie Apigian: And for me, the 

message was very much like emotions and feelings don't matter. What matters is what you do. And so what are you going to do? It was this message of channel it, if you're angry, channel it. If you're sad, channel it.

And it was always channel it into accomplishing more. And it gave me a complete inadequacy in understanding my own emotions and being able to be with them. So then that just became my default because I would consider every emotion as something that would slow me down. Slow me down is the best way to describe it, because I have to stop to feel it and then it confuses me 'cause I don't know how to feel it.

And now it's just taking up my energy because, this is hard for me to do as opposed to having the model of. Knowing what you're feeling, being able to name what you're feeling, being able to allow it to be present, not let it drive you and have you spill it all over other people, but still be able to allow it and not have to hide it or suppress it.

I keep thinking of this idea that we are as sick as our secrets. That's the same as we are as sick as our stuffed emotions. 

[00:15:39] Christa Biegler, RD: Yeah, that's a great, great thing. I think I got really lucky around this. I think I ended up in coaching related to performance and achievement. And part of the coaching model was naming, being aware of thoughts that created feelings that created whatnot, and actions and results.

And so that is what I get to do with clients a little bit. And two, the sorrow is that. Some clients participate with this and some clients who really need it, ignore it. I'm like, oh man, I wish you knew to come to these other sessions that I have, because these are really useful. But I just think, what are our opportunities to stop and observe how we're kind of thinking and feeling around?

That really is the first step. Like, stop and ask yourself. You know, as I run from appointment to appointment, what do I think I feel right now we're going to go ahead and pretend that we're fine because we're high achievers. Mm-hmm. Right? Yeah. But if we're really being honest, speaking of you're as sick as your secrets, right?

We wouldn't think that that's a secret, but it's sort of like it's kind of an appearance, right? What if we took off the facade Exactly. Exactly. Of, and I know that you think it's normal that you've run from thing to thing to thing, but how are you feeling in that moment? Are you pitting out if you are, it's a body stress response.

So you say that stress management doesn't work when you're actually in trauma. And so I wanna kind of differentiate the difference between stress and trauma. I think we kind of lump these together, and I also think it's a little bit of a. Interesting topic because people use the T word a lot now, and sometimes people even have a hard time resonating around that.

So how can we kind of differentiate stress versus trauma, and maybe that's where some of the biology comes into play a little bit more as well. 

[00:17:16] Dr. Aimie Apigian: Yeah, 

absolutely. I've got a question for you. Do you lift weights? Do you run, like what form of exercise do you do?

[00:17:23] Christa Biegler, RD: I lift weights.

[00:17:24] Dr. Aimie Apigian: You lift weights,

[00:17:25] Christa Biegler, RD: and I walk.

[00:17:27] Dr. Aimie Apigian: Yes.

[00:17:27] Christa Biegler, RD: No running. No running for me. No, no running. But I do think it's funny when I ask people what they do for fun and they tell me exercise, I'm like, oh, okay, cool. 

Right. That says a lot 

actually. This is your good time. Fantastic. 

[00:17:39] Dr. Aimie Apigian: Exactly. That says a lot right 

there. 

And how much do you like to lift?

Give me a, a weight.

[00:17:44] Christa Biegler, RD: How much do I like it? 

[00:17:46] Dr. Aimie Apigian: how much do you lift?

[00:17:47] Christa Biegler, RD: How much do I lift? So I just use dumbbell. So maybe like 40 pounds. 

[00:17:52] Dr. Aimie Apigian: 40 pounds. Okay. And when you lift those 40 pounds, does it grow your muscles? 

[00:17:58] Christa Biegler, RD: I trust that it's growing my muscles, 

[00:18:00] Dr. Aimie Apigian: yes. We trust that it's growing up. I mean, that's why we do it, right?

Otherwise, we don't really do that for fun, right? We do it because it will grow us well, what if instead of those 40 pound dumbbells, I gave you 200. Pound dumbbells. Would that grow your muscle or 

break your muscle?

[00:18:21] Christa Biegler, RD: I'm not sure. I've never tried. I feel like I might need some help initially. 

[00:18:26] Dr. Aimie Apigian: Yeah, it would be too much.

It would be too much. So I had a patient, Kenneth, he was also lifting weights and he lifted more than what his capacity was for that day. Normally he goes into the gym, lifts the weights, his muscles grow. He's happy about that. He's a guy. He wants to look good. So he's in there growing his muscles. He lifts this amount of weight and it breaks.

He comes into the emergency room and his bicep is in the middle of his arm. It is no longer attached to his 

shoulder.

[00:18:58] Christa Biegler, RD: Things I've never seen, but yes, I remember hearing about this happening once. I'm like, oh, outside of my brain, 

[00:19:04] Dr. Aimie Apigian: right? He was the first patient for a tendon rupture. I'd never seen, I'd only seen textbooks of this.

This was a real person who had really done this. Now, if this were stress on his muscle, I would've said, Kenneth, you need ice and rest. This wasn't stress. He had broken his muscle. That's the difference between stress and trauma. Stress and analogy. It grows us. It's hard, but it grows us. Trauma is something that overwhelms us and that is why stress and trauma need different things because stress will be able to do, manage stress, make sure that we're not always in stress, but it, it allows us to grow.

I needed to take him to surgery, ice and rest, Tylenol. Is not gonna do it. It, his muscle is going to stay broken if I don't apply the right tools. 

[00:20:15] Christa Biegler, RD: So let's talk about how that translate to cellular biology. What specifically happens in the cell to the mitochondria, to the cell in general, where it gets quote unquote broken.

And really specifically, I also wanna think about this in terms of children, right? Because sometimes I do get asked from parents of rather young children, very young, young children, about how could trauma be? The case, and you'll hear from different types of providers that children will have trauma from the birth canal or something like that.

So can you kind of, I know I'm asking you a lot, but first biology around, what does it mean when the cell is then broken? Or what happens, what physiological change happens and how can we kind of look in the past when we see this childhood trauma maybe presenting as adult autoimmune conditions? 

[00:21:04] Dr. Aimie Apigian: Yes. So.

Chapter one, I lay out the five steps of the body's trauma response. These are the five steps that have to happen in order for us to say, my body had a trauma response, not just a stress response. Now, what surprises people is when we get to chapter four and I say, let's look at the cell. They're like, what do you mean inside the body?

No, no, no. Like this is what I feel emotionally, or this is what it does psychologically. And I'm like, exactly, and it's happening at the cellular level. There is something that's called the cell danger response, which is when our cells no longer are in their stress zone, they have now crossed the line and they are in overwhelm.

When we look at the microscope, we see that a cell that is under stress huns down. It huns down be like, it literally changes shape. It changes shape, and it huns down in order to help us make more energy. Mm. How cool is that? Like even down to all the individual? However many trillion of cells that we think we have, 23 trillion, 50 trillion.

I've heard several numbers at that point. Who's counting? There's trillions of cells and every single one of them is responding to help us. Wow. So it's the whole body at the site level saying, I know that you need the maximum amount of energy right now to overcome this danger. I'm gonna give it to you.

I'm gonna give you my best. And they do. But what if Krista. Our best is not good enough. 

[00:22:53] Christa Biegler, RD: Well, I think that happens a lot, right? That happens a lot. I always think it's like, it's like you hit the pedal and you speed up and then eventually you run out. 

[00:23:03] Dr. Aimie Apigian: Right? And when we run out, when we realize that my best is not going to be good enough, does it continue to make sense to have the foot on the accelerator if it's not gonna make a difference?

No. It doesn't make sense. And in fact, it's actually more dangerous to keep my foot on the accelerator because then I'm just gonna run out of gas as well. Mm-hmm. So it's better to take my foot off the accelerator, put on the emergency brake, and at least save whatever gas I still do have in the gas tank, just in case I might be able to escape at some point.

Mm-hmm. And so that's what our cells do. Our cells, they start to fall apart. Literally they no long. Yes, they're membrane. So around the cell we have this membrane and this membrane is supposed to keep things out and keep other things in. And in this type of response, it starts to become very leaky.

Everything comes in, things go out. And there is a survival strategy in that 'cause it's letting out these. Proteins and it's actually letting out a TP, which is our form of energy, not so that it will be used up, but so that it will signal to the other cells. We're going into overwhelm, we're shutting down.

So it's almost like surrendering the white flag. And I'm gonna let everybody else know in the area that we're shutting down 'cause it's probably a good idea for them to shut down too. And this is then what's happening at the cellular level that creates the sensation. Of the heaviness that we feel when we go into a trauma response.

When we're in a stress response, we have high energy, we have, really rapid thoughts because they're trying to problem solve for us. Do I do this? Do I do this? Do I climb over the wall? Is there another way around? Like, what am I doing? And so it's a very high energy state. That's a problem solving state taking action.

When we shift into that trauma response, this is a low energy state because our cells have literally stopped and they've said, it doesn't make sense for us to keep making all this energy. Now it makes more sense for us to conserve energy. And thus we feel brain fog. We feel heaviness. We really wanna just curl up into a ball, into a fetal position, pull the covers over our head and make it all go away.

So it's a very different cellular experience when we're in that trauma response than when we're in a stress response and we're making all of this energy to use it to overcome a problem. 

[00:25:53] Christa Biegler, RD: I feel like I see this in practice looking like people are going and going and going and then they reach a heightened period of actual stress, like a prolonged tighten period, at least more than a month.

And then they kind of crash and burn. Like everything sort of falls apart. And I liken it to you're using up more nutrients. I think, I have seen. I wasn't calling it membrane falling apart, but degradation of the cell membrane status, which is the same thing, right? So you're not getting nutrients in and out of the cell.

Basically. You become hypersensitive to things as well from a very, like anything you're taking into your body becomes very hypersensitive also. And so I think this makes a ton of sense just because I've seen it clinically happen. And I could really rationalize it, but I wanna, probe in, I wanna press in even deeper about.

Let's talk about when the trauma is getting stored from age. Birth three, six, et cetera. And how that, I think that the same mechanism happens as we just described, where it's like you might have trauma stored in the body and specifically what does that look like? But you might have trauma stored in the body and then you have this chronic period of stress and then it crashes and burns kind of like you just talk about where things fall apart.

Literally is, is how we see the manifestation. So we can talk about how that trauma really gets stored in the cells at a younger age. Mm-hmm. Just kind of hanging out, waiting to be. What's going on, where this gets carried around for a long period of time? 

[00:27:16] Dr. Aimie Apigian: Yeah, so the body has one trauma response.

There's not a trauma response for birth trauma and a different response for a car accident, a different response for neglect. The body has one trauma response, and what it needs is to reset back to safety. That's what the cell danger response needs it. It needs a reset back to safety and how does it do that?

And that's what most people are not getting. That's what most people don't know how to give to their children. They don't know how to give that to themselves. They don't know how to allow their body facilitate that process to return to a full sense of safety after a trauma response. I was talking with a father the other day and his college age son was at a shooting and was just feet away from the shooting and saw the person die.

The father was so concerned about his son, and when he finally found him, he said, my son had a look on his face I'd never seen before. It was this shock. It was this daze, but he didn't seem to even know it. Hmm. I'm concerned, I don't know what to do. I see him channeling this into just more exercise, which is very common for us to do when we are younger and have that kind of energy.

What do I do? Do I take him to therapy? Do I do this? How do I get him to talk about it? Does he need to talk about it? And this is what happens when we experience something that shocks us in that way, which is always what a trauma response is. It's a, it's a shock and a stunning of our heart and our physiology.

And the body then needs that reset back to safety where it truly feels safe and ready for the next stress that may come. And often what we're doing is just like this young boy, college age boy, not actually wanting to feel that, to process mm-hmm. To be with that. So we're avoiding it, we're channeling it, we're doing anything but feeling it.

Then that's when the body just, it lingers because the body's still waiting for its true sense of safety that it never gets staying in that place. Then it creates more damage to our biology, the more that it's in that state, and that's then why years later we're struggling with disease and wondering, why is this happening?

Why me? We're not connecting it back to No, this is years autoimmunity is years of a biology of trauma building underneath the surface. I'm sure you've seen that there's often a specific trigger and the year or two preceding autoimmune diagnosis. Like my patient, Elena, I start, the book with that chat with her story of her developing autoimmunity one year after a car accident one year, right?

Like she wasn't making that connection, but her body was never able to get back to where it had been before that car accident. But it wasn't until a year later that she actually gets the diagnosis of autoimmunity. But of course, it wasn't even that car accident. It was all the way back to her childhood.

The car accident was just the final straw that made her body no longer able to function the way that it had been functioning. But it wasn't that she was thriving. She had just been surviving how best she could, and now that was no longer good enough. And so she gets the diagnosis of autoimmunity. 

[00:31:08] Christa Biegler, RD: I always think it's really incredible and I'm fortunate to work with a lot of clients.

Most of them are able to pinpoint kind of a triggering event. And actually you brought me back to a very early time in practice. I'd met someone in a business group and I remember her saying I was never the same after that car accident. And then we later learn how, traumatic brain injury specifically talks to the immune system and throws the immune system out of range, et cetera, like we have right now.

Reasons, right? And then it's a matter of stacking on the old past reasons. And so the question that comes up for me, 'cause even when sometimes we don't think about, I think humans we're, we're pretty terrible historians for the most part. And I think about. A car accident that I had, my senior year of high school, I was hit by a semi, actually, it was really sudden and I saw it in the rear view mirror and I was actually asked, I actually brought it up recently.

I was talking about it with someone. I was like, yeah, I was pretty un not okay in my body, even for a person being pretty disconnected. I was like. Really in a lot of fear every time I would pass this MI for years. And so anyway, I just bring this up because I hadn't thought about it in a long time in until last week when someone had said something that reminded me of it.

And so my question is really because, and I think this comes up a lot with childhood, is like, do we need to ID the trauma? To create safety in the body because it sounds like the bridge, or like the other side of the canyon is to create safety to calm that cell danger response. And so my question is, do we need to ID that trauma first?

And this is a little bit of a bone of contention in this work overall, right? Where people say, I don't wanna relive that trauma as well. 

[00:32:46] Dr. Aimie Apigian: Yeah. Well and that's the challenge right there, is that oftentimes Id, the trauma has meant then reliving the trauma. And I am very much against that. There is no benefit in reliving.

And what I look at is I'm looking for patterns to know that they're stored trauma. And I'm looking for those patterns in your life today. I'm not giving you a checklist of events and asking you, did any of these things happen to you in your past? It's not even helpful for me to, again, it's bringing it up.

It's making you think about it, making you remember it. For what purpose are we gonna resolve it? If I can't resolve it, I don't want to bring it up. Mm-hmm. I'd rather it just stay there and lie dormant. It's in Pandora's Box and we will eventually open Pandora's box, but I don't need to open the box until I have the tools to work with what's gonna come out of that box.

Mm-hmm. And so what I'm looking for, I'm not looking at your past. I'm looking at what's showing up in your life today. The other reason for that, Krista, is that we can have many experiences of our past that we have resolved. And so we're not looking for resolved traumas, we're looking for unresolved traumas.

And so that's another reason why looking at the past is not helpful. It's looking at your present. What's going on today? Do I see these patterns showing up in your life? Your relationships and your health. Those are the three areas that I look at, because if it's a true pattern of your nervous system, it will show up in all three of those areas.

It will.

[00:34:29] Christa Biegler, RD: Can you give us an example or two of some of the patterns?

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[00:35:40] Dr. Aimie Apigian: Yeah, so these are the patterns that I lay out in chapter nine, four patterns in chapter nine, and then the fifth pattern in chapter 10. The four patterns in chapter nine are coming from the survival strategies. Our nervous system engages when we are going into a trauma response, and those are disconnection, disruption of movement or that immobilization, that freezing, that freeze response energy depletion because of its effects on the cell and our mitochondria and our metabolism, and then we come to this one that's a chronic feature.

Dysregulation. So at the end of the day, Krista, that's what I'm looking for. I'm looking for patterns of dysregulation. Mm-hmm. What does that mean? Dysregulation refers to the type of responses that you have to information. And so when I present you information, you're going to have a response to that information.

Now, sometimes that information is something that, a food that you eat. Food that you eat is information to your body. How are you responding to that information? Information is also what you see or what you feel. You walk outside and there's a temperature change. That temperature change is information to your nervous system for it to do something, for it to have a response.

You want it to start sweating if it's hot outside, so that you can cool down. So you need your nervous system to have a response. It will always have a response. Dysregulation is the type of response that shows stored trauma dysregulation can either be over responding or under responding, but not responding in the way that would be best appropriate for the situation.

So I'm looking at, do you over respond? Do you under respond? Do you do a combination of both? Because if I can see that pattern of how you respond, how you react, then I know we've got something to work with and whatever we work with, I don't need to work on the story yet. I get to work with the dysregulation in the present moment.

Healing happens in the present moment. Healing does not happen in the past and with its stories. It's being able to resolve them in a way that it creates a different present moment for us. And so we start with working with our nervous system states in the present moment, and then we have the skills to work on a story and resolve it without reliving it.

[00:38:28] Christa Biegler, RD: Got it. Okay. So step one is finding these patterns to work on these nervous system.

[00:38:33] Dr. Aimie Apigian: Yes. Recognize the patterns.

[00:38:36] Christa Biegler, RD: And then what comes next? I know you probably lay a lot of this out in your book, but we want to have an understanding. So often this work around trauma has felt some, a little bit inaccessible sometimes, right?

It's felt like challenging, difficult or like people did, there we've had different guests on and talk about d things or it feels like, okay, something I see in clients is this desire to like. Figure something out, close the chapter and move on with life. And that is fine, but sometimes we think, okay, I'm just gonna come in and have a one hour thing with someone on resolving trauma, and then everything should, I should have dealt with it all right?

And so I kind of want, the reason for me asking these tangible takeaways is to try to understand more deeply what this can kind of look like in the overall healing journey. So recognizing patterns comes first and then what happens next? 

[00:39:31] Dr. Aimie Apigian: So. One of the key principles is that our body is designed to heal by itself.

Have you ever had a surgery, Krista?

[00:39:42] Christa Biegler, RD: Yes.

[00:39:43] Dr. Aimie Apigian: What surgery have you had, if you don't mind me asking?

[00:39:45] Christa Biegler, RD: Yeah, I had hand surgery. Hand surgery to a bone.

[00:39:48] Dr. Aimie Apigian: Okay. And to repair that bone, they had to make an incision in your skin. They had to open you up. Right. How well did your skin heal after that surgery?

[00:40:04] Christa Biegler, RD: I think it healed.

Okay. Yeah. It healed on its own. 

[00:40:08] Dr. Aimie Apigian: It healed on its own. You didn't have to talk about it. You didn't have to meditate about it. You didn't have to go to therapy about it. The body knows how to heal when it has what it needs, and so that's the key. Giving it what it needs. If I look at my body has not resolved something from the past that it is normally designed to innately be able to resolve on its own, then somehow I have not given it what it needs.

So that's the next step. Once I recognize that I still have some stored trauma, then I'm looking at what has been blocking my body's healing. Then that allows us to start to personalize what is the next best step? Because it won't be necessarily the same thing for everyone. There are principles that we can go by.

Like you have to start with safety. You have to create the safety or else there's no healing. So there are these principles that we can look at. These are the phases of the healing journey that everyone will go through, but at each phase it's. Am I giving my body what it needs? For some people it will be nutrient deficiencies are what have been blocking my body's innate ability to have the energy to do the trauma healing.

Yeah. There are people that will be biochemical imbalances. There's pyroluria is actually a common association with autoimmunity. So for those with autoimmunity, that's a lab, a biochemical lab that I'm having them test. Because if they have it, it's a block to their healing. Mm-hmm. So now my job is just identifying the underlying reasons for why my body's gotten stuck, and then being able to prioritize the list of things that I discover so that one by one I can be working through them and removing these blocks.

[00:42:03] Christa Biegler, RD: I love it. 

Will you give us an example of a way someone can start to have safety or create safety in their nervous system? Automatic right now. 

[00:42:13] Dr. Aimie Apigian: Yes. And this is where we start. So what? What we start with is learning how to shift the gears in our car. We don't learn how to drive a car by looking under the hood and analyzing the engine and all.

No. Like maybe that will come a time. Maybe we will want to learn our car well enough that we can do that. The first thing to learn to drive is. Shifting gears. 'cause otherwise you're gonna be driving your whole life in first gear or in fifth gear. And that's where you're stuck. So being able to help your body feel safe to be in a different gear.

Many people don't realize that their set point for stress is familiar to them. They are thus bringing their past with them. And if they had a very stressful, chaotic family, oftentimes what's happening is that they are familiar with a certain level of stress in their life that they then feel bored if they actually feel relaxed or feel safe, or maybe they're so used to being on guard, that relaxing doesn't actually feel safe to them.

Instead, it feels like, no, like I need to still be stressed about something. I can't let myself fully relax. If I wanna fully relax, well then maybe I need to grab an alcoholic drink, because then I can numb the fear that I have when I relax and my body's like, oh no, we're softening. Oh no, we're open.

Oh, no. How can we be ready for the next shoe to drop? Because I know that the next danger is just around the corner. Yeah. And I don't feel ready for it. So there's so much more to creating safety than a person might think of. Well, it's just me feeling safe. No, no, no, no. There's so much more to why we haven't felt safe.

What actually feels safe, and then this step by step process. To move towards making that feel more familiar, feel more safe, to feel safe, especially for those people who are perfectionists, that is their set point. If they are not being perfect, they don't feel safe. And are you gonna really tell them, well, what you need to do is you need to feel safe right now.

They don't even know how. The only way that they know how to feel safe is to be perfect. And so it is taking these moments and saying, okay, well for three seconds we're going to let go of the need to be perfect and just create a felt sensation. And I often use somatic self practices to help do this. So that I can create a feeling of safe in my body.

For some people, this can be as easy as grabbing a pillow and putting a pillow, hugging a pillow into their belly and their chest. That may sound so simple, but what the body does is it feels vulnerable when we are open. So being able to just bring in something that is like a barrier, even though it's a pillow, it's not really a barrier, but to our body, it feels like a barrier.

And that's what we're going for. We're going for the feeling, we're going for the sense of safety. It's not something that we can tell ourselves that we should feel. It's a sense that we have to create. And so we can use these types of things to create this sensation knowing that we need to microdose.

Safety because feeling safe has not felt safe for so many people. 

[00:46:01] Christa Biegler, RD: Yeah, there's a lot of relatable points there and I think I would like to underline a couple of them. Right? Any kind of relaxation doesn't feel relaxing. Right. Or having trouble like stopping. A couple of mine were having space on my, even the wanting space on the calendar.

'cause having it over full was creating stress. Having any space felt stressful as well because it was new because of this set point. Right. Yeah. It's just, and I think that's, we don't realize that when that set point is so familiar to us. Right. That's why we probably actually believe that running from appointment to appointment to appointment day after day is normal because that's how it is.

Right. And so it's,

[00:46:39] Dr. Aimie Apigian: it has been our normal.

[00:46:40] Christa Biegler, RD: Right. So until you wake up and can't get outta bed, you're not very motivated to change it.

[00:46:46] Dr. Aimie Apigian: Exactly.

[00:46:47] Christa Biegler, RD: I can imagine. So I see some of my experiences or even story a little bit in your story, and I think as people who want to achieve and figure things out and are just frustrated by lack of results, I imagine that there was some real frustration in your own story, and it was a little bit hard as a provider, as a medical provider, I'm imagining you felt.

Rather unequipped for the work that was ahead of you when you were bedridden? I would imagine just because also coming from a medical background, and then you can go back to the science. It takes a while, right? But it's like a, it's a tough thing and it's kind of this humbling experience of like, wow.

The things I don't know that I don't know yet. Right. Will you share a little bit about how that story, how that kind of story came full circle to now? How long ago was it that you were bedridden overall and kind of what was that healing journey like? Even if you just wanna give us sort of the end points.

[00:47:41] Dr. Aimie Apigian: Yeah. 

So it was in 2014, June, 2014, and it was actually just after the greatest loss and grief that I've ever had. And I went on a medical leave for three months because I could not even work. And at that point, I am looking for answers because conventional medicine, like the system that I am in, has no answers for me.

And as I'm starting to put together the different pieces over the next several years, that's what it would be. It would be one piece at a time and. The layers that I am discovering that I don't even know about myself, the layers that I don't even know about, truly like the human body and physiology, and how did I not know about these things like brain inflammation and the trauma response and these aspects.

That ended up being a very important piece for me to finally get to where I am today. But it wasn't all at once, which probably I'm grateful for. And there's so much wisdom in that as well of for me, learning how to relax into the healing process. That life, the universe, God, whatever you wanna use, will bring you what you need when you are ready for that next piece.

I don't have to worry about it. I don't have to stress about it. I don't have to hustle for it. What I need to do is I need to focus on my biggest work for every day is to get into that calm, alive, my best self, my inner regulation, and then live from that place every day. And that allows me to continue to uncover more layers for what continues to pull me away from being present, what continues to pull me away.

From love, peace, and gratitude. What continues to pull me away from these things of how I want to be, and that's what I get to focus on. And so that's what directs me. So it's been layers and layers and layers. One piece at a time. Sometimes that's been biology layers, like the biochemical imbalances, the brain inflammation, the gut, the parasites.

The toxins. I mean, it's been so much, but one layer at a time as I'm uncovering what's, what's walking me from my next level of calm, alive, love, peace, and gratitude. 

[00:50:22] Christa Biegler, RD: Yeah, I like that perspective. I do think that we all heal in layers and I think sometimes there's a time period for a certain layer and then you need a break, and then there will be a new layer.

Layer later. Exactly. And another human behavior or trait is that we think, and I try to get better and better of describing this to people, is that we think we're gonna go from level 100 to level zero in a few months. And it's like, that's actually not very realistic. To get to 50% in a short amount of time is an incredible accomplishment.

Then the rest is layers of pieces because it's not just one thing, it's multiple things overall. So I appreciate that perspective. Yeah. How long did it take you to go from bedridden to be able to function in daily life again? 

[00:51:02] Dr. Aimie Apigian: Yeah, that's a great question. For those three months I threw myself into a lot of things.

'cause the people like us tend to do

[00:51:11] Christa Biegler, RD: Yeah. Throw some spaghetti at 

the wall, see what works. 

[00:51:13] Dr. Aimie Apigian: Exactly. Exactly. And I was under pressure, right. I'm in the middle of residency. I can't take time off. I don't have an income, like I have to get back to work. So what was interesting for me is that I was able to get to a good enough place of being able to function and get through my day at the three month mark.

But then I went back to work and it all came back, and that was when I realized I was in the wrong profession.

[00:51:43] Christa Biegler, RD: That was hard.

[00:51:44] Dr. Aimie Apigian: That was really hard. 

[00:51:46] Christa Biegler, RD: I love stories like this. You wouldn't believe how many, if I could just, come up with a statistic on this. My favorite stories are these recreation stories, these permission to pivot.

Right. And it wasn't necessarily permission as much as like, if I want to thrive in life, then it may not be right here. 

[00:52:03] Dr. Aimie Apigian: Exactly. If I want to have a life that's different than just managing my symptoms that I need to find my true purpose in life. Yeah. 

[00:52:16] Christa Biegler, RD: Our come to Jesus moments 

are pretty uncomfortable

[00:52:18] Dr. Aimie Apigian: our come to Jesus.

Oh my goodness. Are they uncomfortable?

[00:52:21] Christa Biegler, RD: Yeah. 

So we all want to do better for our clients, for our children, et cetera. So what would you say to any practitioner or parent about the frame? We didn't really get through your entire framework, but what would you say to practitioners or parents wanting to support their children or.

Clients without retraumatizing them, how can they be supportive with this biology? And by the way, this whole arena has a name, right? Is that what? It's psycho neuroimmunology. Is that the field we're discussing?

[00:52:53] Dr. Aimie Apigian: Psycho 

immunology, psychosomatics. There's been different names applied to this idea.

There's been a lot of focus even in those spaces sometimes on, it's just the connection between your beliefs. And your thoughts and your biology. And so what I'm trying to do here is I'm trying to say actually, what really is the root of all of that? Both your beliefs and your biology is your nervous system state, rather than saying, well, it's your beliefs that are creating these problems in, in your biology, because then that leads us to believe that we just need to change our thoughts.

And no, our thoughts are just an expression of our inner nervous system state. And so that's the work that we need to do. We need to learn how to track the nervous system. So whether you're doing this for yourself or like you said, a parent, a coach, someone who's helping someone else still, the most helpful thing that you can do is to learn how to notice.

Recognize and track these nervous system states because without that, you don't know if they are in stress or in they're overwhelmed, which they need very different things. And in order for you to provide the best support to them, you need to know which state they are in so that you know where are they at and what does that state need right now?

And so what do they need right now? 

[00:54:23] Christa Biegler, RD: Yeah. So, and maybe this is the same thing. If someone was listening to this and they're realizing for the very first time that their health issues might have this relationship to trauma stored in the body, what would you say might be their next step, to start to unpack this?

[00:54:41] Dr. Aimie Apigian: What I see as the first step is being able to again, learn how to notice your current nervous system states. 'cause that's where we will start to see the patterns. So I use a nervous system journal. I'm happy to share that with your audience if you like. And it's a way for a person to track their nervous system state for three days.

You can't see a pattern in one day, two days, meh, three days. You're gonna start seeing a pattern, and that's what I want people to be able to start seeing for themselves so that they know to what degree is my nervous system dysregulated. Then we know, well, what do I do? Is it more stress dysregulated? Is it more overwhelmed, dysregulated?

Is it the loop that I talk about in my book? But knowing the pattern allows us to be a lot more intentional and strategic about how we then work with their nervous system to create the shift that we want. Until we know the pattern, we're stuck throwing spaghetti at the wall. 

[00:55:43] Christa Biegler, RD: Yeah. Dr. Amy, where can people find you online?

Maybe pick up the nervous system journal, et cetera. 

[00:55:51] Dr. Aimie Apigian: Yeah, you know what? I will put the nervous system journal on my book webpage and that is biology of trauma.com/book. And then they can go and they can download that and use that. They can share that with their clients. I'm fine with whatever, 'cause I just, I want people to be able to learn.

How to recognize these patterns of their nervous system and which state they are in. And so people can find [email protected]. And again, this nervous system Journal will be on my book webpage, biology of trauma.com/book. 

[00:56:26] Christa Biegler, RD: I'm so curious, what's next for you? Is it a deep rest? Are you going to just try to get this message out far and wide?

[00:56:33] Dr. Aimie Apigian: I am in my stress response, I'm in my activation and expansion until about end of November. Yeah. And then that's when I will go into my rest and my recovery. And then, as you know, right, like it, it's waves and then my body will have its reset to safety and then there'll be some other expansion.

And, looking forward to that. 

[00:56:54] Christa Biegler, RD: I wanna comment on that. I think this is really actually a pretty good. It was subtle, but it was there and I don't see it as much anymore. But a toxic thing that I think we say as humans sometimes is. Well when this settles down or I hope that blah blah blah, like there's no end point.

But you clearly know the end point 'cause you've planned for it. Created space around it. And it's like, I know that this is gonna be a crazier time. Right? And I also see the light at the end of the tunnel. I know it's there. I've planned for it. So I'm willing to go through that. 'cause I see the end of it.

It's the issue of would we do not have an end point? 'cause we've created nothing for the end point, right. Where we. Just Kiana hope and pray for the same thing to not keep happening overall. So I just wanted to highlight that for a moment. 'cause it was subtle but it's actually quite profound.

[00:57:39] Dr. Aimie Apigian: It's been 

profound for me 'cause that is not what I used 

to do. 

[00:57:41] Christa Biegler, RD: Yeah, yeah. I totally get it. Dr. Amy, thank you so much for coming on today and talking about this very important subject and for offering these tools for us. 

[00:57:49] Dr. Aimie Apigian: Ah, well thank you for the work that you do in the world. So important.