Interview on trauma & autism

Natalie did a radio interview recently with MindBodyRadio, where she talked about trauma, somatization, autism, the double empathy problem, and her clinical practice. It’s quite a short interview at 13:14 minutes, but we hope you find it useful.

Radio interview

To listen to the interview, use the Soundcloud player below or listen to it on our Soundcloud profile.

Transcript

Interviewer: [00:00:00] Alrighty, we are back. You’re listening to MindBodyRadio. This is The Daily Show. And our next guest is over the phone from Oakville, Ontario. That’s—welcome Dr. Nathalie Engelbrecht to the program. Dr. Engelbrecht, thanks for coming on today.

Natalie: Good morning. And thank you.

Interviewer: [00:00:20] We appreciate you setting aside some time. We’re going to be speaking about your work as a registered psychotherapist as well as being a naturopathic doctor and I see you’ve been in the medical field for quite some time. So I’ll leave you the spotlight here. Why don’t you tell us a little more about yourself?

Natalie: [00:00:35] I about 28 years ago became a naturopathic doctor and during my practice, I found very early on that there were a lot of emotional problems that people were having that were causing health problems at the time. We knew that—when I went through medical school—that it was about 80% of the health problems that we saw are related to stress, and over time we’ve come to see—understand—that it’s much more significant than that. We’re actually seeing a lot of the health problems being completely related to stress.

[00:01:15] So about a year and a half into my practice, I decided to return and become a registered psychotherapist as well and focus on modern treatment methods for trauma which are different than the traditional talk therapy, but what they were finding with talk therapy was that it was actually making people’s symptoms worse because the brain was just running it through over and over again, and because of brain [neuro]plasticity we end up getting better at being traumatized, basically. So the modern trauma methods focused more on a different part of the brain and we started seeing people have quite miraculous results.

[00:02:00] For example, I actually had fibromyalgia myself, and in a single appointment, I suddenly didn’t. I had it for eight years and tried a number of different things and then actually went to a therapist for some hypnosis and walked away and I’ve never had it again in 12 years.

Interviewer: [00:02:30] Wow. That’s amazing. So you’re saying that talk therapy does—now, does it ever work or would you say it typically does make a problem worse or does make trauma more of an issue?

Natalie: [00:02:45] Well, what we’ve got with talk therapy is that trauma actually happens in a specific part of the brain. It would kind of think the brain is three brains sort of almost lazily put on top of each other. So we start off with this reptile brain at the bottom and then we swap—you know—early mammal brain on—you know, cats or dogs, that sort of animal—and then on top of that we get this more evolved brain that sinks; and when we’re doing talk therapy, we’re hanging out in the top part of the brain—the thinking part. But trauma actually comes in at the middle part of the brain. So—which is why we can see, you know, our pets get distressed and things like that; it’s more of an emotional experience.

[00:03:30] And so when we’re talking about things we’re generally talking on the top level which is—it doesn’t touch the trauma. So what we found is that it’s sort of the part of the brain that practices—getting better at that. So there is research supporting that things like cognitive behavior therapy are actually contraindicated in trauma—initially. It works very well later on, but it’s very different, and… There there’s definitely confusion in the literature.

Natalie: [00:04:00] When we look at something like the modern trauma methods saying that cognitive behavior therapy works as well—which, cognitive behavior therapy is sort of talk therapy—that works as well for trauma as some of the other methods. But it’s different, like—the talk therapy might help you cope with the symptoms, whereas we’re seeing some of the modern trauma treatments actually get rid of the symptoms. So, you know, one is basically you get better at handling your pain; one is you don’t have pain left. Does that answer the question?

Interviewer: [00:04:30] Oh, it sure does. And I see—not only are you working with trauma, but you are also interested in working with those with Asperger’s, or high-functioning autism as it’s also known.

Natalie: [00:04:45] Right. And about three years ago I actually found that I had Asperger’s myself, and I was very shocked as I’ve been in practice for 28 years and worked with people with Asperger’s etc. And it’s found that most females actually in their 40s with the Asperger’s we get diagnosed typically around then. Because…

Interviewer: Really?

Natalie: [00:05:10] Yeah. We’re good at masking. So what happens is we hide our symptoms so effectively we actually practice not being seen. So, you know, you grow up and you watch somebody’s interaction and then you learn and practice that. And the females actually learn and practice from—we watch TV shows and we copy those characters, we read books and we copy those characters. So we come across quite well-spoken. People don’t see it, but internally, we know we feel very very different. And it’s a tremendous problem because we’ve got actually 70% of high—you know, the female Aspies and what’s in the research they call high-functioning autism are suicidal. 50% are actually attempting, and 10% succeed. So it’s horrifying.

[00:06:00] And these are some of what we call the costs of camouflaging. So generally in the 40s, we see people having breakdowns finally, because they just can’t kind of hold that mask together anymore, and then you suddenly see more clearly the symptoms, and that’s when doctors able to diagnose them. The lower-functioning autism, like the—what we call Level 3—it’s just in the research that way—those, that’s more clear because you’re looking at females with lower intelligence and more obvious symptoms. They get diagnosed more easily. So, you know, we thought it was about four males to one female and we’re finding out it’s more about two females to one male [should be two males to one female] in terms of what we’re seeing in society.

Interviewer: [00:06:50] Interesting. Yah, that’s very interesting. Now you sometimes see or I guess one of the conceptions about those with high-functioning Asperger’s is that they are very adept at doing a particular thing. Is that true, or is that just a myth?

Natalie: [00:07:10] No, we definitely—I was—sorry. Yes, we are. We—one of the things about each of us is we tend to have what we call a special interest. So for myself, it’s research, and psychotherapy and—you know, it’s… Part of the things growing up—it’s, you know, instead of hanging out with other people, I generally like to read books, and I—my assistant would say to me, “Why is there a book coming into the clinic every day?” And I’m like, “Well, I read it.” I’m like, “Doesn’t everybody do that?” And so, you know, we all tend to specialize into something that we really love.

[00:07:50] So we see a lot of [autistic people] in the arts, and we see a lot of [autistic people] in the STEM—like, the science/technology fields—we see Aspies. And…

[00:08:00] The people that are able to have a—like, need less support, tend to have a higher intelligence, tend to focus on one or more things. We’re even seeing it as far back as in the cavemen days; We’re seeing that it was Aspies that were drawing the art on the on the caves. So that was quite interesting.

Interviewer: Oh wow.

Natalie: [00:08:25] Yeah. And one of the suspicions is that the gene was very cultivated because, you know, an Aspie would be able to remember the 1,412 different goats in its—you know—flock, and know that these ones would be good to breed. And at the same time be able to do the cave art and keep track of that. So there seems to be in society a need for those specialties, right?

Interviewer: [00:08:55] So where is the—because this sounds, this all sounds good. Where is the drawback? Is it in socialization? Or is it in communication? Or—you tell me—I don’t know.

Natalie: [00:09:10] Well, what they’ve actually found is that it’s a double empathy problem. And so what it is, when Aspies talk to Aspies we’re totally fine; so, we understand each other, it’s easy to communicate, we empathize with each other. So in our own world, there is no drawback other than, I would say, sensory things—but again, that’s to do with the world that we’re brought up in.

[00:09:35] One of the interesting facts is that when you’re looking at autistic children, the reason they don’t tend to look directly in the eyes is: if we use the peripheral vision, it actually filters the level of stimulus down to neurotypical—like a non-autistic. So—and then as we get older we learn how to adapt that. In other… You know… How do you work and you look so you can kind of modulate the sensory information?

Natalie: [00:10:00] But when non-autistic and autistics talk to each other, that’s really where there’s a huge problem because it’s the—we have very different communication styles, like with, you know, the Aspies and autistics, we’re very honest, very direct, and so when we talk to each other that’s very easy to understand each other, and we know that we mean things quite literally. But in non-autistics is a lot of hidden meaning, and for us, that just feels inefficient and, you know, difficult.

Interviewer: [00:10:40] I see. Now, this is a very interesting topic and I know we can probably talk for hours about it, but we have room for one more question here Dr. Natalie, and I like to hear about your goals. What’s in store for the practice moving forward?

Natalie: [00:10:55] There’s a couple of different things that I’m focusing on. One is working with—and help—people that are Aspies be able to understand themselves and overcome trauma, because a high percentage of us do have PTSD.

[00:11:10] And the other part of my practice that I really focus heavily on is trauma, and specifically what we’re calling psychophysiological disorders, which are the disorders where we’re seeing people get into a wheelchair or get pains in their bodies, and it’s actually—what’s happening is, the body doesn’t know how to manage the emotions, and so what it does is—because there’s six basic emotions that we can… that actually activate the body to call to action. So, anger makes you want to stop something, fear makes you want to run, and when we can’t really feel those and express those we store them in the body, and what we find is with some of the therapy methods now that you can do very short-term therapy—you know, couple visits, sometimes a little bit longer with patients, and they can go from having chronic pain their whole life to suddenly having no pain or… I’ve seen people get out of wheelchairs. So it’s those two aspects that I’m focusing on in my practice.

Interviewer: [00:12:20] Alright, wonderful, and if any of our listeners were interested in working with you or maybe sending a message, how could they do so?

Natalie: [00:12:30] Probably the best thing would be through my website, which is Natalie-Engelbrecht.com.

Interviewer: [00:12:40] Alright, excellent. So that would be a www.natalie-nd—as in ‘naturopathic doctor’—.com.

Natalie: Perfect.

Interviewer: [00:12:55] Excellent. And we’re going to take a break at this point. You’re listening to MindBodyRadio with Dr. Natalie Engelbrecht. And, Dr. Engelbrecht, thank you again for joining us.

Natalie: [00:13:05] Thank you so much for having me.

Interviewer: Right then. A big thank you to our audience as well. We’ll be right back shortly.

About

Dr. Natalie Engelbrecht BA MSc ND RP, is a Canadian leader in post-traumatic stress disorder (PTSD), positive psychology, attachment-based therapy, and research-based integrative medicine.

With extensive experience in helping patients recover from trauma and thrive, Natalie knows how to navigate the road to healing and is committed to guiding her patients on their journey to wellness. Her approach to health care combines a strong background in scientific academia, gathered during her medical studies at McMaster University, and her Master’s in Psychology from Liverpool University.