Episode 138: The Biology of Trauma: Why Your Body Holds On When Your Mind Has Healed with Steven Wright
- THA Operations
- Nov 28
- 15 min read
Updated: Dec 2
In this special reverse interview episode, my friend and colleague Steven Wright from Healthy Gut interviews me about the core concepts from my upcoming book, The Biology of Trauma. Steven understands the somatic work, the parts work, the biology, the capacity, and the overwhelm from his own healing journey, making this conversation uniquely insightful.
I share stories I haven't told anywhere else - including my keto diet disaster during surgery residency that became my first clue about the biology of trauma. We explore why I rewrote this book seven times, how I discovered I had all three major biochemical imbalances, and the painful decision to place my adopted son Miguel in a different home - the grief that ultimately led to my autoimmune diagnosis and this entire body of work.
Key Topics & Timestamps
[00:00] The Eight Drafts of the book: Dr. Aimie's journey as an author
[04:12] Beyond ACEs Scores: Why we can become obsessed with our score
[08:36] Capacity is Everything: Understanding your nervous system's dynamic capacity
[13:47] The Biology Block: How Dr. Aimie discovered her own biology was sabotaging her trauma healing
[21:55] The Pain Equation: When humans decide to change
[25:44] Perception vs. Reality: How we create mountains from molehills
[28:19] The Healing Timeline: Why trauma work doesn't have to be a lifelong journey
[34:04] Safety First: The critical sequence for healing trauma without retraumatization
[37:18] Stress vs. Trauma: The crucial distinction that changes everything
[38:18] Miguel's Story: The heartbreaking adoption journey that changed Dr. Aimie
Main Takeaways
The Three-Legged Stool: True trauma healing requires addressing psychological, emotional, AND biological aspects simultaneously
Biology Keeps You Stuck: Inflammation, oxidative stress, and biochemical imbalances create internal danger signals that perpetuate trauma responses
Capacity Changes Moment to Moment: Your nervous system's capacity is dynamic and requires constant awareness, not just daily check-ins
Perception Creates Your Reality: Your body responds to your perception of danger, not actual danger - making that molehill into a mountain
The Right Sequence Matters: Creating safety must come before attempting to process trauma, or symptoms worsen
Fast Healing is Possible: When addressing all three domains properly, healing happens faster than medication with only positive "side effects"
Notable Quotes
"If something makes you sick, that is not stress. Let's call it for what it is. That is your body having gone into a trauma response."
"Our capacity is not being measured up against our reality, it's being measured up against our perceptions."
"The pain of staying the same has to become so bad that we're willing to undergo the pain of change."
"If their body had already felt safe, it would have already opened up all of this stuff and let all of these emotions and trauma go. It hasn't felt safe."
Episode Takeaway
Trauma healing doesn't have to be a lifelong journey. By understanding that trauma lives in your biology - not just your mind - and following the proper sequence of safety, support, then expansion, you can heal faster than traditional approaches suggest. The key is addressing all three aspects: psychological, emotional, and biological, rather than focusing on just one.
Resources Related To This Episode
Resources/Guides:
Biology of Trauma book - Bonuses are available when you Pre-order now.
(available only until September 22nd):
Guided Seeker: Get the Workbook + Mastercourse to go with the book - walking you through each chapter's key concepts
Accelerated Implementer: Everything above + live half-day online group intensive with Dr. Aimie for implementation support
Fast Track Professional: Everything above + one full day in-person with Dr. Aimie at her home to identify your biggest personal block to your next level of healing and regulation as a professional and guide for others
Foundational Journey - If you want to be guided through The Essential Sequence laid out in the Roadmap and the book, join me and my team for this 6 week journey into your inner world with practical somatic and parts self-practices to lay your foundation to do the deeper work safely. These are the daily practices I have found that change one’s biology and health symptoms the fastest.
Steven Wright - Healthy Gut - Learn more about Steven's gut-brain support products: HoloZyme™ digestive enzymes with dual-strain activation technology, Tributyrin-X™ for microbiome diversity and gut lining health, and HCL Guard™ for protein digestion support
Related Episode:
Related YouTube Video:
About Dr. Aimie Apigian
Dr. Aimie Apigian is a double board-certified physician in preventive and addiction medicine who bridges the gap between Western medicine and somatic healing practices. After her own health crisis in 2014 while in medical residency, she discovered how stored trauma was affecting her biology. She has since dedicated her career to helping others understand and heal the biological impacts of trauma through her courses, clinical practice, and her new book "The Biology of Trauma."
Why Biology Is often the Missing Piece in Your Trauma Work: Beyond Mind-Body Approaches
You've spent years in therapy. You can recognize your triggers, understand your childhood patterns, and spot toxic relationships from across the room. Your mind feels healed - you have insight, awareness, and emotional intelligence. Yet your body tells a different story through chronic fatigue, digestive issues, autoimmune conditions, or emotional eating patterns that seem immune to willpower.
This disconnect between mental healing and physical symptoms reveals a crucial gap in how we approach trauma recovery. In a revealing conversation with Steven Wright from Healthy Gut, I share the personal discoveries that led me to understand why traditional therapy often plateaus - and how addressing the biological piece can accelerate healing beyond what most people think possible.
This interview explores stories I haven't shared elsewhere, including the keto diet disaster that became my first clue about trauma biology, why I rewrote my book seven times, and the painful grief that ultimately led to my autoimmune diagnosis and this entire body of work.
Why I Rewrote This Book Seven Times
Writing The Biology of Trauma became an exercise in distillation. How do you take decades of medical training, personal healing, and clinical experience with thousands of patients and present it in a way that's organized, cohesive, and actually usable?
The challenge I faced:
So much knowledge and experience to share
Need to organize it coherently for readers
Finding the most important things for people to know
Making complex science accessible without losing depth
I literally wrote the whole book, threw it in the trash, and started from scratch - seven times. Each version taught me something about how to better serve the reader. The eighth version you'll read represents the clearest path I could create for understanding your body and nervous system.
Steven captured something important about this process: the book transcends and includes various works in both the trauma space and functional medicine. I'm not creating something entirely new or asking people to forget everything they've learned. I'm showing how all these pieces come together and what you need to know about the emotional, psychological, and biological aspects of healing.
The Mental Healing vs. Physical Healing Gap
So many people come to my courses saying they've done extensive work to understand what happened to them and why it impacted them. They've invested years understanding the situation, the events, and the people who hurt them. Their minds feel healed - they can recognize boundary issues and toxic patterns.
But then they tell me: "My mind has been healed, but my body still hasn't."
Common signs of this gap:
Understanding trauma mentally but still experiencing physical symptoms
Recognizing triggers but body still reacts automatically
Insight into patterns but unchanged health conditions
Emotional awareness but persistent fatigue, pain, or digestive issues
This gap reveals why traditional talk therapy often reaches a plateau. If you're still living under the impact of the past in your physical health, that's not yet true freedom. There's still another layer to address.
The Three-Legged Stool Approach
The most efficient path for healing - whether you want to overcome physical problems or mental/emotional challenges - involves working on parallel tracks simultaneously. You support your cellular, tissue, organ, and body biology through testing, supplements, and nutrition, while also creating safety mentally and emotionally.
Why this parallel approach works:
Creates a stable container for healing
Prevents lopsided recovery that topples easily
Addresses root causes rather than just symptoms
Allows for balanced growth and development
It's like trying to balance on a stool with just one leg versus having three solid supports. When we can address the emotional, psychological, and biological levels together, we create the container that allows for sustainable transformation.
Understanding Capacity: The Foundation of Everything
Capacity determines everything - your ability to handle psychological activities like teaching or presenting, your capacity to hold difficult emotions or even positive emotions like love and joy, and your physical capacity for exercise or just getting out of bed each day.
What affects your total capacity:
Psychological pressure and emotional environment
Physical burdens like toxins and oxidative stress
Nervous system state and regulation
Sleep quality and circadian rhythm alignment
Nutritional status and biochemical balance
We all have this one capacity that operates on psychological, emotional, and physical levels simultaneously. When capacity is exceeded - whether by psychological pressure, emotional overwhelm, or physical toxins - our body crosses what I call the Critical Line of Overwhelm.
The dynamic nature of capacity:
Changes from moment to moment based on nervous system state
Requires ongoing check-ins, not just once-daily body awareness
Influenced by internal biology and external environment
Determines whether challenges help us grow or push us into overwhelm
My Journey from Willpower Shame to Biological Understanding
For years, I was programmed to think about everything in terms of psychological mindset. When I struggled with binge eating and emotional eating, I started attending 12-step groups and Overeaters Anonymous. I was completely focused on choice, decision, mindset, and willpower.
The willpower trap I fell into:
Believing emotional eating was just a choice
White-knuckling through cravings and crashes
Shame cycles when willpower inevitably failed
Missing the biological drivers underneath behaviors
The Keto Diet Disaster That Changed Everything
The first shift came from an unexpected source. In 2014, during my major health crash, I was overweight and on two mood medications. Desperate to lose weight, I signed up for a keto diet program - meal packages delivered in the mail, which was a significant investment on a resident's limited income.
What the keto experiment revealed:
Threw me into anxiety and panic attacks
Increased fatigue despite promised energy benefits
Deeper depression and shame cycles
Shutdown responses I discuss in my book
Rather than weight loss success, this drastic dietary change showed me that what I was eating directly caused emotional experiences. I could shift depression, shame, and shutdown responses with food choices. This was my first glimpse that something biological was driving my struggles.
Discovering Brain Inflammation
The next piece came when I found Dr. Datis Kharrazian's book "Why Isn't My Brain Working?" I learned about brain inflammation and what causes the priming of microglia (immune cells in the brain). Looking back, I realized I'd had multiple head injuries, whiplash, and concussions that could explain my brain fog and decision fatigue.
The pattern that emerged:
Physical trauma priming inflammatory responses
Certain foods triggering cognitive symptoms
Connection between past injuries and current struggles
Brain inflammation affecting emotional regulation
All Three Biochemical Imbalances
The final piece came after a 2017 car accident when I wasn't recovering and was progressing into chronic pain, weight gain, fatigue, and depression. That's when I discovered nutritional support protocols for mental health and learned I had all three of the most common biochemical imbalances.
What this meant for my childhood experience:
Pyroluria explained my early headaches and classroom struggles
Understanding why I needed such willpower to maintain good grades
Recognizing the massive energy required to override my biochemistry
Creating new meaning around childhood experiences of overwhelm
This biological lens allowed me to look back on my childhood and form very different meanings around what happened. I wasn't lazy or lacking willpower - I was a three-year-old struggling with biochemical imbalances that made normal activities overwhelming.
Why Biology Is Often the Missing Piece
In my clinical experience, when people don't make the changes they want in emotional or psychological work, their biological capacity is usually holding them back. The biology is often the missing piece they haven't known to address, making it their biggest block.
Why this was shocking to me as a physician:
I thought I knew the body intimately from surgery and ICU work
Had extensive training in anatomy and physiology
Yet wasn't taught about brain inflammation and biochemical imbalances in medical school
My own biology was blocking my trauma healing progress
If I could get stuck as a physician who thought she understood the body, then other people must be in the same position. This became my message: biology is often one of the biggest blocks to progress in trauma work.
The Pain Threshold for Change
One truth I learned from addiction medicine applies to trauma healing: the pain of staying the same has to become greater than the pain of change before we'll take action. This applies whether we're talking about addictions or responses to stress, sleep problems, or relationship patterns.
The change equation:
We rationalize and try the same approaches repeatedly
Tell ourselves "just one more time" or "let me try this other way"
Stay stuck until pain becomes unbearable
Only then become willing to undergo the pain of change
How this shows up in my work:
People see course offerings as "trying to sell something" when pain isn't great enough
When pain threshold is reached, the opportunity becomes an easy "yes"
Recognition that previous attempts aren't reaching nervous system and cellular levels
Willingness to create safety in cells, not just in the mind
The Law of Diminishing Returns in Healing
Steven brought up a mathematical principle that perfectly captures why people get stuck: the law of diminishing returns. You can get 80% of results from cognitive behavioral therapy or neurofeedback relatively quickly and affordably in that narrow field. But getting the last 20% of available results becomes extraordinarily time-consuming and expensive.
The pattern in healing approaches:
Initial progress comes relatively easily
Reaching higher percentages requires exponentially more effort
The last 5% takes the longest and costs the most
People stay stuck trying to perfect one approach instead of switching
Why switching approaches accelerates progress:
Moving from cognitive work to somatic work opens new possibilities
Adding biological support creates rapid shifts
Multiple approaches working together compound results
Avoids the diminishing returns trap of single modalities
Do These Sound Familiar?
Throughout our conversation, Steven asked questions that came directly from his own healing journey - questions that many people wrestling with trauma and chronic health issues find themselves asking:
Key questions:
"How did you figure out it might be your biology holding you back and not something psychological or emotional?"
"Do you find that people who don't make the changes they want to make is because their biology capacity is holding them back?"
"How fast can someone actually make progress if they're supporting all three legs of the stool?"
"What am I misunderstanding that you'd love for me to get?"
Steven also shared some of the patterns of dysregulation he had:
Getting extraordinarily fixated on certain issues or labels
Obsessively calculating ACE scores to see if he "qualified" for trauma
Trying to map the past and understand memory gaps
Having a bigger map but still experiencing the same emotional turmoil, sleep issues, and gut sensitivity
Using fear and urgency to drive success, then crashing by Wednesday
If you recognize yourself in Steven's questions and patterns, you're not alone. These are the exact experiences that led me to understand why so many intelligent, self-aware people get stuck despite doing extensive personal work. The missing piece is often the biological foundation that needs support alongside the emotional and psychological healing.
You might be experiencing:
Extensive therapy progress but persistent physical symptoms
Understanding your patterns but still reacting automatically
Success through pushing yourself, followed by inevitable crashes
Fixation on getting the "right" diagnosis or trauma score
Feeling like you have a map of your past but are still stuck in the same loops
This is why the three-legged stool approach becomes so crucial - when you support the biological piece alongside your emotional and psychological work, you finally have the stable foundation for lasting change.
How Fast Can Healing Actually Happen?
When I started experimenting with patients, bringing in inner child work and somatic self-practices alongside traditional medical approaches, the results shocked me. I was used to medications taking weeks to work, coming with side effects, and requiring additional medications to manage those side effects.
What I discovered with integrated approaches:
Working faster than any medication or supplement I'd used
"Side effects" included joy, connection, and better sleep
Working on multiple domains simultaneously
Teaching self-practices patients could continue at home
Why these approaches work so fast:
Address the nervous system level driving all symptoms
Target root causes rather than downstream effects
Create safety for the body to open and heal naturally
Follow the sequence the body actually needs
For example, I could teach a sequence of somatic self-practices that would decrease depression by 30%, reduce anxiety, improve sleep, help GI symptoms, increase energy, and provide a sense of joy and community - all from one intervention working at the nervous system level.
The Critical Importance of Safety Before Expansion
Many people expect their body to open up and heal without creating the safety to do so. If the body already felt safe, it would have already released stored emotions and trauma. The fact that it hasn't means safety is missing.
Common mistakes in trauma work:
"Feel the fear and do it anyway" - problematic advice for trauma
Opening things up without proper sequencing
Stirring up emotions without bringing resolution
Trying to expand before establishing safety
My experience with poorly sequenced trauma work:
Made symptoms worse, including autoimmunity
Stirred things up without resolution
Created more overwhelm instead of healing
Taught me the importance of proper sequencing
The correct approach:
Feel the fear and respect it
Ask "How do I create safety so there isn't that level of fear?"
Titrate opening at current capacity levels
Pace expansion to prevent overwhelm
Create new experiences of healing, not just retraumatization
The Three Sections of My Book
Each section of my book contains the most important thing for readers to know at that level:
Section One: The Difference Between Stress and Trauma
Key message: If something makes you sick, that's not stress - it's trauma
Your body went into a trauma response
Stop minimizing and calling trauma "just stress"
Section Two: Why Your Body Holds Onto Trauma
Key message: Your own biology keeps you stuck
Creates signals of danger to your nervous system
Oxidative damage, inflammation, gut sensitivity, adrenaline create internal danger
Explains why you cycle between stress and overwhelm
Section Three: The Framework and Tools for Healing
Provides the map, sequence, and tools for healing
Shows the framework and order for using tools
Helps people make actual progress instead of trying hard without seeing change
My Story with Miguel: The Grief That Changed Everything
Many readers want closure on Miguel's story after the opening of my book. Miguel came to me as a four-year-old foster child, and I adopted him around his fifth birthday as a single mom in medical school. I had the privilege of being his mom for six years.
I had expected and committed to being his forever mom, and as I share in the podcast episode, this was not to be. I was working 30 hours straight doing kidney transplants while carrying unprocessed grief, my body said "I can't do this." That precipitated my autoimmunity and chronic fatigue, leading to the morning I couldn't get up for work and had to face my feelings.
It precipitated my own need for healing.
A Message of Hope Through Science
I wrote this book for you, dedicated to Miguel and those who modeled safe love for me. Take it as far as you'd like, knowing that anything is possible.
The path forward:
Understanding your biology doesn't mean you're broken
Science gives us solutions, not just problems
Integration of emotional, psychological, and biological healing accelerates progress
Your body knows how to heal when given proper support
Key principles for sustainable healing:
Support all three legs of the stool simultaneously
Create safety before attempting expansion
Address biology alongside emotional and psychological work
Respect your capacity and work within it
Trust that your body wants to heal
When you finally understand what your body has been trying to tell you through symptoms and responses, you can work with your biology instead of against it. The body knows how to heal - sometimes we just need to remove what's blocking that natural process and provide the right sequence of support.
This integrated approach honors both the wisdom of traditional therapeutic approaches and the cutting-edge understanding of how trauma lives in our biology. It's not about choosing between emotional healing and biological healing - it's about recognizing they're inseparable and supporting both simultaneously for the fastest, most sustainable results.
Helpful Research
Cell Danger Response Theory Naviaux, R.K. (2014). "Metabolic features of cell danger response." Mitochondrion, 16, 7-17.
Dr. Robert Naviaux's Cell Danger Response theory provides the biological foundation for understanding why trauma gets stuck in our bodies at the cellular level. This research explains how cells respond to threats by shifting into a protective metabolic state that prioritizes survival over healing. When this response becomes chronic due to unresolved trauma, it creates the biological blocks to healing that I discuss in the book. Understanding CDR helps explain why people can do extensive emotional work yet still struggle with physical symptoms - their cells are still operating in danger mode.
Polyvagal Theory and Nervous System States Porges, S.W. (2011). "The Polyvagal Theory: neurophysiological foundations of emotions, attachment, communication, and self-regulation." WW Norton & Company.
Stephen Porges' Polyvagal Theory provides the roadmap for understanding the three nervous system states I reference throughout this interview. His research explains how our autonomic nervous system automatically shifts between states of safety (ventral vagal), mobilization (sympathetic), and shutdown (dorsal vagal) based on our perception of safety or danger. This work is crucial for understanding why capacity changes moment to moment and why traditional therapy approaches often plateau - they're not addressing the nervous system states that drive our responses.
Disclaimer
This podcast is for educational purposes only and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. The information shared reflects my clinical expertise and research, but every person's biology and healing journey is unique. Always consult with qualified healthcare providers before making changes to your treatment plan or starting new interventions. If you're experiencing a mental health crisis, please contact emergency services or a crisis helpline immediately.
Join the Conversation
I'd love to hear your thoughts on this episode. What resonated with you? What questions came up?
Please keep comments respectful and supportive. This is a community of people committed to healing. We welcome diverse perspectives and honest questions, but we don't tolerate personal attacks, spam, or content that could harm others on their healing journey.
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