The Biology of Trauma® With Dr. Aimie

➡️ Get the full show notes and episode breakdown at Biology of Trauma® Podcast— What Does Overwhelm Have To Do With Chronic Pain?

If you have chronic pain, you've probably been told that stress is making it worse. But here's what the biology actually shows: by the time your pain is flaring, you're past stress. You've crossed into overwhelm — and that changes everything about what your body can do.

In this episode, Dr. Aimie Apigian — double board-certified physician and author of The Biology of Trauma®  — explains why chronic pain and chronic trauma follow the same biological pattern, and exactly how the body gets stuck in cycles that feel impossible to interrupt.

Once the nervous system crosses the critical line of overwhelm, three survival strategies take over: dissociation, immobilization, and energy conservation. Healing goes offline. That's not a failure of your approach. That's a shift in operating mode — one where the body only has enough energy to survive.

What determines whether a flare happens is neuroception — the nervous system's subconscious safety scan, running below conscious awareness at all times. When it reads threat, the physiology shifts. That shift is where chronic pain lives.

What moves this pattern is building capacity through five specific nervous system skills — so the body spends more time below the line, where healing is actually possible.

In This Episode You'll Learn:

[00:00] Why chronic pain is an overwhelm problem — not a stress problem

[01:34] How pain becomes chronic and why it follows the same biological pattern as trauma

[03:06] Stress is not trauma and trauma is not stress

[03:20] What the critical line of overwhelm is — and why the body stays braced long after the danger is gone

[05:59] The Loop and what it does to the body's healing mechanisms

[08:11] How adrenaline suppresses pain during stress — and what happens when it's removed in overwhelm

[08:49] What microglia are and why they follow the same threshold pattern as the nervous system

[09:30] The three survival strategies the body activates past the critical line — dissociation, freeze, and energy conservation

[11:40] What neuroception is and why it controls whether a pain flare happens

[13:42] Why capacity — not stress — determines where your critical line sits

[15:10] The five nervous system skills that build capacity before the line is crossed - that every adult and every person with chronic pain needs to know — what each skill does and why it matters

[17:44] Why we only go as fast as the slowest part of me feels safe to go

[18:44] How to interrupt a chronic pain cycle before it crosses the line

[20:52] The Three Rs framework — how to recognize, understand, and repair a chronic pain pattern

[22:40] Key Takeaways And Guide

Resources/Guides:

Book: The Biology of Trauma®Book by Dr. Aimie Apigian— Chapter 1 covers the body's trauma response, the critical line of overwhelm, and the steps by which both trauma and pain become chronic. The Nervous System Journal is available at: biologyoftrauma.com/book

Free Guide: A Guide For The Chronic Freeze Response — Learn what to do (and what to avoid) when your body gets stuck in freeze mode, including the survival strategies covered in this episode.

➡️ Get the full show notes and episode breakdown at Biology of Trauma® Podcast - Is the Need to Always Be “Good” a Trauma Response?

What does your body do with guilt it can never undo? 

Have you ever done everything right — and still felt something unresolved living in your body?

Maybe it's not a dramatic story. Maybe it's just a moment you can't stop replaying. A decision you can't forgive yourself for. A version of you that acted against your own values — and your nervous system never got the memo that it's over.

That's what this episode is about.

Gregg Ward accidentally took someone's life at 18. For 46 years, it lived in his body — flushed skin, tense shoulders, a loop that no amount of success, service, or self-improvement could stop. In this conversation with Dr. Aimie, he shares what moral injury actually is, why the body keeps reliving a story with no ending, and how movement became his nervous system's path through what therapy alone couldn't reach.

This is not a story about grief resolved. It's a story about grief metabolized. And the moment the burden finally lifted — not when the pain disappeared, but when the purpose stopped being about him.

If something in you has never fully quieted — no matter how much work you've done — this conversation was made for you.

Gregg Ward is the founder and Executive Director of the Center for Respectful Leadership. He is a global speaker, thought leader, and bestselling author. Gregg’s TEDx San Diego talk has been selected for TED Global publication.

Resources/Guides:

Centerforrespectfulleadership.org — Gregg Ward — Center for Respectful Leadership

Confessions of An Accidental Killer — Gregg Ward — TEDx San Diego

hyacinthfellowship.org —  Hyacinth Fellowship

The Biology of Trauma®Book by Dr. Aimie Apigian — Where you can read Section 2 —  starting with chapter 6 which explains the mechanism by which the body keeps score, even of regret.

Free Guide: Steps to Identify and Heal Trauma by Dr. Aimie Apigian

Related Podcast Episodes:

Episode 35: 5 Ways How Polyvagal Theory Helps With Trauma Work with Stephen Porges

Episode 76: Polyvagal Theory: Become an Active Operator of Your Nervous System During Grief with Deb Dana

Episode 114: The Science Behind Why We Can't 'Get Over' Loss And How to Grieve with Dr. Mary-Frances O'Connor

Episode 124: Grief and Gut Health: Is It Just Emotional or Something More?

Episode 126: Neuroception Explained: How Your Nervous System Decides What's Safe and Why It Matters for Healing

Episode 127: Why Your Body Is Wired for Danger: Understanding Trauma's Impact on Your Nervous System

Episode 135: The Hidden Difference Between Stress and Trauma In How The Body Keeps Score

Episode 138: Why Your Body Holds On When Your Mind Has Healed with Dr. Aimie Apigian

➡️ Get the full episode breakdown at Biology of Trauma® Podcast – Episode 164: Could Your Trauma Be Disrupting Your Metabolism? The Weight Health Conversation

What if the reason your body is holding onto weight has nothing to do with what you're eating — and everything to do with hormones you may not have heard about? 

In this episode, Dr. Aimie talks with registered dietitian and author Ashley Koff to unpack the hidden world of weight health hormones: GLP-1, leptin, ghrelin, and more — and why optimizing them matters for everybody, not just people trying to lose weight. What you'll hear will change how you see your body — not as something failing you, but as a sophisticated ecosystem sending you signals worth decoding.

Ashley reveals why 93% of Americans are metabolically dysregulated, how trauma and chronic stress directly suppress the hormones that regulate metabolism and body composition, and why "weight loss" as a goal is actually working against your biology. Whether you're curious about GLP-1 medications, perimenopause weight changes, or just why the scale never seems to match your effort — this conversation will shift everything.

In This Episode You'll Learn: 

(00:00): Introducing the connection - weight, metabolism and GLP-1

(02:04): The weight-trauma connection: Why the body holds on despite every effort

(03:00):  What “weight health” means biologically — and why weight loss as a goal misses the point

(05:59) The incretin discovery: How GLP-1, leptin, ghrelin, and seven other weight health hormones regulate your biology

(09:50).Why 93% of Americans show signs of suboptimal metabolic health — and what that actually means for you

(10:33) Ashley’s pizza framework: The right sequence for assessing your metabolic ecosystem

(14:54) How to assess your weight health hormones — and why a blood test alone won’t tell you what you need to know

(22:56) Perimenopause and menopause: Why digestion fails first — and how that drives belly fat and brain fog

(30:14) Learned behaviors vs. hormone imbalance: How to tell what is biology and what is a survival strategy from childhood

(37:29) Where to start: Ashley’s first step for anyone wanting to optimize weight health

(40:41) The deliciousness signal: Why a “seven or above” is a physiologic mechanism, not a preference

(44:05) Ashley’s final message — where to find (her book) Your Best Shot and her clinical resources

Resources/Guides:

Your Best Shot by Ashley Koff, RD: The Personalized System for Optimal   Weight Health — GLP-1 Shot or Not

Ashley Koff’s website — For more on digestive, metabolic, and hormone health optimization

The Biology of Trauma®  Book by Dr. Aimie Apigian — Where you can find the framework for finding your block in Chapter 12

Free Guide: Steps to Identify and Heal Trauma by Dr. Aimie Apigian

Related Podcast Episodes:

Episode 56 — Hormones: A Portal Into Our Stored Trauma with Dr. Aimie Apigian

Episode 75 — Fear Stored in the Gut: Attachment, Relational Trauma & Solutions for the Hyper-Sensitive Gut

Episode 82 — Using Biological Rhythms to Recover From Trauma with Dr. Leslie Korn

Episode 138 — Why Your Body Holds On When Your Mind Has Healed

Episode 151 — Why Healed Trauma Returns in Perimenopause: Chinese Medicine Lens with Dr. Lorne Brown

➡️ Get the full episode breakdown at Biology of Trauma® Podcast - Episode 163: Growing Up With Addiction Left a Trauma Your Body Still Carries

What happens when a child has to become the adult in the family? Dr. Tian Dayton, clinical psychologist and author of Growing Up with Addiction, joins Dr. Aimie for one of the most personal conversations on the podcast. Both share their own childhood stories of reading the room, managing a parent’s emotions, and the unspoken rules that shaped their nervous systems for decades.

This episode reveals how children in unpredictable families redirect their brain’s resources from play to survival, how addiction’s rhythms become the child’s operating manual, and why chronic survival physiology leads to digestive dysfunction in midlife. Whether addiction was part of your family or not, these dynamics may be running your body today.

In This Episode You'll Learn:

(00:00) What happens when a child has to become the emotional manager of the family

(02:58) What chaos actually looks like in a family that appears organized on the surface

(05:00) How a child’s brain shifts from play and curiosity to strategizing and operating

(07:23) The different physiological states of a parent in addiction: sober, craving, and under the influence

(10:22) Why addiction spills beyond substances into food, process addictions, and mood cycles

(14:55) The connection between protein deficiency, neurotransmitter production, and craving cycles

(22:16) How the insula processes conflicting emotions and body sensations during overwhelming moments

(27:51) Why chronic survival physiology leads to digestive issues, bloating, and gut inflammation

(29:33) The perimenopause tipping point: when the body stops adapting to decades of unresolved stress

(52:17) The Al-Anon principle that changed everything: love the person, separate the disease

Resources/Guides:

Growing Up with Addiction by Dr. Tian Dayton — How Adult Children of Addicts Can Heal Family Trauma, C-PTSD, and Codependency

Dr. Tian Dayton’s website — Relational Trauma Repair resources and training

The Biology of Trauma by Dr. Aimie Apigian

Songs of the Inner World — Dr. Aimie’s YouTube music channel

Related Podcast Episodes:

Episode 92: How Chaos of Early Childhood Trauma Affects Our Adult Nervous System with Dr. Tian Dayton

Episode 146: How Attachment Affects Us For Life: 6 Childhood Pains and How to Repair

➡️ Get the full episode breakdown at Biology of Trauma® Podcast — Episode 162: Why Fixing Someone You Love Is Destroying Your Nervous System

When someone you love is struggling with addiction, your nervous system absorbs what theirs numbs out. Relational trauma repair therapist Karen Moser joins Dr. Aimie Apigian to explain why the families of substance users often carry deeper nervous system dysregulation than the users themselves. This episode reveals the biological cost of trying to control another person's healing and what it takes to reclaim the parts of yourself that got lost along the way.

In This Episode You'll Learn:

(00:00) Why helping someone you love may be destroying your nervous system

(02:00) What Relational Trauma Repair (RTR) is and how it works with the body

(06:30) How Karen Moser brought Relational Trauma Repair (RTR) into addiction treatment and family work

(08:00) Why the family's nervous system is often more dysregulated than the user's

(11:00) Why sobriety alone does not resolve the family's nervous system patterns

(15:00) Where relational trauma repair starts with families and self-relationship

(19:00) How floor checks help name and locate emotions in the body

(22:30) Why anger, shame, and even joy are emotions people learn to avoid

(28:00) How childhood survival roles create adult role fatigue and burnout

(38:00) A practical exercise to reconnect with the alive, strong parts of yourself

Resources/Guides:

The Biology of Trauma book — Get your copy here

Songs of the Inner World — Dr. Aimie’s YouTube channel for real, raw, honest words for your inner world.

Nervous System Journal — Download at biologyoftrauma.com/book. Track how often you are in a survival state.

Related Podcast Episodes:

Episode 136: How Chaos of Early Childhood Trauma Affects Our Adult Nervous System with Dr. Tian Dayton

Episode 158: Marijuana, Addiction, and the Body: What We’ve Been Getting Wrong with Kevin Sabet