Ice Bath for Behavioral Health: PTSD

Jason: I'm Jason Buck. I'm a doctor of behavioral health. So I work with people through traumatic wounds on a regular basis. During COVID time, I was really feeling a lot of fear and anxiety and panic about the potential of death that was there. And I heard about this guy Wim Hof and so immediately I started the breathing tools and those are so immediately beneficial. So I did a Wim Hof virtual workshop for 2 days learning the breathing technique and the cold exposure around 2020, 2021 maybe.

Thomas: What is a doctor of behavioral health? Because it's not a psychiatrist who would go to medical school and it's not a psychologist who would have a doctorate in psychology, but it is a clinical role.

Jason: The doctor of behavioral health incorporates someone like me who's a licensed professional counselor and then it integrates part of the medical model to where when you're working with a patient, you're always assessing not just their mental wellness, but their physical wellness as well and encouraging them down those pathways of getting enough sleep. I just had a client yesterday, probably genius level IQ 150. Parts of what he misses in his treatment is the basics—sleeping, eating, diet, maybe do a non-sleep deep rest protocol, maybe do a 14-minute Tai Chi.

Thomas: When I hear medical doctors talk about it, they call this lifestyle. Is behavioral health and lifestyle the same things?

Jason: You might be on to something there. The implication in a term like behavioral health is that your health is related to your behaviors. And so changing your behaviors can improve or degrade your health depending upon what state you're starting in and where you're headed to. Most people think of behavior as exercise and probably diet. These get lumped into what physicians will call lifestyle choices.

Jason: The first thing that comes to mind is going back into childhood and accessing the actual child that was younger that was there itself. Not just a memory that was there, but the child itself. So going back to that 5-year-old child or that 10-year-old child that had been traumatized there and actually getting a sense of them and getting that person connected to that part of themselves. The 5 to 10-year-old self could be taking over their adult self because when they were 5 or 10, they had no other tools to work with than to do it that way. So when they face certain crossroads in their current experience, they're letting that 5 or 10-year-old take over again.

Thomas: As children, we learn behaviors that help us cope or adapt. A child who's very young, two or three, might have a tantrum. And this can work when they're one, but as they become three, we counsel them to use their words. They have to grow up into another developmental state, unlearn behaviors that work for them at a younger age, and learn new coping mechanisms. But as adults, we sometimes become trapped in those behaviors that we learned as children that are no longer adaptive. They are maladaptive. No one wants to see a tantrum in a 6'4 grown man.

Thomas: The trouble with growing up is that these behaviors learned in childhood that help people cope are deeply entrenched now because they were learned when our brain was quite plastic. How do you unlearn that?

Jason: When we are children and we are five and we are 10, we're told "that's not okay, put that away" from our caregivers, our parents, our guardians. So a huge part of that healing process is going back to earlier, just bringing those parts back in and finding that when we do it that way, the people don't just go through a traumatic memory just to relive it and reexperience it.

Jason: It's integrated now. And so now they're one with themselves instead of two separate parts. I've read in Peter Levine's work—the compulsion to repeat—that is we can experience stress that never gets resolved and we have obsessive thoughts to relive those experiences in our imagination as if we were searching for a resolution to whatever it was when we felt powerless or immobilized. Levine says that this is universal among intelligent mammals. This isn't just a human thing.

Thomas: He gave an example of these cheetah cubs on some nature special. The cheetah cubs were attacked by a hyena and they escaped by climbing up the tree and staying there until the hyena got bored and ran away. But what did they do for the whole rest of the day? They played hyena attack. They took turns playing the role of the hyena and then scrambling up the tree or fighting back against the hyena or roleplaying different ways that they could deal with the trauma if it ever happens to them again.

Thomas: Leonard Cohen wrote a book called Playful Parenting. He says, "Imagine your three-year-old that has to go to the dentist or something uncomfortable, has to go and get vaccinated. When that child comes home, what do they want to do?" Well, they want to get their dolly. They want to play dentist office or doctor's visit. But they will always adopt the role of the authority figure. They will adopt the position of control and they will then relive the experience with their dolly. From that position of control, they can resolve the stress lest it become post-traumatic stress disorder.

Thomas: Lavine says that trauma gets held in the body and it will not be released from the sympathetic division of the central nervous system without this resolution. Upon resolution you retain the memory but without the emotional attachment to the memory. In a home run scenario, you see a transformation—the 5-year-old who had no control is now the heroic 5-year-old who embraces the identity.

Jason: I'm not only the hair club president, but I'm also the client. I don't just tell you, use this cognitive tool if it wasn't a cognitive tool that I had seen either benefit me personally or somebody else. Getting back into the hero of the journey, knowing that this quest is wrought with pitfalls and there are setbacks and there are dragons out there, but if you're prepared for them, there's nothing that you have to fear really. In fact, you can access these courageous parts to help you in whatever it is you're facing.

Jason: At one time in my life, the greatest fear that I could possibly imagine was 1995 and I just stepped foot on the campus of South Dakota State University and they told me for you to get your diploma, you're going to have to take this speech or communications 101 course. I had nightmares. I festered over it. I had terrible anxiety. I almost just said screw this and left college. That was actually one of the catalysts that got me into counseling—they had this free counseling service available on campus for students.

Thomas: Nothing developmentally can happen without the permission of the protector. There are different dimensions inside of us. And one of those aspects of our personality is meant to protect our psyche. Seinfeld does this good bit where he points out, "Most people report their number one fear is public speaking." They will rate the fear of public speaking ahead of death. He quips that means if you're at a funeral, you'd rather be in the casket than giving the eulogy. Part of our personality is meant to protect us against that judgment.

Jason: I remember less than a year ago going in and getting my DEXA. "Okay, you're over 50 years old now, so you need to get your bone density tested." Sure enough, I get the bone density results and they say, "This is interesting because your bone density says that you are of like of a 30-year-old bone density, but your fat percentage on your legs is like 30%." And I'm looking at your leg and it looks like you could kick through a wall.

Thomas: There is something going on with the body fat scanners that is not calibrated for brown fat. Anytime I try to introduce the browning and the beige fat process that could be there, including in the limbs and not just in the core, they just don't understand. Something like 95% of adult Americans have zero detectable brown fat. They're not calibrated for people with brown fat.

Thomas: It used to be that doctors thought there was no such thing as brown fat in an adult human being. But then these Swedish researchers kept seeing symmetrical depots show up on the PET scans and they say, "Well, tumors aren't symmetrical. That's got to be something else." In less than 5% of them, they also found brown fat depots in adult human beings. Those were people who had a history of regular cold exposure.

Thomas: Cold air will activate brown fat. It's not as effective for heat extraction as the cold water is. The water sucks the heat right out of you whereas the air just is not as good a heat conductor. So you've got to be at either a lower temperature or a longer exposure time to get the same heat extraction out of a cryochamber that you're going to get out of an ice bath. This is why cryo chambers will go down to like negative 140 Fahrenheit.

Thomas: I recently saw a post by Mindy Peltz. She explained that just 11 seconds of cold water on the face will halt those catastrophic ruminating voices in your mind that are the source sometimes of anxiety when you suffer from PTSD. Coming out of her experiences with the LA fires, she would have this chatter in her mind, a constant background anxiety of how everything awful is about to happen. She said she started doing cold plunge therapy and those catastrophic voices were replaced by more optimistic ones.

Thomas: Marsha Linehan has written about cold water on the face in her book treating borderline personality and other personality disorders with cognitive behavioral therapy. She has a whole page about using a bowl of ice water to snap your body out of the catastrophic cycle of thoughts that might overcome someone who's dealing with PTSD.

Jason: For one, when you're in the ice bath, all your other worries have to go away because all you can do is breathe and survive, and you're activating those survival instincts to where whatever that bill I have to pay next week—glad I wrote a note on that because it's not here now. With that immediate relief of the intensity of the PTSD, that feedback physically that they're getting of the extreme cold on them is going to be a relief of a pressure that's there.

Jason: I now have a polar bear plunge community and we do this as a collective. Three or four of us get together every two weeks and we do about a 10 to 15 minute exposure in a sauna. We lead into that with a couple of sets of Wim Hof breathing and camaraderie. We're all clinical colleagues as well. My tank stays steady with a Nuvio chiller at about 50 to 55 Fahrenheit throughout the week. I'll get in there up to 10 or 15 minutes for that temperature. As the temperature goes lower into the 32s with ice packed around me, I typically don't do that longer than two, three, maybe four minutes max.