Summary: How to Do the Work By Dr. Nicole LePera
Summary: How to Do the Work By Dr. Nicole LePera

Summary: How to Do the Work By Dr. Nicole LePera

You Are Your Own Best Healer

There is an awakening going on right this moment. No longer do we need to accept the narrative of “faulty genes” as our fate. Emerging science tells us that the genes we inherit aren’t fixed; they are influenced by their environment, beginning in utero and continuing throughout our lives. The groundbreaking discovery of epigenetics tells a new story about our ability to change.

We are, of course, given a set of genes, but, like a deck of cards, to some degree we can choose which hands we want to play. We can make choices about our sleep, nutrition, relationships, and the ways we move our body that all alter gene expression.

We are not only our genetic wiring. Once we understand this, the more inadequate the traditional deterministic approach of “recircuiting” faulty wiring through interventions such as medicine and surgery seems. We can and should help heal our bodies and our minds to create wellness for ourselves.


The Conscious Self: Becoming Aware

It is only when you are conscious that you are able to see yourself, a process of self-awareness that can suddenly reveal so many of the previously hidden forces constantly at work molding you, manipulating you, and holding you back. You can’t eat better, stop drinking, love your partner, or improve yourself in any way until you become transparent to yourself. Because if you intuitively know what you need to do to change for the better—why don’t you do it? It’s not a moral failure; it’s because you’re stuck repeating these more or less automatic behavioral patterns.

Maybe this situation sounds familiar: You head to work at the same time every day, and the routine to get out the door is more or less memorized. You shower, brush your teeth, make coffee, eat breakfast, get dressed, drive to work, and so on. You barely have to think consciously about doing any of these things because you’ve done them so frequently that your mind is on autopilot. Have you ever traveled to work and wondered, How did I get here?

When we’re running on autopilot, a primitive, or subconscious, part of our mind drives our reactions. Astonishingly, our subconscious stores every single experience we ever have. This however isn’t just a neutral storehouse for facts and figures; it’s emotional, reactive, and irrational.

Running on autopilot is a function of our conditioning. Most of us are stuck in subconscious programming; in fact, some brain scans reveal that we operate only 5 percent of the day in a conscious state. The rest of the time, we are in subconscious autopilot. This means that we are making active choices during only a small sliver of our days and letting our subconscious run the show the rest of the time.

Find one to two minutes in your day when you can practice being focused on and truly present in whatever you’re doing. This could be while you are doing the dishes, folding laundry, or taking a bath. It could mean stopping on your walk to look up at the clouds or taking a moment to really smell the aromas of your work space throughout the day. Make a conscious choice to witness the entirety of your experience in that moment. Say to yourself, “I am in this present moment.” Your mind may respond with a steady stream of mental resistance because it’s being jolted out of its conditioning and it’s being watched. All sorts of thoughts may come up in your mind. This is okay. Just practice witnessing them.

Ground yourself in the moment. Our senses allow us to leave the monkey mind and find a deeper connection to the present moment. Let’s say you’ve chosen to do this exercise while doing dishes. Feel the soap on your hands. See how the soap bubbles over your hands; feel the slickness of the dishes in the sink; smell the scent of the air. This will enable you to stay in this moment without your mind commanding you out of it. Doing this will become more and more comfortable with practice.

After practicing this for one to two minutes, acknowledge that you gave yourself this time. This will allow your mind and body to understand how it feels and give you a moment to thank yourself for the time you took to do the work.

Repeat this exercise at least once a day. As you get more comfortable, you’ll begin to notice more moments when you can repeat the practice.


A New Theory of Trauma

Trauma, as the majority of mental health professionals understand it, is the result of a deeply catastrophic event, like severe abuse or neglect. Such events are life altering, splintering a person’s world into a “before” and an “after”.

The reality is that there are many people who cannot point to several moments (or even one moment) that broke their life apart. Many might not be able to admit that any part of their childhood was damaging. That doesn’t mean that there wasn’t trauma present.

Our understanding of trauma should be widened to include a diverse range of overwhelming experiences or, as the neurologist Robert Scaer defined it, any negative life event “that occurs in a state of relative helplessness.”

In other words, traumatic experiences aren’t always obvious. Our perception of the trauma is just as valid as the trauma itself. This is especially true in childhood, when we are most helpless and dependent. Trauma occurred when we consistently betrayed ourselves for love, were consistently treated in a way that made us feel unworthy or unacceptable resulting in a severed connection to our authentic Self. Trauma creates the fundamental belief that we must betray who we are in order to survive.


Trauma Body

The ways in which trauma affects the body are varied and complex, and physical dysfunction boils down to one common denominator: stress. Stress is more than just a mental state; it is an internal condition that challenges homeostasis, which is a state of physical, emotional, and mental balance. We experience a physiological stress response when our brain perceives that we don’t have adequate resources to survive an obstacle or threat (which is the general state of affairs when it comes to unresolved trauma). Addiction and stress expert Dr. Gabor Maté, who is the author of many books including When the Body Says No: The Cost of Hidden Stress, calls this the “stress-disease connection.”

When we are stressed, the body shifts its resources from maintaining homeostasis, that happy place of well-being and balance, to protecting itself. Stress is unavoidable (just trying to avoid it would stress you out!). Normative stress, for example, is a natural part of life: birth, death, marriage, breakups, job loss—these are all part of the human experience. As an adaptive response, we can develop coping strategies to help return us to our psychological and physiological baseline: seeking supportive resources, learning how to self-soothe, and assisting our often stuck nervous systems to return to homeostasis. This process of leaving and then returning to our baseline of balance is called allostasis. It allows us to develop the biological capacity for resilience.


Mind-Body Healing Practices


Healing starts with learning how to tap into the needs of our body and reconnecting with our intuitive Self. It begins with the act of witnessing: How is my body reacting? What does my body need?

Even though our nervous system reactions are automatic, there are ways to improve your vagal tone, manage your trauma-conditioned responses to stress, and return more quickly to the open, loving, safe space of social engagement mode. This is such a fruitful area of research right now that many researchers are studying the use of vagal tone stimulators (essentially implants that deliver electrical impulses directly to the vagus nerve) to treat an amazing array of illnesses, from epilepsy to depression to obesity to recovery after heart and lung failures. The way to do this without intervention is to activate the parts of our autonomic system that are within our control, such as our breath and voice.

Though many bottom-up and top-down processes are out of our control, we can consciously choose specific interventions that actively decrease our psychological stress, slow the sympathetic responses in our nervous system, and even strengthen our musculoskeletal and cardiovascular systems. In addition, when we activate, challenge, and tone our vagus nerve in a safe and controlled environment, we build tolerance and learn how to live with discomfort, which is key to building resilience, the ability to recover quickly from hardship.

As you begin to work on toning your vagus nerve, it may be helpful to know that you will undoubtedly experience uncomfortable internal pushback. It’s never beneficial to flood ourselves with discomfort; easing our way into it can bring us closer to healing. It’s important that this work be done in a safe, stable place, where the stress and challenge to our bodies and minds are under our control. That way we can push ourselves within safe confines, which prepares us to deal with stresses outside our control

What follows are some of the most effective, practical ways we can harness the healing power of our bodies to regain balance and build resilience. All of these practices are important tools for strengthening the mind-body connection and promoting healthy vagal tone. These are foundational steps on the path to holistic healing.



We have around 500 million neurons in our gut, which can “talk” directly with the brain via a pathway known as the gut-brain axis, one of the most studied examples of the mind-body connection. The gut-brain axis is the highway that enables the exchange of a range of information, including how hungry we are, what kind of nutrients we need, how quickly food is passing through our stomach, and even when the muscles in our esophagus contract. Our friend the vagus nerve is one of the key messengers that facilitate the sending of these signals back and forth between our gut and brain.

In a trauma state, physical dysregulation in both the nervous system and the gut impairs our digestion, working against our ability to properly absorb nutrients from our food. When our body is stressed, we cannot enter the parasympathetic state that sends messages of calmness and security to our body. Without these necessary messages, we either expel our food or hold on to it, resulting in symptoms such as diarrhea and constipation. Our body’s dysregulation is likely mirrored in the gut, where an imbalanced microbiome also hinders the extraction of nutrients from our food. Over time, our bodies become chronically deprived of the nutrients they need and no matter how “healthy” or plentiful our diet is, we can often end up undernourished and hungry.

If our diet isn’t so healthy, things get worse. Our intestinal lining becomes inflamed when we consume foods that cause damage to that lining, including sugar, processed carbohydrates, and inflammatory fats (such as trans fats and many vegetable oils). These foods provide sustenance for the less desirable occupants of your gut microbiome (some microbes are good for you, while others can make you sick). This collection of microbes lays the groundwork for a condition called gut dysbiosis, in which the balance of your inner ecosystem favors the “bad” bugs.

The quickest way to improve your gut health—to support your microbes and maintain the integrity of your gut wall—is to eat whole, nutrient-dense food. The direct line between the gut and the brain makes each meal an opportunity for healing and nourishment. It is helpful not to think of deprivation when we cut processed and unhealthy foods out of our diets and instead view doing so as an exciting opportunity to improve our physical and mental well-being one bite at a time. It’s rare to find a psychologist who will ask you what you’re eating, though food plays an incredibly important role in mental wellness. In addition to consuming nutrient-dense foods that make you feel your best, adding fermented foods, such as sauerkraut, yogurt, kefir, and kimchi, to your diet can also be helpful, as they are rich in naturally occurring probiotics.



After food, the most common way we let ourselves down happens every night: most of us don’t get enough sleep.

We now know that inadequate sleep is incredibly damaging—especially to a growing body. When we sleep, our body repairs itself. This is when our gut gets a chance to take a break from digestion, our brain “washes itself” and clears away debris, and our cells regenerate. Sleep is a time of ultimate healing. All of the organs and systems of our body, including our nervous system, benefit from sleep. We know this because of the work done on sleep deprivation, which is linked to depression, cardiovascular illness, and even cancer, obesity, and neurological conditions, such as Alzheimer’s disease.

The most important way to improve your sleep is to help ease your parasympathetic system into its happy place of relaxation. Substances such as coffee and alcohol, which directly work against the most important stage in our sleep cycle, rapid eye movement (REM), are the biggest physiological barriers to getting into this restful place. Try to limit your alcohol and caffeine consumption to certain hours (preferably stop drinking alcohol three hours before bed and limit coffee to before noon). Maintaining a consistent bedtime routine is also important, as it primes your body to enter the parasympathetic state in the lead-up to actually getting into bed



We know that our autonomic nervous system is automatic (it functions outside of our awareness), though there is one part of our body’s systems that is under our conscious control. We can’t tell our heart to beat more slowly or our liver to detox our body faster, but we can slow and deepen our breath, thereby decreasing our heart rate and calming our mind. We can draw in more air, helping us move air from our lungs to the rest of our body and oxygenating all of our cells.

Doing breathwork engages the autonomic nervous system; it’s like doing planks for the vagus nerve. As we know, the vagus nerve is a two-way information highway that not only connects the brain and the gut but also connects various parts of the body, including the lungs, heart, and liver. When we use our breath to subdue our arousal system, we communicate to the brain that we are in a nonthreatening environment, a message that is shared with the other systems in our bodies. This is a bottom-up approach to polyvagal toning.

One of the most extraordinary utilizers of the power of breath is Wim Hof, popularly known as “The Iceman.” Hof’s breathing technique involves inhaling through the nose and exhaling through the mouth, then holding the breath, which challenges and expands the lungs. He often couples this with exposure to cold, another kind of bottom-up approach that tests our body limits and stresses the vagus nerve in beneficial ways.

There are many breathwork practices to explore and if you have the space and time to engage in a slightly longer practice, is this:

  • Try to start this on an empty stomach (morning or night is best).
  • Sit or lie down in a comfortable place with few distractions.
  • Take in a deep breath from the lowest part of your stomach.
  • When you can’t take in any more air, stop and hold your breath for two to three seconds.
  • Exhale nice and slowly without any force. Take one cycle of regular breathing (in and out).
  • Repeat ten times.



Any activity—running, swimming, hiking—where mind and body are linked in a safe place helps us “widen the window,” as Dr. Porges wrote, of stress tolerance. Exercises that challenge your mind and body reduce your risk of developing cardiovascular disease and dementia and may even slow the aging process.

Physical exercise deepens sleep and improves mood by releasing neurochemicals in the brain, including dopamine, serotonin, and norepinephrine, which all make you feel happier and less stressed. In general, cardiovascular exercise, which increases oxygen and blood circulation all over the body, creates measurable changes in the brain, increasing the size and health of the organ while stimulating new neuronal pathways and strengthening existing ones.

An ultimate “window-widening” exercise, given its direct activation of the vagus nerve, is yoga. Dr. Porges is also a huge advocate of yoga (he’s written extensively about its benefits on vagal tone in academic journals). Yoga engages both the mind and body by combining the regulatory power of our breath with movement.

The whole idea behind yoga, he said in an interview, “is that through training, you can begin going into these immobilizing states normally linked with faint and freeze, but more aware and less frightened.” He described it as “the ability to go deep inside oneself and feel secure” in response to a perceived threat

This is key to healing: learning the power of your body and your mind by testing their outer limits. As we take on deeper and more taxing postures, our vagus nerve learns how to control our stress response and return more readily to the state of calmness and safety where healing happens.



Joy, the expression of pure happiness, is a mere memory for most of us. We’ve forgotten the happy freedom of doing something for the mere delight of doing it—not for any secondary gain, requirement, or external motivation. When we were children, we did things just because we wanted to. Many of you can remember a time in your childhood when you felt this way; maybe it was while taking a dance class, running around freely on the beach, or expressing yourself artistically through drawing and painting.

A common favorite playtime activity that engages the vagus nerve is singing. Singing feels pleasurable for many of us. We may have been conditioned to keep our voices to ourselves when others said we couldn’t carry a tune. Try to remember back to when you were a child and the various ways singing was used to develop self-awareness, confidence, and joy. The benefits of singing do not stop in adulthood. Belting out your favorite song will help tone your vagus nerve in many of the similar ways that breathwork, yoga, and play do. If you can sing with others, the benefits are even greater; the co-regulatory force of a room full of singers is incredibly uplifting. Even singing to yourself in the shower can be healing.

Our bodies truly are incredible. We now know that we are not “destined” to be sick just because our family members are. Nothing is set in stone. Our cells respond to our surroundings from the moment of conception. We’ve seen how our environments—from our childhood traumas to the food we choose to put into our bodies—mold us, especially our nervous system, immune system, and microbiome, systems that are particularly responsive to stress and trauma.

The next step is applying this empowered state of consciousness and belief in transformation to the mind—understanding our past selves, meeting our inner child, befriending our ego, and learning about the traumatic bonds that continue to shape our world. This wisdom helps free our minds in the same way we’ve freed our bodies.

Let’s go.