Grounding First: Ruth Lanius on Neuroscience, Dissociation, and the Future of Trauma Care

January 21
36 mins

Episode Description

Internationally renowned clinician-researcher Ruth Lanius, MD, PhD joins Janina to trace their shared roots at Bessel van der Kolk’s Trauma Center and explore how brain science can—and should—change what we do in the therapy room. They dig into why grounding must precede mindfulness for highly dissociative clients, the promise of Deep Brain Reorienting, adapting SMART for adults, and how real-world samples (not just tightly controlled trials) can finally validate the integrative treatments therapists use every day. They wrap with a clear, brain-based take on psychedelics (hello, default mode network) and a hopeful vision for the next decade of trauma care.

In this episode, you’ll hear:

  • The early days at the Trauma Center—and why a non-blaming, grief-literate clinical culture matters

  • Lanius’s pivotal neuroimaging findings that differentiated hyperarousal from dissociation

  • Why many clients “retain nothing” without grounding, grounding, grounding before skills training

  • What Deep Brain Reorienting (DBR) targets (orienting → shock → pain/affect) and who it’s not for

  • Adapting SMART (Sensory Motor Arousal Regulation Treatment) for adults and how sensory pathways invite language and connection

  • The case for real-world evidence so insurers cover integrative, neuroscience-guided care

  • A concise brain-based explanation of how psychedelics may help (disrupting habitual patterns, influencing the default mode network)

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