Episode # 65- Interview with Dr. Howard Schubiner

Today’s episode is not to be missed! 

I interview Dr. Howard Schubiner- a Pioneer, Researcher and Leader in Mind-Body Medicine.

Howard is such a kind and sweet person, and explains pain and neural circuits in a compassionate, scientific, and easy to understand way. 

He has developed a protocol for diagnosing neural circuit pain (also called neuroplastic pain, neurogenic pain, TMS, Mind-body Syndrome). 

And he trains medical professionals to unlearn what they have been taught, and become aware of the role the brain plays in generating pain.

Today’s episode covers understanding the brain’s role in pain, and how to tell if your pain is a neural circuit disorder.

If you have not yet given my podcast a rating or review, PLEASE do that here:

https://podcasts.apple.com/us/podcast/the-unstoppable-body-and-minds-podcast/id1493360543

 

Join the Body and Mind Life Coach Facebook Group here:

https://www.facebook.com/groups/231187234912768

You can find the video of this interview with subtitles there!  And this is where I'll be live each week to coach and answer questions!

 

If you haven't yet seen Dr Schubiner's YouTube videos explaining pain, check out #1 here:

https://www.youtube.com/watch?v=rSgnFIJKY08&t=242s

Transcript- Automatically generated:

This is Betsy Jensen, and you are listening to Unstoppable Body and Mind, Episode 65, Interview with Dr. Howard Schubiner. In this podcast, we learned to upgrade our brain and understand the power of our thoughts, to heal and to create the results we want in our life. Become the person in control of your healing and make peace with your life.
Become Unstoppable Body and Mind. Hello, my loves. I have Dr. Howard Schubiner on the program today, which is very awesome.
Hey, Howard.
Hello.
Welcome. And Dr. Schubiner, Howard, he lets us call him, is a pioneer in the mind-body world. You got started working with John Sarno, right?
Back in the day, a bit.
So he's been in the mind-body field for a long time and done a lot of research, currently a professor at Michigan State and has written Unlearn Your Pain, a 28-day process to reprogram your brain and then also unlearn your anxiety and depression. I attended the virtual retreat that you did a couple months ago, and it was for medical professionals to help us understand neural circuit pain, which is either you could call it neurogenic or neuroplastic or TMS or mind-body. And it really, the way that you presented, first of all, how you describe pain, I think is awesome.
And then the criterion you have for determining if something is neural circuit or not, I found so helpful. So maybe we could start by you describing pain, how you would to a patient that comes with you with back pain or something.
Yeah, that's a good place to start. And that's what I do with all my patients. And what I say is that you can't understand pain unless you understand how the brain works.
And then I say, well, the brain works by something called predictive coding. Our brains are designed to keep us safe. And so our brains have these mechanisms for balancing our salt and water intake and keeping us upright and balanced and everything.
But our brain also has this really important danger signal. And if it feels we're in danger, it's going to alert us and alarm us to keep us safe. And that's been going on for hundreds of thousands of years.
It's really good at it. So our brain, and that's one thing. And the second thing is our brain actually generates what we experience.
So we don't see with our eyes, which seems odd. We see with our brain. We see the visual cortex.
Light comes in our eyes, but we don't see anything unless our brain interprets that light and creates the image. And sometimes the images that our brain creates are not what our eyes are actually seeing.
And we even have that spot where the optic nerve connects, that we don't actually have vision, but our brain just fills it in, the blind spot.
That's a great, great point. And with hearing, our ear, our brain creates what we actually hear. And sometimes we hear stuff that's not there.
How many people have heard their name called when someone wasn't calling their name? And what we feel, how many times have people felt their cell phone vibrating in their pocket when it actually wasn't? And so our brain creates what we experience.
And if our brain feels we're in danger, it's going to create something to alarm us and alert us. And our brain has this very interesting quirk that a physical injury can activate pain, but an emotional injury can activate the exact same pain. And the pain is the same because all pain is generated by the brain.
And you can have an injury and not have pain because pain is a decision that the brain makes. So once people understand that, then we can begin to understand, we can begin to explore with them and investigate their situation. And if their brain is creating pain or if their body is generating pain signals or dangerous signals in the body, or if it's a combination of the two.
Yeah, so understanding the brain is so important with pain. All pain is real pain, I've heard you say, and all pain is created in the brain. Even if you have a cut finger, the pain is created in the brain.
Correct. Like you say, all pain is real.
And all pain is real.
So people who have who have pain are not crazy. It's not their fault. It's not because they want the pain.
It's not because they're weak. It's because their brain is generating pain. And why would the brain generate pain?
Well, the brain generates pain because it's afraid of something. There's some fear that's going on, something that started the pain in the first place. Maybe it started with an injury.
So the brain was afraid. And the message was rest and get a cast on your arm or whatever. But sometimes if there's an emotional injury at the same time as the physical injury, the danger signal in the brain doesn't turn off when the injury heals.
So the pain continues and people get the impression, sometimes doctors also get the impression, that the injury didn't heal when in fact the injury did heal because all injuries heal. But the neural circuits causing the pain become persistent. And then people begin to not only, their brain might be afraid of some emotional issue in their life, but maybe the emotional issue in their life passes, and that's not an ongoing problem.
Now the person with pain begins to be afraid of the pain itself. Worried about the pain, frustrated about the pain, focusing on the pain and all of that gives feedback to the brain, that yeah, there's something wrong here, which makes the brain feel more in danger, which makes the pain continue or get worse over time or spread over time.
Yeah, and most people go to their doctor and try to find out what is going on at that site, right? Like if it's their back, they would probably have an x-ray or MRI, and if they find some structural damage, then they have even more evidence, you know, evidence that that's what's causing their pain. But maybe we should talk a little bit about the structural damage and whether that actually causes pain or not, as you said, with injuries that have healed.
Right. Well, structural damage can certainly trigger pain, but a lot of people have abnormalities on an x-ray or MRI and not have structural damage. And this is a little bit hard for people to understand.
It's hard for doctors to understand. There was a recent study where they read people's MRIs of their back in two ways. Half the people got the normal reading, which emphasized all the things that were wrong, and the other half of the people got the enlightened reading, which said, look, a lot of people have these, what Dr. Sarno used to call normal abnormalities.
They have these variations that are due to normal aging. And so bulging disc, facet issues, degenerative disc, all those things are common in people starting in their 30s, 20s and 30s even, and they rise with age, and 80, 90% of people in their 50s and 60s have these, who have no pain. And so these findings are not the cause of pain.
An MRI can show something wrong, like an abscess, a tumor, a fracture. It can show an inflammatory condition, like ankylosing spondylitis. It can show a severely huge bulging disc, herniated disc, that is actually pressing on the nerve.
That can happen. But the vast majority of people with back pain don't have any of those things.
Yeah, they have the normal aging process related abnormalities. Just like you might have wrinkles on your face or gray hairs.
Wait a minute.
People might.
What are you talking about here?
I mean, I don't ever have to cover my gray hair, but...
I always say gray hair doesn't hurt. It's normal.
Unless it's emotionally.
When you look in the mirror, it can hurt.
And that's just a great example of our society and how the way that we interpret the changes in our body makes a difference in how we feel.
I always say that aging, I always say that getting older is inevitable. But aging is a state of mind. So we try to.
Yeah, I believe that. I feel a lot younger than people, some in their 30s that are saying, Oh, getting older, my back's always hurting, you know. Like you're 30.
What?
Yeah, so definitely, I think understanding that structural changes are just normal, and that's not the cause of pain, is so huge, and it's this predictive coding. But what if it's something that just happens, like someone threw their back out? How often is that something structural versus this predictive coding showing up someplace new?
Well, people do get injured, and you can injure yourself by a sudden twist or turn. You can injure yourself by overdoing it. But those injuries are quite mild.
These are soft tissue injuries, and all injuries heal. So a fracture bone heals in six weeks, usually, maybe eight weeks. But a soft tissue injury, like an ankle sprain or a pulled back, is going to heal in a matter of days, a matter of a few weeks at most.
And so what we need to realize is that if the pain persists after the normal healing timeframe, then we have to think, well, it's not just the injury that we're dealing with here.
Yeah, and I think I've heard you say, I think in the conference, you did say something like most acute pain can be a neural circuit pain.
Well, sure. I mean, a lot of times we get a headache. If we have a stressful day, that's a neural circuit pain.
You get a stomach ache if you're worried about something. You can get a neck ache again if you know something's going on at work or something's going on in your family. These are acute pains, but they're neural circuit pains because you didn't injure, you didn't actually injure yourself.
It's easy to figure that out, but it's only easy to figure it out if you're aware of the possibility. Most people are not really aware of the possibility that a neck ache would be caused by stress, as opposed to eye strain or how I'm holding my head or how I slept or things like that.
Yeah, I do. I've seen that a lot with physical therapy, too. People have the expectation that it was because of something they did, how they moved, doing too much.
I hear that a lot. Some of the things you said that were interesting to me, as far as things that are not typically causing pain would even include certain foods. So if people are having certain reactions to foods, that's a predictive pattern from the brain and neural circuit.
Yeah, it's really common that people end up getting afraid of foods or alcohol or whatever, because they may have a reaction. Let's say you're having a stressful day and you're eating broccoli. Well, your brain has just connected broccoli with a stress, or broccoli with the stomach pain that you have from the stress, but you happen to be eating broccoli.
So now your brain is making that association, and then broccoli can easily become a conditioned response. So when you eat broccoli, your brain is turning on pain as a trigger. There's nothing to do with the broccoli itself, but then you think it does, so you avoid broccoli.
And the more you avoid broccoli, the more afraid of broccoli you are. And then even smelling broccoli can start to cause some pain. And then that can spread.
You say, oh, I'm allergic to broccoli. And then, you know, you get stomach pain, and then you blame it on wheat, or you blame it on dairy, or you blame it on, you know, meat. And then it just then that can just spiral.
And I've seen a lot of people who are, have constricted their diet so much, they can only eat a couple foods. And it's really, it's just horrible. They're, you know, they're on what I call the fear food diet.
Yeah, that's got to cause a lot of stress too, which just plays into that cycle.
Yeah.
What are the common, like, GI-related, gastrointestinal-related neural circuit issues? I know you've talked about IBS. Yeah, irritable bowel.
That's the most common one. There's something like 20 million people who have this condition in the US anyway. I do.
I mean, so many people have it. It's part of being human that our gut responds to our emotions. So you can get constipated, you can get diarrhea, you can get bloating, you can get stomach pain.
Another condition they call is functional dyspepsia, which just means stomach pain for no reason. A lot of people suffer with GER, gastrointestinal gastroesophageal reflux. And a lot of people have the symptoms of reflux without actually having reflux when they're studied.
But they call it that, and then they take medication, and sometimes the medication may work, but maybe the medication is working as a placebo, and the reflux isn't actually the problem. Reflux does exist. Some people certainly haven't.
And so there's a variety of symptoms that occur in the abdomen. Of course, all the pelvic pain syndromes. Some people have pain in the pelvic area that have, again, go by a whole variety of names, such as pelvic floor dysfunction, ventral corralgia, interstitial cystitis, vulvodynia, coccidinia, all these names that basically mean you have pain, and we don't know why.
Yeah.
I had a graphic in your presentation that said the percentage of these conditions that are brain-induced, and most of them were 90% to 99% brain-induced, and that was irritable bowel, fibromyalgia, headaches, including migraines.
Anxiety and depression.
Anxiety and depression. That's interesting.
Because anxiety and depression, you can have a medical condition causing anxiety like hyperthyroidism.
Okay.
But the vast majority of people with anxiety don't have medical conditions causing them. They have anxiety, again, produced by the brain, by neural circuits in the brain. Same with depression.
Men with very low testosterone levels can be depressed as a medical condition. Not that common.
Like 1% if it's...
Yeah, exactly. Yeah, wow. And so, same with pelvic pain syndromes.
With back pain, you know, it's funny because people would, when you think about it, you say, okay, neurologists know that almost all headaches are not medical conditions, in the sense that they're not due to some underlying structural problem, like some kind of need in the brain, tumor in the brain, vasculitis, ear disease, sinus disease, tooth disease, et cetera. But with back pain, it's the opposite that everyone thinks. Neurologists will say, yeah, almost all back pain is due to a structural problem.
Well, that doesn't make any sense. It's how can 90, 95, let's say, percent of headaches be due to non-structural problems, and 95% of back pain be due to structural problems, chronic pain?
Right.
It really just doesn't make sense. And we've been studying that. And in our Boulder back pain study, 95% of the people that I evaluated who had back pain for an average of 10 years had nothing wrong with their back.
They had minor abnormalities on MRI, as we discussed. The pain was due to neural circuits. And I'm doing a study now, a larger study.
We're going to have roughly 200 people in the study, consecutive people coming in for chronic back and neck pain. And we're evaluating them in a very careful way, as I've been teaching, as you pointed out. And we're finding that about 85% of them don't have a structural problem.
But it really is, especially since people are getting a lot of treatments on the structures and even surgeries and putting so much emphasis on something that's not working.
Yeah, I know. And the treatment then can, of course, be counterproductive.
Yeah.
It can make people worse because it can be invasive. Yeah. And if it doesn't work, it's frustrating.
And the labeling of the problem is being crippling, being incurable, being, you know, I don't know what we can do, or threatening to have surgery, which scares people like crazy, and just fear piling on top of fear, which obviously makes people worse. Yeah.
I mean, I've heard people being told they have the spine of an 80-year-old, and, you know, and they really, you know, that affects people. They think of themselves in that way after that.
Right. It's hard to not share that after you've COVID. And I've had so many people, you know, repeat to me what they're, some of those words that the doctors have said, like, you know, your back looks like, you know, really crippled.
You may never get better. You will probably have to live with this the rest of your life. These are really scary statements.
Medical cursing. I've heard it called.
Yeah, that's a good...
But as a physical therapist, you know, I understand, like, you try to explain these things as best you can. And it was interesting to me to hear you say things like, you know, the leg length discrepancies, the weak core muscles, the muscular imbalances, joint instability, even inflammation doesn't cause pain.
Right. We are doing a lot of work with teaching physical therapists and people who do manual medicine, like chiropractors and osteopaths. We're doing a lot of work in trying to help them unlearn some of these ideas and concepts that they have been taught are the cause of chronic pain when they're just normal variations.
Yeah.
Inflammation is really an interesting situation because, and I've written about this a bit, but people fail, I think, to distinguish what I would call macro-inflammation from micro-inflammation. Macro-inflammation or localized inflammation can certainly be the cause of pain. Rheumatoid arthritis can cause inflamed joints.
Lupus can cause inflamed joints that can be hot and red and swollen and tender, and you can see them. It's macro-inflammation. Having a strep throat is macro-inflammation.
You can see it, and it clearly trigger pain. On the other hand, micro-inflammation is often blamed for chronic pain because you can't see it. It's supposedly there, and it's true that everyone has micro-inflammation.
There's inflammation in our gums. There's inflammation in our arteries. It's a micro-inflammation, and that inflammation doesn't cause pain.
My gums don't hurt. But yes, there's inflammation there. I have to keep flossing to keep the inflammation down.
But it's there. There's inflammation in our arteries. And that's where another layer of fear tends to come in, where people say you have to fight inflammation, and what they mean is you have to fight micro-inflammation.
And fighting micro-inflammation, for example, by, let's say, meditating, having a healthy diet, going vegan. You know, these are great things. I am all in favor of that.
And maybe it will make your life better. Maybe it will make you live longer. It probably will.
I have no doubt about that. But that has nothing to do with chronic pain. Okay, that's the distinction that I will make.
But, you know, when people get afraid to have potato chips, because it's going to cause inflammation, it's going to cause them pain, then they're back into that pain-fear pain cycle.
So if it's... This is kind of my theory. If it's moderate, like, we're designed as humans, we can withstand a little bit of sugar.
You know, it's not crippling to our system. And like you said, it's... Maybe a potato chip isn't going to cause that inflammation, or we already have inflammation, and so it's, you know, just...
We've been told that we have to avoid these things to avoid this inflammation, to fight it, where we do have the capacity to kind of metabolize a decent amount of...
Well, I do.
I might just be justifying eating candy here, but for me, it makes sense that, you know, unless our diet is purely candy, you know, we can handle some of that.
I agree with that. And it's... And we have to take care of our mental health, too.
Yes. You know, I mean, you know, a piece of cake every now and then is kind of good for birthdays. You know, it's kind of good for our mental health, I think.
And, you know, maybe I'm wrong, but...
Well, I think we all can, right, decide for ourselves. Like, maybe someone is a lot happier not eating sugar, and that feels good to them. But if it doesn't work for you and you're trying to fit into that, then that's going to cause you a little more mental anguish.
And just eat your cake and enjoy it. If you're choosing to eat it, then just love it, enjoy it, savor it.
Yeah. Yeah, someone, one of my patients, gave me a book this week. I think it's called A Boy, A Fox, A Mole, and A Horse.
It's a beautiful, beautiful little book. And it's filled with wisdom. One of the pages, it says something like, is there a school for unlearning?
And I was showing it to my wife and she said, yeah, you have that school, Howard. I mean, that's your school for unlearning, right?
Yeah, it really is.
It has this great stuff in this book. And it's one of the questions they say, well, what do you want to be when you grow up? And the mole says, kind.
And it's just beautiful, right? Anyway, so what made me think of it is the mole, they ask him something like, well, what's your favorite thing in the world? And he goes, cake.
So sweet, so simple, so joyful. Like, I think a lot of us as humans have a hard time even enjoying ourselves, like really being happy. We say all the time that we want to be happy, but do you find that people have a hard time even leaning into those positive emotions?
Only adults.
Adults, yeah, right.
Kids tend not to have a problem with that, but, you know, kids grow up quicker, and, you know, teenagers, skyrocketing rates of anxiety and depression in teenagers, skyrocketing rates of pain in teenagers as we adultify them and put pressure on them, and social media pressure, and all sorts of things. But, you know, part of the treatment of a mind-body disorder or a neurocircuit disorder is to play more. I tell my patients, there's three L's you need to do more of.
Living, loving, and laughing. And how trite and, you know, silly is that? But it's completely true, because that's one of the ways you change the neurocircuits in your brain, out of this pattern of fear and worry and frustration and fighting all the time to a place of joy and ease and grace and calm.
And, you know, we have to live our lives that way. You know, life is too short.
Yeah.
We live at being fearful all the time. And it's not to minimize people's stress and the hardships that so many people go through.
Right. And there is going to be some pain as part of life. But sometimes we don't accept the pleasure either.
We deny ourselves the pleasure, or we think somehow it's dangerous to allow ourselves to be happy.
Yeah.
As far as the history that you find with people, I know that sometimes people have some very traumatic things in their childhood. Other people don't seem to have that. There are definitely personality traits that play into it.
What in your mind are kind of the biggest factors that contribute, other than being a human and having a brain?
Well, your point is very well taken, because all humans get neural circuit pain, all humans have stress, all humans react to it. Our brain is always there as a danger signal, alerting us if there's something that's wrong. But clearly, people who have had childhood trauma, if they had a lot of difficulties in their life, their brain tends to become more sensitive to stress.
And so their danger signal may be set at a more sensitive level, so it may take less stress in them to trigger headaches or back pain or anxiety or fatigue compared to somebody else. And I was just talking to a young woman today who I, you know, we admitted that she's a perfect people pleaser.
Yeah, so many people are, and it's not a bad trait to want to be nice to other people and please other people. But when you take it to such an extreme where you negate yourself and you don't stand up for yourself, that's a disability. And that's something that that's part of the message that her pain is giving her is part of the message and part of the growth and learning that she can do from this and seeing her pain as a gift, really, to help her be a stronger and more confident person, is to start to dial some of that people pleasing back and to practice saying this, you know, what I always say, the magic word that starts with an N and ends with an O and only has two letters can be.
Yeah, that's it's a hard word to say. Sometimes I heard Brene Brown saying, you can just say no without giving an explanation. And that was like impossible for me.
I'm like, I'll at least try to not like make a white lie. But I want to like give some explanation. It's crazy how ingrained that is in me.
Yeah, that's exactly what I was just talking about with her an hour ago. It's just exactly that. You don't have to say, you know, well, I can't because of X, Y, and Z.
You can just say, no, I can't.
Yeah, you have to have that boundary. You have to have that self-care. You have to have that, you know, compassion for yourself and say no.
If you're giving it your own expense.
Yeah, exactly. And so people who have had, you know, trauma in their life often have learned to not be kind to themselves. And so to enhance that is, you know, it's a really important part of the treatment process.
And so the pain is signaling to them. Something's got to change. There's some danger here.
And it's not necessarily the danger of, you know, something that you did too much and you move too much. But you've got to change something else. You can't keep living this way and thinking this way.
It's painful.
Right. Right. So we start, you know, we start the treatment process with a deep and clear understanding of the brain and pain, fatigue, insomnia, depression, anxiety, that the brain is creating these things in everyone at different times, and then investigate their own situation carefully, looking for the details that would rule in or rule out a neural circuit problem.
The last thing we want to do is miss a true structural problem. That's, you know, that's horrible. And occasionally it happens, but we try, you know, so hard to minimize that.
But it's usually not that hard, you know, because people get routine medical testing and they don't find anything. And we can rule in a neural circuit problem by the fact of the characteristics of the situation, the fact that when the pain came on, what was going on in your life, or the fact that did you have these personality traits? Do you have lots of pain in different places?
Have you had lots of these other mind-body type symptoms? And most importantly, does the pain shift from one place to the other? Does the pain move?
Does it turn on and off? Does it go away when you're on vacation? Is it triggered by the wind or by cold or by rain?
Is it triggered by stress? Is it triggered by foods? All these innocuous things that actually show us and the brain is actually showing us, well, look, it's me, I'm doing this.
Oh, I like that way. The brain is showing us that by these patterns.
Exactly. Right. You know, it's, it's, you know, it's in one, one wrist and it goes to the other.
It's well, I, I thought I injured my right wrist, but I didn't do anything to the left wrist. Why did the pain jump over there? He's going like, hello.
Yeah. I mean, as physical therapists, we'd say like, oh, you must be compensating. You know, you're probably just, you're using this wrist more now, or, you know, with the back, we could always say it up and down the line.
Oh, your, your shoulder. Well, your back, you're probably twisting, you know, but it's just your brain.
Yeah, it's so simple. And once you understand this dynamic, now you can't not see that. Once you really understand it.
So I'm working with a physiatrist, a PM&R doctor, great, great guy who went, who's doing standard PM&R practice, seeing tons of back pain, doing tons of injections, thinking it was all structural. And he went to a lecture and the lecture said, you know, there's a mind-body connection here. Look closely.
And he started looking closely. And he's like, wait a minute. The closer I look, the more I see.
It just doesn't add up. He had a great, he had an amazing case the other day, told me about. He had a patient with kind of an older guy who's like a manual laborer, works really hard, you know, been working using his back and his muscles his whole life.
He's got this severe low back pain. It's there all the time. It doesn't vary and never changes, never goes away.
He's got severe spinal stenosis on his MRI. And my friend who is very well aware of the mind body connection thought this was a structural problem. Okay, so the spinal stenosis is causing all these nerve roots to be compressed, supposedly on the MRI, but yet he doesn't have leg pain.
If the nerves are actually compressed, you would expect leg pain, right? Well, he didn't have.
And a certain distribution too, right?
Yes, and a certain distribution, the back of the leg, side of the leg, etc. That's one nerve root, L5. He didn't have any leg pain.
Okay, well, so but then, but he's got these nerve root compressions, so we'll do epidural injections. So he gets three epidural injections twice, doesn't do anything. Okay, so what's with that?
And then he say, well, we'll do these medial branch blocks. So medial branch blocks are injections in the facet joints. Well, the facet joints don't do anything to the nerve roots.
The facet joints have to do with basically arthritis of the spine. So the injections are lidocaine. So the lidocaine is going to go in and it's going to cure the problem if the problem is inflammation in those facet joints.
But it's only going to cure the problem for four to seven hours because the lidocaine is going to wear away, wear off. So this guy gets these facet joints and within an hour, he's fine. He's like totally fine.
Totally fine.
Totally fine, pain gone. So that could be the efficacy of the lidocaine. So the guy comes back to see him a week later.
He's totally fine.
Wait a minute. Wait a minute. The lidocaine went off six and a half days ago.
Why are you fine now? And he's like, guess what? This was not a structural problem.
And he still does manual labor, right? He's still doing his job.
Yeah, he's still working.
Yeah, he's fine.
It's been a month now. The guy's fine for the last month. From this one lidocaine injection.
That's a placebo effect.
Yeah. And it's so interesting because it's like, you know, sometimes people hear about this work and they're like, okay, so I have to like, journal every day, and I have to get into my childhood trauma, and I have to like, aren't there just like hundreds of different ways people find that are their own unique answers?
Absolutely. I am very leery of one size fits all.
Yeah.
If you read my books, yeah, there's a program there, but my advice is don't do it.
Don't do all of it.
Pick and choose what you need. But don't get locked into, don't be constrained to feel like you have to do everything, because now you're people-pleasing. Now you're being obsessive and you're increasing fear.
If I don't write every day, my pain will come back. Well, that's not true.
That's the fear energy that's perpetuating your pain.
So, you know, I don't start with the emotional processing work. I do that more toward later. And again, only if people need it, and only to whatever degree they need it.
Yeah, some with just the education, that alone gets rid of their pain. And I've seen this even with someone with childhood trauma that in the course of six months, we never even talked about once, but within four weeks of her learning about her back pain and believing something different, her back pain was gone.
Yeah, I saw a woman yesterday, incredible, horrible, not only childhood trauma, but then incredible trauma from an abusive, severely abusive husband for, I don't know, seven or eight years, something like that. Now, she's out of that relationship, but she has a ton of pain, you know, pain level eight, you know, eight out of ten all the time. You know, it's been going on for 20 years.
So I saw her yesterday. I'd seen her one week before. How are you doing now?
Well, my pain's at three now. In one week? Yeah, she didn't do any emotional processing of all that.
You just educated her on neural circuits.
Right, and start the process of separating from the pain. Start the process of not fighting it, not fixing it. Start the process of not fearing it.
How do you suggest when someone's in an eight out of ten pain?
How do you suggest?
Starting that process of not fearing it.
Well, step by step. Just a little bit. Just doing the process.
If you took the course that I teach, I demonstrated what I've been calling provocative testing. I'm starting to call it neural circuit testing now. But anyway, help trying to demonstrate to people in real time that these neural circuits can change.
I've used that a lot, actually, since that time. What are you finding?
I had a woman that she was convinced. Her doctor had told her her knee arthritis was so bad. She needed a knee replacement.
In fact, I wanted to ask you about this, because she did have swelling in that knee. And so she used that as justification of like, it's got to be a structural cause of the pain. But she said the worst thing was standing up from a chair.
So she stood up and she rated it a certain number. And then she sat there, and I had her just go into her body, calm down for just a second, and feel her knee and imagine doing that. And she had the exact same amount of pain.
Most people, it's less or there's a twinge. She had the exact same amount of pain, imagining it.
And how did she react to that when you pointed out that that was her brain?
It was still a lot of disbelief. And I mean, she was silent. I find people are silent for a good amount of time.
Do you see that, where they're just like, when they imagine it, and then they're just like, wow. And she's reached out to me again, and she is interested in exploring it more. But I think what her doctor told her, she really felt like she was almost, this is what I thought, maybe being negligent, if she didn't take care of that damage that was there, even though I just proved to her her brain was causing that.
Yeah. Yeah. I mean, there's so many variations of this, and that's what makes the practice great, because you know how people respond, different people respond differently.
But what about that knee? How would you like, someone does say like, but look, the swelling is just in the knee, it's warm to the touch.
Yeah. Well, I mean, there, you know, there's not to say that she doesn't have some arthritis there. And number one, the brain can cause swelling.
I've seen that. Number two, arthritis can cause swelling, but maybe the pain she's having is way out of line with the amount of arthritis that she actually has. And research shows that when you compare x-rays of people's knees and hips, et cetera, the x-rays are not perfectly correlated with the amount of pain that people have.
There's a great degree of mis-correlation between how much findings are in the x-ray and how much pain, if any, people have. So we work with people where they're at, but if she's imagining standing up causes pain, there's definitely a component, if not the complete component, of her brain doing this. And then what we would do, of course, is try to see if that makes sense.
If that makes sense to her, that it's her brain, or at least a significant component of her brain, then we can calm her, have her do some affirmations, tell herself she's okay, and imagine, and then imagine standing up while she's repeating in her mind to herself, I'm safe, I'm not in danger. Safe, I'm not in danger. And imagine standing up again.
Yeah.
See what happens this time. And usually the pain will decrease or even go away with the imagine standing up. So imagining is a graded exposure, just a very low level of exposure.
She's not even standing up. But if you can show her that changing her mindset from fear and danger to safety and calm changes the amount of discomfort she has with imagining standing, that's showing her that she can change her neural circuit. And then, of course, you can have her do the same process of affirmations, imagining, not imagining, but telling herself she's okay, she's okay, smiling, joy, and then actually stand up with that in her mind.
And sometimes you see amazing things. And that's what happened with the thing I was telling you about who went from the eighth level to the three in one week, because this neural circuit testing showed her that it was really her brain and she gained much more confidence and could relax more.
Yes.
And her brain could relax more and her pain went away.
Yes. And I love how you described like that feeling of safety. So it's not just kind of like thinking, thoughts, that you're safe.
Like the kind of visceral somatic relaxation.
Yeah. Yeah. And exactly.
And trying to bring in a smile, trying to tell a little joke, trying to bring in the beauty of just breathing, the joy of breathing, the joy of imagining standing up, the joy of imagining walking. I was talking to working with a woman this week who used to be a runner, but now she can't run. So part of our treatment was having her imagining running with joy, right?
Imagine running with the wind blowing through her hair.
It was just beautiful.
And she really responded to that on, like you say, a visceral level to help change the neural circuits in her brain.
Yes. Number one way to rewire our brain, right, is to react with that calm, that safety. And since I went to your course, I've been telling myself that I'm safe.
In all of these situations that I, you know, my cognitive brain is like, this is really fascinating, interesting. I never would have thought I felt unsafe. But how much that changes my body physiology and allows me to relax.
You know, even in yoga, I'll sometimes feel some sensation. And just telling my wrist it's safe goes right away.
Even in doing a podcast?
In doing a podcast that I'm safe? No, honestly, though, I do with all of the things, because I think my body at a fundamental level is scared of like doing things wrong and making mistakes. And I kind of think it's my upbringing, you know, my religious background, but probably most people have their own version of how they don't feel safe, right?
Yeah, yeah, we all have had times when we didn't feel safe. And the key, I think, is using those times to help us grow and help us learn to be more stress-hardy, right? Because research shows that it's not the amount of stress necessarily.
I mean, there's obviously extremes, but it's not the amount of stress necessarily that causes problems. It's our perception of if we can handle it or not. And Victor Frankl taught us that in his book from the 50s, Man's Search for Meaning, where he made it through a concentration camp by focusing on love, by focusing on caring, by focusing on feeling that he had some ability to control his situation, even in a situation where there's virtually no control, to see his surroundings as a challenge, as an opportunity to grow and become a better human being.
I mean, it's an amazing, amazing book, an amazing person. But we all can do that in our own little ways with our own situations, I think.
Yes, we're always presented with some of these situations, right? Like, that's part of life. A pain-free life doesn't exist.
That's not humanity. But seeing that pain is opportunities to grow.
And an emotion-free life is not an option. Emotions aren't dangerous, and we can learn to accept and tolerate our emotions. We can learn to express them in safe and healthy ways.
I often think that kids on their bedroom should have a little whiteboard that has three columns. One that says things that make me mad, things that make me sad, and things that make me glad. And they can learn that it's okay to be angry, and it's okay to be sad, and so it's great to be happy.
Yeah.
Get stuff down.
Right. I don't know.
I just think it's a good idea.
I think it's a great idea. I love that. Because, yeah, I think we don't talk a lot about our emotions.
We're just kind of taught, like, you should be happy all the time, and if not, take a pill for it. So it's definitely interesting, and especially where I think there was a study you referenced where, or maybe you did, where the type of treatment, the emotional recognition, was it, treatment? What is it called?
Emotional awareness and experience.
Is more effective than the cognitive behavioral therapy and some of the current treatments that are the gold standard?
Correct. Yeah, we did that study when people with fibromyalgia, and it was one of the first, if not the first study, to show that one psychological intervention for chronic pain was actually superior to a different psychological intervention.
And that intervention is recognized by the US. Government Health and Human Services Department as a recognized treatment for chronic pain. So we're happy with that.
And my colleague Mark Lumley is a brilliant psychologist at Wayne State University in Detroit, who was really the person who wrote the grant and got us the money to do that cool study.
Congratulations on that. That is huge. And it's emotional awareness and expression and expression therapy.
So it's probably like it sounds. The emphasis is on being aware of your emotions, expressing them.
Right. And we learned this from from Dr. Alan Avis, the psychiatrist in Halifax, Nova Scotia, who is a brilliant researcher, clinician and teacher of the form of therapy that we used as a basis for this, which is intensive short-term dynamic psychotherapy. So the acronym is ISTDP.
And Alan teaches this all around the world, and it's really a very powerful and useful way of helping people deal with emotions.
Hmm, yeah, definitely the emotion pain line is very blurry. It's kind of a continuum, right?
All together. They're all in there together. Physical pain causes emotional pain, and emotional pain can cause physical pain.
Yes. Well, we are about to wrap up. I just have one more question for you that was from one of my clients, if that's okay.
She's a physician, and I think she heard you talking about psychedelics and research. And the benefits that we've been seeing. And she was concerned as far as like, there's already this opioid epidemic.
Isn't this just introducing something else that's equally as dangerous?
Yeah, that's a great question. Well, the research on psychedelics, of course, goes back to the 1950s. There's no evidence that these these agents are addicted.
That's pretty interesting.
Yeah, that's interesting.
Yeah, and it's kind of important to know. There's strong evidence now and growing evidence that they can be very beneficial in the setting of therapy. They're not always beneficial in the non-therapeutic setting.
So using them recreationally, I mean, it's been fine. People have been doing it for generations. Native people have been using psychedelics for hundreds of years.
Mostly, they're doing them also in therapeutic settings, religious kind of ceremony type settings. And so we're not, I don't think anyone's really advocating widespread chronic use of psychedelics throughout the population. But they are, they can be mind opening in the right setting with the right mindset in short term use, not long term use, and definitely not, and since they're not addictive, and they don't, they don't, you know, have side effects.
I mean, you can have, you can, you can go into a lot of fear and you can go panic reaction during one of these psychedelic journeys for sure. But if you're in a safe place, that can be managed. If you're not in a safe place, that could be harmful.
So you have to be careful with that for sure. But what we're talking about with mind body medicine is using the natural chemistry of our brain to heal ourselves. The power of the placebo to heal ourselves, it's using the power of hope and love and optimism and knowledge and calmness and awe and joy.
It's using those to heal us. And those are powerful chemicals. Yeah.
Joe Dispenza talks about this pharmacy that we have in our own heads.
Absolutely.
Yeah. So yeah, by cultivating different thoughts and emotions on purpose, we're really creating different chemicals in our body. Yeah.
All right.
Well, very cool. I really appreciate your time. It's really been a pleasure talking to you.
And I think this will really help a lot of people. And your information is so valuable and needed and respected. So thank you.
Thanks, Betsy. It's a pleasure to talk to you.
Anytime. Have a great day. Me too.