[00:00:00] Welcome to Move With Deb. I'm Deb your friendly neuroplastician. And this is a podcast that explores the relationship between the body and the mind from a health at every size, judgment, free perspective. I teach you how developing a new internal conversation based on curiosity, self friendship and simple neuro-plasticity techniques can rewire your bodymind out of pain and emotional overwhelm to help you build the rich full life that you want to live. Disclaimer, this is not a replacement for medical care.
[00:00:50] Hello, my dear ones. Welcome to Move With Deb,the podcast episode 43. I was reminded again, just the other day that the number one symptom that we're dealing with is fear. Dr. Schubiner who has written an amazing book called Heal Your Pain, he is a leading body physician and a leader in this field, and he has a number of research projects and papers under his name, including the Boulder Back Pain Study. And he is my teacher in training me in this mind body work. He told my colleague Callie at Lin health the other day that the number one thing we're helping people with is fear. That was just a really clear reminder when we are working on neuroplastic pain. The reason why this process works with all different kinds of pain is because we are working with the meaning of the pain, the origin of the pain being a response to fear, being a part of a learned conditioned response from the brain based on experiences of the past, or when I see people who, you know, have a lot of different symptoms that happen in different areas in the body or pain that grows like fibromyalgia that has an overall hypersensitivity.
[00:02:11] Pain is painful and uncomfortable. We don't like it. And what happens is we train the brain to pay attention to it. And that attention is what makes it grow. If we weren't afraid about what it means, then the fear of response in that predictive brain wouldn't have us keeping track of it all the time. If you weren't ever afraid of getting hurt, you would just do lots of things and people who don't feel pain, usually don't live very long because they've injured themselves beyond repair.
[00:02:46] So pain is a protective mechanism, but it also can become a mistake. And it can become a mistake that perpetuates itself. And then the fear of the pain becomes our general operating system. So the main thing that we're helping people with is fear. So if you only really explore this one thing, your whole life could change.
[00:03:12] In this episode, I will explain why fear is the issue. Not with all the neuroscience, because one, I'm not a neuroscientist, even though I'm a neuroscience mega fan. But because I want you to explore within your own story, within your own mind, body, what your patterns are in your life. Not in all the parts of the brain, because you realize that you don't actually have to know what any part of your brain is named for your brain to work. Did you know that you didn't have to know that you have an anterior cingulate cortex to have it work?
[00:03:54] So, this is why like neuroscience is great, understanding things really powerful, and also not necessary in that you can heal without knowing any of the names of any of the parts of any of the pieces of your brain. So sometimes when we get excited and into the weeds of knowing things, I want to remind you that that isn't the point of this work.
[00:04:22] It can be. If you were a neuroscientist studying brain and pain, like my colleague, Dr. Yoni Ashar, that's his job. His job is to be able to look at the FMRI data and study it and make conclusions come up with theories and treatment protocols based on that.
[00:04:42] Your job is to live your life and to feel empowered and to change your brain and to change your pain. So you can go do things that you want to do. Some of, you might want to become neuroscientists, but some of you might just want to go take a walk in the woods and, you know, have whatever job you have. Or if you want to go on a bike ride with friends, or you want to be able to sit at your job, that you love, sit at your desk and be able to work and not be in pain.
[00:05:13] Say this, that, that we remember what the point is of doing all this work so that you don't have to understand every piece to understand how it works together. But if you're curious, Dr. Huberman of the Huberman Lab did a podcast on the neuroscience of fear, I thought that was really interesting. So I will link to that in the transcript.
[00:05:35] If you listen to these podcasts, to these researchers who are able to break down scientific concepts and share them with the public, you can find the little links to how this stuff all fits together. Maybe someday I'll break down like a Huberman Lab podcast. And you know, it'll be like this one bit of research explains why this mind, body process creates pain and how we un-create pain.
[00:05:59] So maybe I'll do that in the future, but also these things are just theories and the reality is kind of like. In my last episode, when I talked about recovery stories. So sometimes we get kind of dismissive that so much of this work is anecdotal and not based on research, except that research is theories and anecdotal is actually just another human being who is like you.
[00:06:25] So research is great, but also other human beings who are just like you, who are using these tools to heal their pain, aren't they the experts? Don't you want to hear from them? Find out what they're doing, and then you create experiments inside your own mind and body. So that's the kind of place that I live in which it's like, I'm both the recovery story and I'm the translator of research.
[00:06:52] So maybe that's my Venn diagram for you. Hopefully, maybe some of what I share with you and help you explore in this podcast, which is to help you create experiments for yourself. So, because even though science can explain something, it is not science that is the creator of our experience.
[00:07:13] We exist, we feel things, we are human, whether or not neuroscience or any kind of science has an answer. So I just want to invite you into the realness of your experience, just as with pain, what you are feeling is real, even then there's no tissue damage, even though there's. If there's no disease process.
[00:07:36] So I want you to really begin to understand the relationship between your mind and your body so that you can feel better. One thing that I see that happens after someone has been sick is that they begin to anticipate and fear symptoms, which is quite understandable. And then they do with Doctor Zoffness calls Pain Voice, or a symptom assumption behavior as I call it, which is not a good name. So maybe I'll come up with a new name.
[00:08:05] We start to act as if A plus B will always equal C and then begin to plan our lives this way. So trying to avoid unpleasant, physical, and emotional experiences. And I get it because they're uncomfortable or scary. We have a lot of subconscious thoughts and beliefs about ourselves, about what this pain or symptom mean for us, for our futures, for our hopes and for our dreams. So I want to invite you to listen to my podcast, episode 16, what am I making this mean? And I'll link to that in the transcript.
[00:08:41] I've worked with a few clients who have fibromyalgia or chronic fatigue syndrome recently, as well as a new client who's having some respiratory issues. In our work together. I teach them about pain science education so that we have a basic set of shared knowledge.
[00:08:55] I like to think of this knowledge as the antidote for the pain prediction voice that is in their head, whether that was something that was planted in there from doctors or family, or the completely rational fear of symptoms repeating, because you've had them for so long or information from the online communities or from Dr. Google or from watching friends or families struggle with the same issues. All of that brain stuff. Those thoughts and beliefs work together to maintain the prediction of symptoms that the mind body is experiencing, crowding out the possibility or even the truth of when they're not happening.
[00:09:38] Fear has us checking around corners for symptoms, even when we're not feeling them currently. And we miss the fact that we aren't currently in pain or fatigue, because fear is a very important feature of the mind body in keeping us alive. And there's also the main reason we feel awful. So after my clients and I start working with a shared language about pain, we'd like to start and explore and play with language and beliefs.
[00:10:04] We find the opposite to of all the fear stories. When I hear things, clients say like, I can't handle it, or it will always be this way or symptom X will be triggered if I do Y, I ask, how is this not true? Or so what, and I asked, when did that not happen? Where is the evidence that this isn't true, a hundred percent of the time.. And it's always there hanging out in plain sight, waiting for someone to notice it, the not happening, the absence of symptoms, but that truth, which is just as true as the pain, is ignored because of fear and beginning to see the entirety of our mind body experience is essential for healing. I see people feel better every day because they learn to train a brain to pay attention to the not pain. Also, they learned to have a new relationship to fear. A so what relationship, that's what I want to invite you to start to develop. So when you feel pain or when you're in that kind of pain voice, that anticipation of symptoms, that anticipation of something that's going to hurt.
[00:11:23] And you're like, I'm going to sit in this chair or I can do only do this activity for this long, any way that you've organized your life to manage your pain and your symptoms, I want to invite you to begin to see those behaviors are maintaining the prediction of pain being continued by the brain and that the most important thing to look at, not necessarily the pain itself, but the fear.
[00:11:49] So what happens if you don't sit in that chair, write down all the things you're afraid of. Let's get familiar with that quality and sense of fear. So one of the things with my new client that we discovered was an interesting experience. So we were talking through her experience of getting up and moving around and the information that the doctor had shared with her about what her symptoms were and kind of why they were happening in her body.
[00:12:18] And so her difficulty is around getting enough oxygen and the doctor had given a whole list of expectations or rationale of why this is happening in her body. Then I asked her, is there any time where this is not happening? And she actually listed to me, oh yeah, I had this experience and I wasn't feeling the same way that I'm feeling now.
[00:12:41] I thought, well, that was interesting because that kind of contradicts what your doctor says. Okay. No, I'm sorry if I'm being vague, but I don't really want to go into like elaborate details. But basically the information of her actual lived experience had been discounted by her own perception because it didn't match the information that her doctor gave her about her diagnosis.
[00:13:03] So this is not to say that she's right, and the doctor is wrong or that the doctor is right and that she is wrong. It's just that we want to put together the puzzle of what is actually happening on the inside of her body. What are the experiences that the doctor has given to us to think about and how do we organize our fear experience? Because one of the things that she completely discounted was how her body felt when she moved out of fear. And because we were talking about the breath and respiration, there's so much about the autonomic nervous system that goes into the ability to take a full inhale of breath, to feel relaxed about breathing.
[00:13:43] And while this work may not cure her, working with fear will definitely help her breathing. And also working with breathing will help fear. So there's a symbiotic relationship between breathing and the physical sensations of anxiety. The most important thing to start with was to find evidence of an experience that she had had, which was not fear. Which was feeling expansive in her breath, which was feeling a difference in the sensation and the symptoms at a time when she had a little break from the intensity. And then we really talked through when she was having the worst symptom, it was when she was having the worst fear and then the fear and the symptoms kind of work together in tandem with either. And when we're in fear, we're hypervigilant. And of course we feel things more intensely.
[00:14:38] So that's like one example of working with her. Now I have an example of working with a client who has a lot of anxiety and a lot of physical symptoms related to anxiety, and a lot of fear about the muscle tension and pain that they were experiencing. As we worked through this fear piece and help them not have a hyperreactive hypervigilant reaction to a symptom, we walked through a process of creating, curious awareness, any time as symptoms arose, their whole body, relaxed. Their whole body relaxed fear. And, you know, for certain fear things that we knew that were coming up, we built strategies. We planned ahead. We talked about things, whether it was work or family or relationships, we planned mind body strategies because what we came to understand was their response to stress was all of this muscle tension, but then the muscle tension kicked off the fear and the fear is what created the pain. So that was our journey of discovery. And so we were discovering all the different strategies to use, to create less fear, to create less hypersensitivity, to create less hypervigilance and create more resilience.
[00:15:55] And now their life circumstances are still the same. The people in their life are still the same people. The pandemic is still the pandemic. Now they're able to move themselves out of these reoccurring symptoms for the most part. I mean, they're still human, so they're still working on it. But in a few short weeks, we've been able to really help them stay more, present more, even keeled and more resilient, being able to move through stressful situations and not have flare ups. Not have what normally would have kept them in bed for days, recovering. Those experiences didn't happen. So then they didn't need to recover. So we're creating a lot of opportunities for corrective experiences and for nervous system management. It is because we are looking at the fear and the fear of the symptoms.
[00:16:47] Sometimes it's other fears. Sometimes it's fear related to childhood experiences. But at some point we just have to start with the fear that's right in front of our face. Sometimes the fear is just the fear of the pain itself and the fear of the symptoms and fear of missing out the fear of the experiences that we're having when we are in pain.
[00:17:08] And that's the best place to start, because if we can learn how to manage fear or change our relationship to fear, then we can go back and think about our childhood. Because then when we think about that childhood, now we also have a relationship to fear, to discomfort and safety, and we can create safety and plan for taking care of ourselves no matter what happens now, especially when we think about the past.
[00:17:33] A third example is a client who just sent me a message. We had worked together way back on her migraines, which she stopped having. She sent me a beautiful picture of her and her new baby. She said, guess what? I just gave birth completely unmedicated by accident. And it was awesome. I wanted you to know that I use tools from the chronic pain course during the labor process. I had a moment of fear when I realized it was too late for an epidural or pain meds. And then I thought I have the tools for this. And now she's like also not in pain after giving birth either. And we weren't even doing this work around that directly. She had just embodied this understanding and this practice that she can talk to her brain, that like fear was something that she didn't need to be reactive to. Yeah, she felt the fear. And then she talked to that fear. She felt the fear. And then she talked to her nervous system. She said, I got this. And then she applied the tools and had she felt pain, I'm sure they would have figured something out, but she was like, let me try this, do this.
[00:18:46] And you know, the answer is always looking at our fear and willing to feel things, being willing to feel fear and say so what. When you ask yourself, what are you afraid of? You will find all the things that you are afraid of, all the thoughts that are creating this sensation of fear in your body.
[00:19:06] Fear has a felt sense, our relationship to fear. So it's not even necessarily fear itself. When they talk about trauma or a shock that when you retell the story about what happens, that helps teach your nervous system, that you're safe. So there's the initial event. And oftentimes there's the way that it gets processed is to continue to tell the story in this factual way, which then allows the brain to create a separation from it. And then the feeling of fear dissipates separating the feeling from the event. So in my mind body work I use a practice called thought work, in which we separate the circumstance from the thought and the feeling. We spend time creating that separation. So that one, we can experience a feeling. What fear does, is that fear, preempts thinking, fear hijacks your thinking, learning cognitive brain and keeps us in this kind of activated nervous system state. Right? So we think about polyvagal theory that vagus nerve is in the body and it helps manage your autonomic nervous system. And they're all related. Thinking and our feeling and our body and our organs and our sensory experiences. They're all one thing linked together.
[00:20:29] And so when Dr. Schubiner told my colleague, remember the number one symptom that we're dealing with is fear. I thought that was such a beautiful reminder. And the answer is not to never feel fear. The answer is to lean into feeling fear, and then looking at fear and just asking ourselves, so what? And when we hear ourselves say things like I can't handle it, it will always be this way. This X symptom will be triggered if I do Y, we need to explore these questions because those are the questions in the beliefs that perpetuate fear, perpetuate the brain's prediction of what's going to happen.
[00:21:10] So when we ask, so what, and when we investigate how this might not be true all the time, it's not because we're mean or not, because we're not believing you it's because we're asking you to find evidence for your brain so we can update the prediction and teach the brain that no, it's not always true. You can handle it. It won't always be this way. And this X symptom will not always be triggered if you do Y. I've had a number of clients who've changed a lot of their triggers, whether it's about sitting, whether it's about food that they're eating. A lot of these things are reversible and changeable, and we need to look at fear.
[00:21:53] But you also have to want to, has to be meaningful to you. So, this is not me telling you, look at fear because you should, or you have to, but if you want to feel better and you want to change your pain or your chronic condition, this is one part of that. I want to encourage you to start to think about the condition responses that you create around your pain that are very fear-based and that are about managing fear and trying to control symptoms. And you can go slowly and you can move at your own pace.
[00:22:27] And you just want to keep building the understanding of this autonomic nervous system dysregulation. It is something that is workable and that different people are going to need different kinds of interventions and that's okay. But healing is a possibility for you.
[00:22:44] And it was a possibility for me. And as I continue on my healing journey around my fear around my knee pain, which I mostly don't have right now. And occasionally have. And as I continue my journey in terms of building more strength and mobility, which is a value and desire of mine, I'm going to keep sharing that story and that information so you can follow me on my Instagram @movewithdeb. I look forward to sharing on my next podcast with you, which is kind of weekly ish. Thank you for listening and I'll catch you later.