← Abundant Practice Podcast
Loading summary
Transcript48 lines
- [00:00]
A
Foreign.
- [00:09]
B
Hi, welcome to the Abundant Practice Podcast. I'm Alison from Abundance Practice Building. I have a nearly diagnosable obsession with helping therapists build sustainable, joy filled private practices, just like I've done for tens of thousands of therapists across the world. I'm excited to help you too. If you want to fill your practice with ideal clients, we have loads of free resources and paid support. Go to abundance practice building.com Links all right, onto the show so I've talked about therapy notes on here for years. I could talk about the features and the benefits in my sleep. But there are a couple things I want you to know about therapy notes that doesn't typically make it into an ad script. First is that they actually care if you like their platform. They don't only make themselves available on the phone to troubleshoot so you don't pull your hair out when you get stuck. They also take member suggestions and implement those that there's client demand for, like Therapy Search, an included listing service that helps clients find you internal and external secure messaging Clinical outcome measures to keep an eye on how your clients are progressing. A super smooth super bill process Real time eligibility to check on your client's insurance. In my conversations with the employees there at all levels, they all really believe in their product and they want you to love it too. Second, they are proudly independently owned. Why should you care about that? Because as soon as venture capital becomes involved, the focus shifts from making customers happy to making investors happy. Prices go way up. Innovation plateaus. Making more money with as little output as possible becomes the number one focus. With over 100,000 therapists using their platform, they've been able to stay incredibly successful and they don't have to sacrifice your experience to stay there. You can try two months free@therapynotes.com with the coupon code. Abundant Therapists whose practices are full Is this actually the practice you want? If you're secretly stuck, you're cramming in evening sessions, glued to insurance panels, unable to raise rates. Limitless practice is your way out. Over 12 weeks, you'll make the changes you've been thinking about making for months so that you can work fewer hours while making more money. You'll design a schedule that actually fits your life and you'll say yes to only the clients you love. Together, we'll release you from your golden handcuffs. We're capping the cohort at 10 people because I'm personally running every individual call, every group call, and every accountability check in. People on the waitlist will get first dibs on those Spots and then the opportunity to sign up will go out to the rest of my audience. So join the wait list Now. I'm going to put the link in the show notes and I look forward to helping you get your practice exactly where you want it. Welcome back to the Abundant Practice Podcast. I'm your host, Allison Per, founder of Abundance Practice Building. I'm here with Sean Hershey, who I have known for years and years now. He is one of our students from way back and I'm really excited about his topic today because I feel like it's going to help all of us be better clinicians. So thanks for being here, Sean.
- [03:16]
A
Thanks so much for having me. And I mean, true. It is true. I was an Abundant Student Years back, 2000 or 2, 2021, when I started my practice. And I mean, I just have to say thank you to you because like somebody in one of your podcasts or some post you put out at that time said, like, I just followed Alison Faryer's advice and now I have a private practice. And I was like, okay, that sounds promising. Let me just do that. And now I have a private practice. So truly, thank you. Thank you for everything you do to help all of us. It means a lot.
- [03:52]
B
Absolutely.
- [03:53]
A
Yeah.
- [03:53]
B
And now I'm glad because you're going to get to help everybody.
- [03:57]
A
Yes.
- [03:58]
B
Should we do some origin story? Because your niche, you switched your niche.
- [04:02]
A
I did.
- [04:03]
B
Can you tell us some of that process, how you landed, where you landed, and what we're going to talk about today?
- [04:09]
A
Yeah. Yeah. Okay. Yeah. Yes. Yes. So today we're going to talk about chronic pain and treating chronic pain from an emotional and psychological standpoint. And truly, like, the work I do now is helping clients heal from chronic pain and chronic symptoms using emotional and psychological modalities. And most people don't even know that's possible, but it is. And I certainly didn't know that was possible. You know, when I started my practice, I was working with LGBTQIA plus clients. Dealing with relationship issues like attachment would be my language for it, but that would be like more the client's language for it. And then I personally had this like very eye opening journey with my own chronic pain symptoms. Like, I had terrible, terrible IBS for many, many, many, many, many years. The irritable, irritable bowel. Many years during my twenties and so, so many hip pain, so many different symptoms that have truly, since I started doing this work for myself, improved significantly or gone away entirely. It's, it has been so profound for me and such a different Mindset that I just didn't know anything about. And I'm like, this is it now. Like, this is it. And so now I have changed niches, and I mean, I basically do both, but I know from abundance, you know, pick one and market that.
- [05:45]
B
So, yeah.
- [05:47]
A
So this is what I'm marketing now. And it's been very fun. It's been slower, and, you know, we could talk offline about maybe why that is, but it slower from a business standpoint. But it's been very deeply gratifying from a personal and clinical standpoint because I relate so much to the work. It's been so fun, and it's awesome.
- [06:09]
B
Yeah, it's interesting. I remember. So I've had stomach issues my entire life. And as I think when I was like, 19 or 20, I was at the gastroenterologist, and the gastro said, you need to work on your anger.
- [06:24]
A
Yes.
- [06:25]
B
And I was like, what anger? I don't even know what anger feels like. What's that word? Yeah, it took a while.
- [06:34]
A
I'm like, you at that age would have been my ideal client. There we go. Yeah. Yeah.
- [06:39]
B
Totally clueless about the emotional link to somaticizing everything like a champ, man. That was a muscle I really developed.
- [06:49]
A
And honestly, I'm very excited to speak to your audience of therapists about this today because many of us are sort of wired that way. You know, like, many of us are very sensitive people, people who feel a lot and people whose bodies take on a lot. And in our society, we're not really taught like, oh, IBS might mean anger, it might mean sadness, it might mean grief, it might mean anxiety. I mean. I mean, I guess that's a little more. So people sort of talk that way, but a lot of times, like, oh, you must have gut dysbiosis. You must have something. You know, you gotta get a colonoscopy, we gotta do allergy testing. And it's like, all that is relevant, because that may be the case, but that's not the only thing that could be causing a problem like that. And similar with back pain, neck pain. I mean, there's a lot for us to talk about.
- [07:41]
B
Yeah. Okay, let's do it.
- [07:43]
A
Yeah. All right. Let's. Let's dive in. Like I said, I'm really excited to be talking to your audience of therapists today because most of us feel very professionally and honestly personally disempowered when it comes to dealing with somatic complaints and dealing with physical complaints. But most of us weren't trained this way. Maybe some very Old school sort of psychoanalysts were trained more in somatic stuff. And then very new wave might be, you know, people might be trained in somatic stuff. But for most people who went through a mainstream psychology or social work or program, you know, similar. Most of us weren't taught about how to deal with somatic complaints, or we were, we weren't taught like thoroughly. And so we feel very disempowered in working with clients with physical symptoms. And we're taught that they're like, not even within our scope of practice. So it seems like it seems possibly unethical to even suggest that a therapist could work with somatic complaints. Not true. It is within our purview. But the opposite side is also true. Medical education is really lacking in an understanding of emotions and how emotions affect the body. And so they feel very confused and clueless about how to treat somatic complaints. And so there's a massive gap and it's not only for our patients and our clients, but it like, it's also for us. You know, like, we are like, everyone listening to this podcast is a human with a body and a brain and you are susceptible to mind body conditions just, just like me. And so it's just such a huge gap in the medical field, in the mental health field and in society that I'm like, let's talk about it. So yes, what I want to talk about is a new way to understand pain. So some people listening might be familiar with some of this stuff. So what I'm talking about is the work of Dr. John Sarno, who wrote a book called Healing back pain in 1991 and he wrote many other books that's his most popular. I'm talking about something called pain reprocessing therapy, or PRT is the acronym. It's not necessarily mainstream yet because it's, that's kind of new pain reprocessing therapy. But it builds off of the same theories that Dr. John Sarno posited in his book. And I'm sure some of your listeners have, have heard of that stuff. And like I said, I mean this has been so profoundly helpful for me personally, like after my like decades long struggle with ibs, dealing with those symptoms through an emotional and psychological lens. Truly, like, I do not have severe chronic IBS anymore, like over. And I still have a sensitive stomach and I still have like emotions land in my body, in my stomach. But now I know, I know what it is and it doesn't scare me and I know how to deal with it. And not so What I'm offering and what I'm communicating to the, to your audience today is very different than CBT for chronic pain, which is how to manage your symptoms. Something's clearly wrong with your body. So we've got to work on how to manage your life so that it's, you know, so you can still live a good life even though you have something wrong with you. This is very much not that Dr. John Sarno's work and the mind, body work that I do in pain reprocessing therapy is very much about like, you don't have to have chronic symptoms. Like you, yeah, you'll experience pains in your body. Everyone does. There's many, you know, both emotional and physical. There's many reasons why you will experience pain in your body, in your life, but you do not have to have severe chronic pain. If you treat it psychologically and emotionally, the symptoms can come way down and even go away. So what I'm not talking about is how to manage your chronic pain. What I'm talking about is like, how to learn to let it go and truly live without it. So it's just very exciting and I hope people listening are like, wait, what is this? Is this possible for me? I, I want to list so people can recognize this. I want to list some, like, classic conditions that, you know, where, where this might be manifesting. So like classic ways that mind body pain would manifest in the physical body. It's, and this. So this paradigm applies to many, many, many cases of chronic back pain, chronic neck pain, chronic hip pain, chronic shoulder pain, chronic knee pain, chronic el. Pain from disc bulges in the back or neck pain from disc degeneration, other musculoskeletal pain, sciatica, neuropathy, migraine, irritable bowel syndrome, as we've been talking about, pelvic pain, interstitial cystitis, fibromyalgia, chronic fatigue syndrome, complex regional pain syndrome, sometimes called CRPs, and more. I mean, there are many ways in which the psychological and emotional factors manifest in the body, but those are kind of classic, classic heavy hitters that many people will recognize that most people don't think are, you know, if somebody has back pain, they think, I must have a slip disc. I maybe need surgery, I need physical therapy. And while maybe, but maybe it's something different. And that is what I want to talk to your audience about today. And so here we are talking about it.
- [13:27]
B
Yeah, it's interesting because I think about how just like with my own medical history, it's like, okay, well, stop eating These things and see how that feels and, you know, do these kinds of stretches or exercises and see how that feels. And those things. For me, as somebody who tends towards the rigid, I'm like, excellent, Let me put it on my to do list. I will knock it out. I will give it an A plus. And then nothing's changing, or it's only changing a fraction. But diving into the emotional side of life and really feeling it is so much harder and so much. I'm so much more willing to neglect that and not put it on my to do list than, you know, some physical therapy, exercise, or, you know, not having coffee.
- [14:14]
A
Yeah, a thousand. Okay. First of all, same. The same. It's like, give me a to do list. I'll do it, you know, for the abundance checklist that you offer. I get it.
- [14:27]
B
Right, right.
- [14:28]
A
So helpful. You know, so helpful. And that's something that I actually work on with a lot of my therapy clients, is there's a difference between. Most people with chronic pain have a very. It's easy for us to become kind of like obsessive and treat ourselves as if something's wrong with us. And any kind of intervention that's like, you need to fix something wrong with you. That's the kind of stuff that most of will easily gravitate towards and try to do with the diamonds. Like, something's wrong with you and you gotta fix it. The paradigm that I'm working from and that I'm helping my clients move towards is taking care of, like, the true authentic self. Not who you want to be, not who you will be once all your to do lists are complete. Not who you'll be in 10 years once you're fixed, quote unquote. You know, what I'm helping people do is, is work with, like the real kind of animal self of who you are, even if it's not who you want to be or it's not who your family would want you to be, or it's not who certainly your family of origin would want you to be or society would want you to be. It is much harder to work on that person. And yet that's what chronic pain is inviting us to do.
- [15:45]
B
Right. So walk us through some of how. And I know you're going to do a much more in depth training in the bun dance party, but tell us the highlights of how we could be working with people or things we could be asking before we're more deeply trained. Like, how do you. How do you start with people?
- [16:05]
A
Yeah, yeah, yeah, Great question. Well, let me say that it's. It really is a very different mindset because people think of pain. Well, okay, okay. So why don't I say a little bit about, like, I have these notes written down, so I want to say about this. Pain. People think of pain incorrectly, or I wouldn't even say incorrectly. People think of pain like, not holistically. It's like what we know is correct, but there's also much more. So our mainstream understanding of pain and symptoms in the body is incomplete. So pain is a danger signal in the mind, body system, and that's always the case, no matter what the pain or symptom may be. So say you put your hand on a hot stove, obviously your hand is going to hurt, and that's because your hand is in danger. Say you get slapped in the face. Yes, your face is going to hurt because your face is in danger. So pain is a danger signal. And we have been trained to believe that pain is always and only a sign that something is structurally wrong with the body at the site of the pain or some kind of illness or disease at the site of the pain. And that is one cause of pain that's certainly not wrong. You know, that, that, that. That obviously is real, and it's not the only cause of pain. Like, that is an incomplete understanding of pain. Not an incorrect understanding, but an incomplete understanding. And pain is not always what you think it is. And chronic pain, Chronic pain is different than acute pain. Pain that lasts for a long time. Pain that's days, weeks, months, certainly years, which, which many people have, you know, certainly me included, you know, like that. That's my story. Chronic pain is usually caused by emotional and psychological factors, and it's usually not caused by physical or structural factors. So why don't I take just a couple minutes to walk through the three most, like, basically the three most common ways in which chronic pain arises. Cool.
- [18:20]
B
Sounds good.
- [18:21]
A
Okay, cool, cool. So the, the three that I, that I teach about are emotional is number one. I think that'll be easier to understand. Psychological is number two. And being misattuned and misaligned with your true self is number three. So number one, emotional. Most people with chronic pain are people who have learned somewhere along the way that, like, the emotions you feel, like, the strong emotions you feel are, like, not safe, not good, certainly not easy, maybe will not be attended to by others, don't matter to others. And therefore, like the emotions that we feel, like it's best to not feel it. And we can be very good at trying to fix emotions, trying to solve Emotions, trying to fix the things that are underneath our emotions, but solve the problems that are underneath our emotions. And that's great. You know, a lot of therapy is about that. And like, that. That's great work. And there are some things that you can't fix for and something you can't solve for. And you meet every. Every therapist knows that. And there's a huge difference between fixing your emotions versus just feeling your emotions and allowing yourself to feel your emotions and not being afraid to feel your emotions. And so most of us with chronic pain are the type of people who want to fix everything. We don't want to feel it. We don't like to feel it. And we come by that honestly because usually that's like, you know, we were in an environment that in some way was not validating and did not see us, and we were not mirrored. And certainly it could. Absolutely. This can come from trauma. And so we feel emotions are a threat. So as emotions rise in the body, which will happen every day, you know, not a day goes by without emotions. As strong emotions rise in the body, that feels threatening to the mind, body, system. And on an unconscious level, the body will create pain and symptoms because it's afraid of, you know, it's similar to, like the hand on the hot stove. It's like the emotions have a similar function in the body. It's like as that rises, the body's like, no, no, no, don't like, don't like dangerous. And that, of course, creates a danger signal. So a huge part of the treatment for chronic pain is learning how to befriend your emotions. Because, I mean, most of us have a lot of repressed emotions, a lot of stuff we don't like to address. And so airing out and getting to know and making friends with those repressed emotions is a huge part of dealing with chronic pain. All right, so that's the first thing. Emotional pain, where the emotion causes the danger signal, which causes the pain. Second is psychological. So this is. This is the realm in which pain is caused by the sense of threat that causes the pain is the. Is the pain itself. So there's something called the pain threat cycle. I mean, it's for people, for therapists who are similar with a panic disorder, it's like that. But with pain, where it's like, the thing that gives you the most anxiety is the sensations of anxiety. This is like where the. The pain, you know, when. When you have, say, you wake up with a pain in your neck and you don't know it, but it's because of some emotional situation you're dealing with. And then it goes on and on, and it's days and it's weeks, and then maybe the emotional situation has now blown over, and that's okay. Awesome. Good. That is sort of resolved, at least temporarily for now. Good. But the pain may remain because every morning you might wake up like, oh, God, my neck. How does it feel right now? Oh, maybe it feels okay. What if I sit up when I'm working today? What kind of position do I need to be in? Oh, is my neck going to start hurting? Oh, no, I think I feel it. I think, oh, God, it's going to be a bad neck day. Right. And all of that, that becomes the new danger signal and stresses out your body so much that it's going to perpetuate the symptoms. So there's something called pain threat cycle, which is like when you feel pain and you're threatened by the pain, and pain is a danger signal. So feeling threatened will make the pain worse. And then when the pain get worse, gets worse, you feel more threatened, and then it causes more pain and more threat, and you just like going down a downward spiral. So what we really work on there, what I work on with my clients there, is not being afraid of the pain and the symptoms and learning to reverse that cycle. And that cycle can get real bad. People without, certainly through no fault of their own, they're just not familiar with what's going on. They end up bedbound, housebound, you know, people, the chronic. I think there's a. There's a belief that, like, if your chronic pain or chronic symptoms are emotional in nature, there's no way it could be that bad. Like, if it's really bad, something really wrong with your body, and that's not true. These emotional and psychological symptoms can be incredibly bad, incredibly severe. And so, so, so, yes, getting out of that is important. All right, last thing briefly, in terms of the three ways in which chronic pain typically rises, first, we talked about emotional. Second, psychological. Third is where the danger is like the fear of being your true self. Everywhere you go, there you are. We all know that. And if you're always. I mean, chronic pain usually happens for people like me who have been taught along the way, like, you're not right how you are. You should be different. You shouldn't be this way, you shouldn't be that way. You should be more like this. And everywhere you go, your true self is there. You know, we're all born with a temperament. We're all born with a personality, and of course, you know, the environment affects us hugely. We can develop this way or that way. And yet all of us, like, we are all a real person who has a real personality. And, and like we come into the world with something. And if you are trained to dislike and try to repress whatever's inside you, that will be there all the time. And so every, you know, everywhere you go, you may be feeling threatened by your true self. And this is some of the hardest work. It certainly has been for me, and it is for most people who are on this path. But making friends with yourself and allowing yourself to be yourself will drastically help with chronic pain. And people like, that's a far leap for a lot of people who are like, wait, but I need to get a, you know, I need to get an mri, I need to get an X ray. And to just say like, you actually need to befriend your true self is like for so many people. But in most cases it is actually true. And so it can be kind of a long on ramp. You know, like I start with people with like the education and the emotional stuff and usually getting, getting into like being yourself and learning to love yourself. It doesn't have to be so dramatic. Like you love everything about yourself, but just learning to tolerate yourself, that's like a later phase of treatment. So I. Okay, last thing. I just want to briefly say Dr. Sarno has a list of personality traits. This is a list of traits for people, typical personality traits that people have who fear their true selves and typical personality traits that people have who develop chronic pain. And a lot of people relate to this stuff. And a lot of therapists have this personality profile. Perfectionism, goodism, wanting to be seen as good by others all the time, people pleasing, high conscientiousness, stoicism, low self esteem and highly self, self critical. I certainly relate to basically all of that. And I know a lot of your listeners will and a lot of therapists will. And so what I want to invite people into is like, if you or the clients who you have are experiencing chronic pain and have that kind of personality profile, there's a good chance that this is what, that this is what they're either they or you are dealing with in their body or in your body. And the good news is, like, there really is hope for this. It can absolutely get better. Like if you treat the symptoms emotionally and psychologically, you can be doing worlds better. Like the symptoms will go down significantly, go away in many cases. Certainly not be chronic anymore. There's so much hope and so I want to. I want people to know that because, like, I needed this information so long before I actually got it. So it feels good to be able to share this with people. And I hope that this lands with some of your listeners and that they, you know, that they feel hopeful and maybe are. Because this can be a really big awakening. Like, for some people listening to this, it might be like, oh, wow, wait, could this be true for me? And that is a huge awakening. And so I just want people to know there's a lot of hope for these conditions.
- [27:46]
B
Oh, I love it. Thank you so much, Sean. I'm, like, trying not to massage my shoulder. I'm like, okay, okay. I'm excited about the training you're gonna do in the party because, well, you know, it's funny, I have had Sarno's book on my shelf. I'm not somebody who has a big stack of TBRs, but I have had that book on my shelf for maybe a decade because so many people have recommended it to me over the years, and I just keep not reading it. So I'm going to take this as a sign to, like, pick that sucker up and read it.
- [28:17]
A
So it's very life changing for a lot of people. And it really. I mean, one of the things that they say in the world of chronic pain treatment is, and this is a Dr. Sarno quote, denial of the syndrome is part of the syndrome, because if your emotions are repressed and if parts of yourself are repressed, you're protecting yourself against that, you know, subconsciously. Like, you don't want to just pick up a book that says, like, explore your emotional life, because there are parts of you that are like, don't explore your emotional.
- [28:45]
B
Yes, yes. Most of me.
- [28:47]
A
Yeah.
- [28:48]
B
I love how many. Many of us therapists are like, no. I mean, feelings are really important for you to feel, but not so much me. I don't want to. Yeah, yeah.
- [28:59]
A
And we're very good caretakers and helping others and oftentimes, like, we're not on the list of people who, like, deserve care and which certainly has been the case for me and still is the case for me in many ways. And that's something I'm still working on. And. But we're people too. All of us deserve self care and care by others. All of us deserve that.
- [29:25]
B
Yes. Yes. Awesome. Well, I will see you soon, Sean, and thank you so much.
- [29:29]
A
Let me say, for people who want more, I have a podcast of my own. So let me just.
- [29:34]
B
Yes. Oh, yes, thank you.
- [29:35]
A
Which I actually learned from you that the best kind of marketing provides a service, and that's honestly kind of the. The inspiration behind the podcast that I have. So I have a podcast, it's called Mind Body Medicine for Chronic Pain. You know, Apple, Spotify, wherever you get your podcast, you can find it there. And the deep dives on a lot of stuff, like, I've got a bunch of episodes at this point, lots of interviews. I think it's very good and it very much is in the abundance mindset. You know, like, the podcast really does provide a service. It provides a service for people who want more information about this, people who don't know about this people. It really is very educational and. And also fun. I think the podcast is very fun and kind of inspired. It's like, it's like good vibes and it does market my practice. But the cool thing is that it's like, if people want to go deeper and would want to work with me, then great, they can reach out to me and all my information is there. But the podcast itself is really helpful and it's totally free and it's, it's, it's just, it's very abundant. So happy with you and your audience.
- [30:46]
B
I love it. Yes. We'll make sure we put a link to it in the show notes so it's easy to access.
- [30:51]
A
Well, sounds good.
- [30:52]
B
Awesome.
- [30:53]
A
Yay.
- [30:53]
B
Well, I will see you soon. Thanks so much, Sean.
- [30:56]
A
See ya.
- [30:59]
B
If you're ready for a much easier practice, TherapyNotes is the way to go. Go to therapynotes.com and use the promo code abundant for two months. Free. If you're listening, you probably need some support building your practice. If you're a super newbie, grab our free checklist using the link in the show notes. I'd love for you to follow rate and review, but I really want you to share this episode with a therapist.
- [31:21]
A
Friend.
- [31:21]
B
Friend. Let's help all our colleagues build what they want.