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- [00:00]
A
This is Building Resilience podcast, episode 219 unlearn your pain with special guest, Dr. Howard Schubiner. Welcome to Building Resilience, a podcast where theory, practical strategies and inspiring stories show you how to unlock your best life. I'm your host, Leah Davidson. As a certified life coach, speech language pathologist and nervous system resilience expert, it is my mission to teach you how to be more resilient to life's adversities. I will show you how to manage your mind, befriend your nervous system, process your emotions, and even eliminate stress. It's time to do more than just survive. It's time to thrive. Let's get started. Hello everybody. Welcome back to the Building Resilience Podcast. You are in for a treat today. I have a very special guest, but before I tell you all about my guests, I just want to remind you that my guided journal, Resilience is out and available for sale on both Amazon.com and Amazon CA. It is a mental health journal for emotional well being and nervous system care. There are links for it in the show notes. If you search my name on Amazon, you will not find it because it's under my brand Resilient Brilliance, so you can search it like that too or use the link. Today I have Dr. Howard Schubiner here to talk with me all about pain. He is one of the world's leading experts and pioneers in the area of chronic pain. I've had the opportunity to take some of his trainings. I took Freedom from chronic Pain, just completed his training this past December in emotional awareness and expression therapy, which he talks a little bit about in today's episode. If you suffer from any chronic pain or symptoms, or anxiety or depression, or if you have a loved one who does, or, or pretty much if you're human, then you're going to want to listen and even take some notes. Because Dr. Schubiner graced us with a wealth of information, let me tell you a little bit about him. Dr. Schubiner is an internist and clinical professor at the Michigan State University College of Human Medicine and has authored more than 100 publications in scientific journals and books. He lectures regionally, nationally and internationally and is the author of three books, Unlearn your Pain, Unlearn your Anxiety and Depression and Hidden from view, written with Dr. Allen Abbas. Dr. Schubiner has worked with Dr. Mark Lumley to develop a novel psychological treatment for chronic pain, emotion, awareness and expression therapy, which has been shown to be highly effective in randomized, controlled trials. Dr. Schubiner sees patients virtually from anywhere in the world@kormendi health.com and lives in Detroit area with his wife of 40 years and they have two adult children. Without further ado, please enjoy this interview. Hello, Dr. Schubiner, welcome to the Building Resilience podcast. I am so excited to have you here. I have been a long time fan. I have taken some of your trainings. I have of course read your book unlearn your pain and unlearn your anxiety. And I know that you have another one coming up which I am so excited to.
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B
That's true. Thank you. Thank you for having me. I really appreciate it.
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A
Today I just wanted to talk a lot more about the science and the background of healing chronic pain and exploring mind body syndrome. And I know that these are things that you really are a pioneer and an expert in this area. And I've touched on it a little bit before on my podcast. I've done a couple of episodes and I just am so happy to have this opportunity to bring you in, the expert in all things to set the stage and teach us a little bit about pain and the difference between chronic pain and acute pain and what we can do about pain and where it's coming from and all those good things.
- [04:17]
B
Yeah, it's really amazing. Most doctors, I'm a physician, internal medicine doctor. I had not a lot of interest in working with people with pain for half of my career. Most doctors really don't like to work with people in pain, especially chronic pain, because we haven't had good treatment models and it's been frustrating. And so doctors will tend to shun people up. Go to the pain management people, let them take care of your pain. Because I can't deal with it.
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C
Yeah, yeah, no.
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B
And then I found myself being completely interested in pain and being excited to see people who have chronic pain, even pain. That's 5, 10, 20 years. Because lo and behold, all of a sudden I had learned something that you could do about it and What a complete 180 degree turn that was in.
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A
My career to be able to have the empowerment that there's something to be done about pain. So let's start with the basics, because I know that you give an amazing explanation to your clients of what actually is pain. And it's so helpful to have that background.
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B
Yeah, it's. And this is revolutionary, a completely revolutionary understanding of what pain is in the first place. Because you would think that everyone thinks, and what we were taught in medical school and what every doctor knows and what every person knows is that if there's pain, there must be something wrong in the body. There has to be. I mean, how else could you possibly have pain if there's not something wrong in the body? That just makes perfect sense. Everyone knows that. And it turns out that our brains don't work that way. Our body doesn't work that way. It turns out that our brain creates what we experience. And this sounds like a new age concept, like, woo, woo. Oh, your brain creates what you experience. Oh, cool. Give me the crystals. And you know, and it's so weird, but you. We see with our brain. You can see when you're in your sleep with your eyes closed because you're dreaming, right. When we see things, it's because our brain has created it. Light comes in our eyes and hits the rods and cones of the retina, but then it gets transformed into these neural impulses. And the neural impulses go to the visual cortex, center of the brain. And that's where images are created, are generated. And it turns out that a large number of fibers, more fibers come into the visual cortex from within the brain than from the eyes. So in order to see, we need to have memory. We need to know what birds look like and trees and flowers, and because we have to recognize them at a very rapid rate, faster than our eyes could literally process. Because our brain needs to protect us. And sight is a big important part of protection. When you think about 60,000 years of human history of being having to have the eyesight to notice if there's something dangerous, if you see the bush rustle and you take action to get out of the way, you are more likely to be safe than if you don't see it.
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C
Right.
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B
And so our brain learns to protect us. So vision occurs and people see things that aren't there all the time. You know, people who see a crime have to go to the police station and pick the person who did it out of a lineup. And they typically pick the wrong person because what they thought they saw, they actually didn't see. And hearing occurs the same way we hear with our brain. People hear their name being called or they, they hear lyrics of songs that are completely different. Everyone knows that.
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A
That's right.
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C
Yeah.
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B
Right. But when it comes to touch, we think that our brain accurately represents what we're feeling in our body. And it turns out it's not true. And the simple way we know that, Leah, is that people can have an injury and have no pain.
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C
Right?
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B
You think about that for a second because thousands of people have Had. And the story I always tell is, a friend of mine shot a nail in his hand at a construction site and had absolutely no pain. How could that be? And that's because a finger can't cause pain. Only the brain can cause the experience of pain. And that means that when you get an injury, your brain usually turns on pain because you need pain to protect ourselves. You break an ankle, you want pain, right. But sometimes it won't. And if it won't, that means it has control over pain. So first thing is, not all injuries cause pain.
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C
Right.
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B
The second thing is not all pain is due to an injury. Now this is completely mind blowing.
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A
That is. That is mind blowing.
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C
Yeah.
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B
How can you have pain in the absence of an injury? Well, everybody knows you can have a headache after a stressful day at work. Everybody knows your stomach can turn into knots when you have to give a public lecture. You know, Everyone knows that. Everyone knows your face blushes. You know, you get redness when you get embarrassed. Right. And so we know that people can have pain, real pain, in the absence of an injury. And the story we always tell is the guy who had a nail in his boot, he had the nail go all the way through his boot at a construction site. He screamed in pain, they rushed to the hospital, took his boot off, there was no injury at all. Which mean his brain had turned on pain, real pain. Because all pain is real. All pain is created by the brain, either in the presence of injury or the absence of injury. And it turns out the brain has a danger signal, like a smoke alarm. And that danger signal will go off when our brain thinks we're in danger, when there's some danger, whether it's a predator coming across the field, whether it's a car swerving toward us or research shows that emotional issues activate the same parts of the brain as does a physical injury. And this is the third thing that's mind blowing and revolutionary, and it's a hundred percent true, that if you feel objected, if you feel betrayed, if you feel threatened, if you feel micromanaged, if you feel that you have way too much pressure on yourself, your brain at some point is going to send a signal like a smoke alarm. And the brain doesn't speak English.
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A
Has its own language.
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B
It has its own language. And it may cause tense anxiety.
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C
Yeah.
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B
It may cause headache, back pain, stomach pain. It may cause nausea because tingling in the hands and feet or burning pain. It may cause stuttering.
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C
Yeah.
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B
You know, speech issues.
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C
Yeah.
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B
It may cause diarrhea, which I've had in My life.
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A
Yeah, me too.
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B
Yeah. And we think if you're having diarrhea, the first thing you think about, of course I have an infection, I have food poisoning. And maybe that's true.
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C
Yeah.
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B
Yeah. And certainly that can certainly be true.
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C
Yeah.
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B
And the same thing with pain. If you have pain, you want to say, did I hurt myself? And people certainly get injuries and hurt themselves.
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C
Right.
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B
But now the fourth thing that's amazing and revolutionary is very simple, is that the body heals. So this is like, okay, yeah, we know that. Right, Dr. Schubiner. Yeah. But do we really know that?
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C
Yeah.
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B
Because the body heals.
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C
Yeah.
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B
And millions of people have had a car accident and hurt their neck or their back, or they twisted their back or neck, or they twisted their shoulder or something, or they hit their head. Right. Or something that caused an injury and they had pain or other symptoms, but then the pain and the other symptoms persisted for not just a few days, but a few weeks, a few months, a few years, and sometimes, Leah, a few decades.
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C
Yeah. Yeah.
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B
And we kind of think like, well, the injury didn't heal somehow or the injury is still there.
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C
Yeah.
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B
But that's usually not the case. And that is a revolutionary way of understanding how the body works, because we learn, our brain learns. And you. We were just talking before and use the term neuroplasticity, neurons that fire together wire together. So our brain learns all the time. It learns what's dangerous and what's not dangerous. And sometimes your brain will learn that bending over is dangerous because it's had pain with bending over and associates pain with bending over and becomes a vicious cycle.
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C
Right.
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B
Or it associates pain or eye strain with the computer screen. And then the computer screen is seen as dangerous. And the more we avoid the computer screen, the worse we get.
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C
Right.
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B
Where the brain can cause fatigue with a small amount of exercise. And so we're kind of teaching the brain. Exactly.
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C
Yeah.
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B
And then it becomes a vicious cycle. The more symptom, the more worry about the symptom, the worse that people get. And then it leads to a chronic situation where people feel so. So broken.
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C
Right.
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B
You know, so hopeless. And they're told that they can never.
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A
Recover, that they're just going to have to live with this.
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B
Exactly. And that gets back to the beginning. That's why most doctors don't want to see people.
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A
That's right.
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B
With chronic pain, fatigue, eye strain, chronic dizziness, chronic anxiety. You know, they send them off to other people. But what if we could accurately diagnose people as having either a neuroplastic condition versus a structural condition. And some people may have some of each. Granted, certainly that can be the case. But what if we try to sort it out? And that was the genius that I first learned 22 years ago that was taught to me by Dr. Sarno, the genius of saying, you know what, if you accurately take the time to listen to people, you can sort out situations where chronic pain, anxiety, depression, fatigue, insomnia, etc, chronic symptoms are actually neuroplastic. Because if they're neuroplastic, what does that mean?
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A
If you've learned it, you can unlearn it. This is the name of your book, right?
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B
And it's just. Yeah, so that's, you know, I've been talking just on and on.
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A
I love it, I love it. Everything, every question I have, you're answering the next one. Now my question, it leads into, okay, so how do you tell the difference? Because I know that especially if somebody has had an injury in the past or they've had something structural, then there's this assumption, like you said, must keep going, like I'll have people while it's scar tissue there, or this is something that's never healed and I'm living with this, and I'll live with this for the rest of my life. How do we differentiate between something that I guess is structural and maybe permanent versus something that is neuroplastic? And we have the potential of moving towards healing.
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B
Right? Yeah, critical question. And that's what I spend a lot of time doing and I take the time to listen to people. And the first step, of course, is the medical evaluation is to make sure that there's no ongoing disorder, as opposed to a old disorder that has become static. So an ongoing disorder, cancer, tumor that's growing and spreading is an ongoing disorder. Certain inflammatory conditions can be ongoing, but we've got good medications for treating inflammatory conditions now. And just because someone has been diagnosed with an inflammatory condition doesn't mean that all their symptoms or their current symptoms are due to that because they've been treated medically. People can have a fracture, but fractures will heal. People can have a brain injury. Brain injuries become static. They don't. When, if you have a brain injury and you have some loss of function, the brain rewires, the brain will learn to take over functions and that starts within an hour or two of having an injury. Yeah, and there's some really amazing research shows, for example, when you blindfold somebody for an hour and then you give them tests of what's called two point discrimination on their body where you have them distinguish where they're feeling touch and where they're not feeling touch. Within an hour, the parts of the brain that have been used for vision start getting used for touch.
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A
Right.
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B
That is incredible.
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A
The brain can take over.
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B
Yeah, it can take over. And so if the injury is static, then it's more likely that the symptoms are neuroplastic, number one. Number two, if the medical testing shows a disorder that is seen in normal people, and this happens with neck and back pain all the time, where we see an MRI shows bulging disc, degenerative disc, spinal stenosis, spondylolisthesis, and if you look at the data on that, people who are normal have those things. So to assume that someone has degenerative disc disease as the cause of their pain because they have degenerative disc disease on their MRI is probably not accurate. And we did it because healthy, normal people have the same thing. And we did a study with 222 people that we published last year who had chronic neck and back pain. And we evaluated using the method I'm going to finish telling you about if I can get there, because I keep talking, but I'm getting there, I promise.
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A
No worries.
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C
I love it.
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B
We use that method, and we found that 88% of them had neuroplastic back pain or mind body back pain. 88%. Now, 98% of them had abnormal MRIs. They all had abnormal MRIs.
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C
Right.
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B
But the abnormal MRIs were not a fracture. We're not a tumor, we're not an absence. We're not something that was clearly structural. And then we use what I call the fit criteria. And the fit criteria are disorders that are fit, functional, inconsistent, and triggered. So if the pain is in a wide area of the body, it starts for no reason. You woke up with it. If it is symmetric on both sides of the body, these are things that make it more likely to be neuroplastic. That's functional. If it's inconsistent, it moves around sometimes on the left side of the back or the right side or the top of the back or the bottom, or it's in the head, but it's in this part of the head. But now it's in that part of the head. That's inconsistency. And that inconsistency tells us that it's not structural, because structural disorders don't jump around. That's common sense. Right?
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C
Right.
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B
And then finally, is it triggered? Is it triggered by innocuous stimuli? And so if the pain is triggered by the wind or triggered by the Weather or triggered by stress, or triggered by innocuous things like sound or light. Right. And so that's where we get into computer screens where people say, well, the computer is, was causing the pain because the puke, but is it really causing on a structural level or is it triggering? And that is a huge difference. And the third story always tells about the guy who had a shrapnel wound in a war many years ago, got injured, had a lot of leg pain because of the wound. He got medevaced out of the field on a helicopter and his injury healed because all injury heal. His brain turned off the dangerous signal. He was fine, pain free. Twenty years later, he's walking down the street, gets startled by the sound of a helicopter in the sky. He gets the same pain as leg he had 20 years earlier. The helicopter had been learned by the brain to be associated with the pain.
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C
Right.
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B
And this is called a conditioned response. Like Pavlova.
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C
Yeah, the dog.
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B
And so when someone has pain with the wind or the weather, and tons of studies have shown that weather does not actually cause our joints to be in pain. Everyone thinks it does because that's what we know.
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C
Yeah, yeah.
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B
Computer screens, sound, food. So many people have sensitivities to foods that we've been able to reverse because these are conditioned responses. So when we look very carefully at people and look closely at the data, my job isn't to convince people that all their pain is neuroplastic, because not all pain is neuroplastic. But I will tell you, after spending 23 years doing this work, the vast majority of people with headaches, neck and back pain, stomach pain, widespread pain, pelvic pain, abdominal pain, the vast majority of them are neuroplastic. And we're talking about roughly 90% or more.
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C
Wow.
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A
Now, when you share that with people, I know one of the criticisms people hear that you're saying all pain is in your head. And then they, you know, even after they learn, I find that when I provide education for some of my clients, they will make the. Okay, I believe it, I buy it. But this is actually real. Like, this is actually real. Like. I see. How do you answer to that?
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B
Yeah, it's so important. And every person we talk about this with, every single person, because as I said, all pain is real and all pain is generated by the brain. If you start with that premise, which is true, this is science. It's not wishful thinking or woo woo. All pain is real. All pain is generated by the brain. It's the same with nausea, same with Headaches, same with tingling, numbness, stuttering, eye strain, et cetera. Now, if it's generated by the brain, then the question is, what's triggering it to be generated by the brain? Brain. A physical injury or learned neural circuits in the brain. And that's what we can sort out. But what I tell people is, people may have told you it's all in your head. People may have told you that you're faking or it's not real, or that you're imagining it, or that you want the pain or that it's your fault or that you're crazy or messed up. And none of that is true. None of that is true. You know that and I know that. And we have to start with that.
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C
Yeah, yeah.
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B
But because this work is so revolutionary and so counterintuitive, as you said, people tend to fall back into that idea. And, you know, they buy my book and then they send it back, they say it's not for me, or they. First they throw it across the wall in disgust, really angry. And I understand that, because nobody wants to be invalidated. Nobody wants to be told that what they're experiencing isn't real. That's horrible. Which shows lack of. Anyone who says that. Which shows lack of compassion, lack of caring, lack of knowledge, lack of understanding. And sometimes it's just cruel, you know?
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C
Yeah.
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A
Because it is real. Their experience is real. I always say where we want to validate that, but what we're looking at is what is fueling the pain. And it's all being fueled through the brain. The brain is the place where everything is happening.
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B
Which leads to hope, right?
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A
Absolutely.
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B
Which leads to hope for reversal. Because as you said before, people are told, you just have to live with it and cope with it better. And that's where modern science was at several years ago, because they didn't have the methods that we now have. They didn't have the understanding that we now have. But now, if we can offer hope for people, hope for reversal, not just, you know, nipping at the margins. Yeah, wow, that can make a huge difference. And that. That leads to how we treat people.
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A
Which I know is the next thing I was going to ask, because people may be like, okay, I get it. Now. What do I do? How do I unlearn this pain? Unlearn these symptoms.
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B
Yeah. So the five steps, first, as we said, make it. Do the assessment. Make sure that the pain or the other symptoms are neuroplastic. And the more pain, the more different parts of the body, the more different places, the more different symptoms throughout people's lives, the more likely it is. And then we're also linking stressful life events with the onset or the exacerbation of these different pain or other symptoms like anxiety, depression, fatigue, migraine, etc, and so people can begin to see, oh, there's a reason for it, it's not just bad luck.
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C
Right.
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B
I didn't start getting migraine when I was a kid because of something wrong with me. There was something wrong with how I was being treated.
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C
Yeah.
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B
There was something my brain was upset about. And that leads to compassion. Right. It leads to compassion for that person, not blaming them. And so we do that history throughout people's lives so that we can really make this full assessment and understand it. And then we. There's three, three main methods for helping people. One, we call pain reprocessing therapy, which is how to rewire the neural circuits in the brain. The second is emotional awareness and expression therapy, which is to deal with any underlying emotional or situational conflicts that have occurred in people's life in the past or present. And not everybody needs that.
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C
Right.
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B
And then the third is how do people treat themselves? It turns out that the way you treat yourself is important.
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C
It matters.
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B
It matters.
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C
Yeah.
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B
And most people think they have relationships with other people, which we do, but we also have a relationship with ourselves. And you know, Dr. Sarno learned this 50 years ago that people with chronic painful conditions and other these kinds of associated conditions are more likely to be hard on themselves, to be so critical, more likely to not take time and care for themselves, more likely to feel overly guilty or responsible for things, worry about what other people think, think so much. And those are things that have to do with your relationship with yourself.
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C
Right.
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B
A lot of times people are they, if you ask them, they say, yeah, I'm really good at being kind and caring to other people, but not so much to myself.
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C
Yeah.
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B
And it turns out when you think about the brain as a danger signal, those things matter.
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A
They do.
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B
How you treat yourself, if you're putting yourself last all the time, never speaking up for your needs, your brain may go, hey, wait a minute, that's right. Time out. This is not working. This is not fair. This is not right.
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C
Yeah.
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B
You're in situations where you're being treated unfairly by a boss, by a spouse, by a cousin, by a kid, your brain may react to that. So those are the three kind of general areas where the treatment, the pain reprocessing, the emotional awareness part, and the self care part.
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C
Self care.
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A
I want to touch on two of them, the first one, the emotional piece, how do emotions play into pain and how is there a link? Because I know that sometimes if people, and like you said, not everybody, we have to go down that, that route. I just took your training in this program, so I'm so fascinated by it. And I see it's not everybody that you have to go down that, that route of emotions. But how are emotions linked to chronic pain and illness?
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B
Right. Well, when you think about it from the point of view of evolution, to go way back. Yeah, people, human beings were on the earth at the same time as Neanderthal people. Neanderthals were bigger, stronger, faster and they even had bigger brains. But Neanderthals died out. And the reason is that humans banded together in groups and the group was their survival mechanism because they hunted together, raised children together, ate together, gathered together, et cetera, et cetera. So it turns out that being in the group is a lifeline, is survival. Getting kicked, therefore getting kicked out of the group is a death sentence. So how would you get kicked out of a group? By emotional stuff. Beating up somebody, sleeping with somebody's wife, you know, thinning. Doing bad things.
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A
Yeah, all the bad things.
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B
Bad things. And getting kicked out, being shamed, feeling guilty. And so these emotions are completely linked to survival. And the brain, our brain, as I said before, the brain doesn't speak English. So the brain can turn on pain or other symptoms when you're in danger. And being in danger of getting kicked out of a group is when girls are mean to other girls.
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C
Yeah.
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B
Being in danger of being kicked out of your family when your parents divorce or when somebody's using drugs or somebody's abusive, in danger of getting kicked out of your work environment when you're, when your colleague is mean to you or your boss is demanding too much, those are all emotional things that are directly linked to the danger signal in the brain. And what happens is that people tend to want to shove down the emotions and just not worry about them, Just move on, just. Yeah, keep going. Which makes sense. And that works much of the time. But if you're holding on to low level anger about something that's like a thorn in your side, that's not going to go away. If you're hanging on to guilt about something that you think you've done, that you've hurt somebody or something, that's a barn in your side, that's not going to go away. If you're hanging on to fear of the situation, if you're hanging on to sadness and grief and so the emotional awareness and expression therapy is to become aware of these emotions and to express them in safe and healthy ways as opposed to ignoring them and just trying to shove them down.
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C
Right.
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B
And expressing emotions in safe and healthy ways is actually not that hard because you can do it in the privacy of your own home.
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C
Yeah.
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B
As opposed to walk into your office and take your boss's chair and throw it up and throw the papers off the desk and scream at them. You're going to get fired. That's not going to solve any problems.
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A
That's right.
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C
Yeah.
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B
So this anger that you have, if you're in your house, you can scream and imagine doing all that to your boss and then let it go.
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C
Yeah.
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A
You have that.
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B
Other emotions. You have a way of resolving these emotions if you're. Who hasn't been angry at their child?
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C
Yeah, yeah.
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B
People you love the most. Who hasn't been angry at them? But what do you do? You just keep getting angry and angrier. But no, you want to express it. You want to be able to imagine yelling at them.
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A
And that doesn't.
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B
So that you can let it go.
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A
You have to go to that person and have that expression. I think that was a big aha.
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B
For me when I don't want to do that training.
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C
Yeah.
- [32:48]
A
Because I know it'd be like, is it healthy to express that anger? Is it good to have all that anger? But the differentiation of, I'm not going after that person in real life and throwing all that anger on them. I am having a healthy container, like you said, either imagined or within the safety of somebody else or at home, where I can allow that anger to happen.
- [33:11]
B
So then you can release it.
- [33:13]
C
Right.
- [33:14]
B
And then you can allow the hurt, allow the sadness.
- [33:17]
C
Right.
- [33:18]
B
And turn that sadness into compassion.
- [33:20]
C
Right.
- [33:21]
A
Because otherwise those emotions will show up in the body.
- [33:26]
B
Right. Exactly. So two years ago, my hospital let me go. I was. I don't make a lot of money for the hospital because I talk to people. I'd been there 20 years and they were in budget crisis, so they just terminated my contract or didn't renew my contract. And I was really hurt and my back started to hurt. And a couple weeks later, I realized that I hadn't dealt with any of those emotions.
- [33:54]
C
Right.
- [33:55]
B
And so I was in my car and I started just screaming and yelling at the hospital, swearing my head off, screaming about all the ills of medicine. And I imagined blowing up the hospital with tnt, like in a cartoon, which is something you would go to jail for if you do it in real life.
- [34:12]
C
Right.
- [34:14]
B
But as soon as I imagined blowing up the hospital, all of a sudden all that anger subsided. And I could process it and I could eventually forgive the hospital because they were just doing their job and that's just the way it goes.
- [34:27]
C
Yeah.
- [34:28]
B
But hanging on to the anger, and then I went to the hurt and the sadness of getting kicked out and being abandoned me, basically. And I turned that hurt into compassion for myself. I forgave them. And the back pain completely disappeared. That's amazing.
- [34:44]
A
That's amazing. That's incredible.
- [34:46]
B
And who would think of that? What pain doctor would think of that? What regular doctor would think of that? But it turns out emotions are highly linked to pain and other symptoms.
- [35:00]
A
And that when you express these emotions in different forms. I know Sarano talked a lot about journaling and I talk a lot about journaling and like art and doodling and things like that to express the emotions. You're sending that message back to your brain that it's safe, it's okay to do that. Like you can express these emotions. And instead of it flipping the danger signal, we're now rewiring to flip the safety.
- [35:26]
B
If you were brought up in a house where there was a rage aholic parent, you learned that anger is not safe. And you learn to be angry is a horrible way to be. So you grow up always trying to suppress your anger.
- [35:39]
C
Right.
- [35:39]
B
Or you start to mirror that and you let the anger out in public, which gets you in trouble all the time.
- [35:46]
A
Yeah. So it's fascinating. I love how. And the emotional pain, very similar to physical pain in the brain is that.
- [35:53]
B
It's exactly the same. It's identical, Right? It's identical. And so the pain that comes from an emotion is as real as the pain that comes from breaking a leg.
- [36:04]
C
Right? Yeah.
- [36:05]
A
Which.
- [36:05]
B
Exactly the same.
- [36:07]
C
Yeah.
- [36:07]
A
It's very validating when people have really struggled with a lot of emotional pain, that it's very real. It's not something. It's also not something necessarily that you can just talk your way out of. Like there's a release there, there's. From the body is storing it.
- [36:25]
B
Right. And the other treatment, the pain reprocessing therapy arm of the treatment, in addition to the emotional awareness part, is about literally changing the neural circuits in the brain that are causing pain and rewiring the brain to turn off those pain or other fatigue, anxiety, depression, et cetera, all those other signals. And the way we do that is by understanding that the symptoms are real, but not structural, teaching the brain to calm, giving feedback to the brain, and this has to do with our relationship to ourselves. Because if you're in pain all the time, the constant feedback you're giving to your brain is danger, danger, danger. I'm in pain. It's not getting better. It's not going away. What's wrong? I can't take it, I can't tolerate it. And all those are the normal reactions people have, but they actually fuel the danger signal in the brain.
- [37:20]
C
Yeah.
- [37:20]
B
The more you pay attention to something, the more you worry about it, the worse it gets. And so we're teaching people, which is hard sometimes, admittedly, teaching people to be calmer in the face of the sensations in their body. Teaching people to lower the danger signal by reassuring themselves, giving themselves the messages that, I'm okay, I'm safe, there's nothing wrong with my back or my head, that I'm going to get better.
- [37:48]
C
Yeah. Yeah.
- [37:49]
B
And it's amazing how powerful those messages are.
- [37:52]
C
Yeah.
- [37:53]
B
Right. And we have research studies on both of these methods. We have randomized controlled trials using pain reprocessing therapy, two different trials, and there's three more in the works. We've got four different randomized controlled trials on the emotional awareness and expression therapy showing that these treatments are actually superior to the standard psychological treatments that have been used for the last 40 years. Cognitive behavioral therapy, mindfulness therapy, acceptance and commitment therapy. So we're very excited about these prospects because it's just amazing. When I started doing this work 22 years ago, and I'm just a regular doctor, internal medicine doctor, no special training in pain, no procedures, no techniques other than talking to people and using these models. And when you see somebody go from 5, 10, 20, 30 years of chronic pain, depression, anxiety, fatigue, and get better, not just a little better, but get completely better. It's just mind blowing.
- [38:59]
C
Yeah.
- [39:00]
B
And it's amazing. And people are so happy.
- [39:04]
C
Yeah.
- [39:05]
B
So happy.
- [39:06]
C
Yeah.
- [39:08]
A
The last thing before we close, I love hearing the stories about when people get better. And then there are people who don't get better as quickly or have challenges. And I want to speak to that for a minute because I know that in your. I believe it's in your book, you Talk about the 5 Fs and also looking at sometimes in pain reprocessing therapy, we talk about personality traits and things like worry and pressure and that inner critic and the intensity and the fear and all those things that do impact your ability to, quote, unquote, get better.
- [39:45]
B
Yeah. There's no one can claim that their treatment for anything is going to be 100% effective if you think your treatment is 100% effective. You're either lying or delusional, I think. And you see that you're both. Yeah. You can see that on certain websites people say 100% effect. We can't say that either.
- [40:04]
C
Right.
- [40:04]
B
But what are the things? What you're asking is what are the things that kind of get in the way? What are the obstacles? And sometimes the obstacles have to do with childhood trauma that needs to be addressed. Sometimes the obstacles have to do with how people treat themselves. That has to be addressed in terms of that caring self, compassion, in terms of doing things for themselves. Sometimes there's a situation in people's lives that they actually need to change.
- [40:29]
C
Yeah.
- [40:29]
B
I had a patient whose migraine disappeared when she left her husband. I mean, it's not that we recommend everyone get a divorce.
- [40:37]
A
So it's not no fun joke that my 20s, my IBS was very debilitating and it seemed to get better post children in my early 30s, which was the exact time I also got divorced. And so I see that sometimes the stressors, the changes, different triggering things, and then it just allowed me to work more on myself. That self compassion, that kindness, having all those things. Taking a look at the intensity, the pressure, the critic that I. I put on myself as well.
- [41:09]
B
Yeah. Sometimes people need to change their job or their neighborhood or have marriage counseling or set boundaries with certain family members. And then sometimes it's a lot. Sometimes it's the fact that the symptoms are so severe that it's very difficult to step back from them, that it's very difficult to observe them. It's very difficult to keep going, keep moving when you're in so much pain. And so sometimes people need to really take baby steps.
- [41:40]
C
Yeah.
- [41:41]
B
And sometimes it takes. There's a lady I write about in my new book that it took her two years and she was in so much pain. She was bedbound and she couldn't move anything, that she could move her hand, her fingers. And she started moving her fingers and she started dancing with her fingers to music.
- [42:01]
C
Wow.
- [42:02]
B
And she just started to change, literally change the neural circuits in her brain little by little, day by day. It took her two years.
- [42:11]
C
Wow.
- [42:12]
A
That's incredible, though. How much is your belief that it's mind, body, that it's neuroplastic? How much is your belief in the possibility of being able to heal that hope? How much does that play into it?
- [42:27]
B
A lot. Yeah, a lot, it turns out. It's a lot, it turns out. And this is what I write about in my new book. That people often have a click moment where it clicks in. All of a sudden, it's clicks that, oh, my God, my foot is not really damaged, or my back's not really damaged, or my brain's not really damaged. It's actually the neural circuits, and I can get better. And that hope often proclaims, repels people. And it may take time to get to that click.
- [42:57]
C
Yeah, yeah.
- [42:59]
B
You know, it may take time by watching and observing. Why did all of a sudden the pain go up? Why did it go up on Tuesday and go down on Thursday?
- [43:06]
C
Yeah, yeah.
- [43:07]
B
What structural problem does that? You know, probably not. And then you think about what happened on Tuesday, what happened on Thursday.
- [43:14]
C
Yeah.
- [43:15]
B
And then you can start to start to see. I had a guy who had this horrible back pain. He's a doctor, and he. He was. He would. He could walk up the stairs without pain, but if he walked up the stairs carrying a cup of tea, he got pain. And he was like, what's the tea? How heavy is this tea coat?
- [43:34]
C
Right.
- [43:35]
B
And then he said, it's because of the tension of carrying the teacup, not spilling. And I said, where's that tension coming from? And he said, oh, that tension is coming from my brain. And then he goes, oh, my God, I got it.
- [43:45]
A
That's right.
- [43:46]
B
That was his click moment.
- [43:48]
C
Yeah.
- [43:48]
B
And then he started getting better. Took him another couple months, but he was fine in a couple months.
- [43:53]
C
Yeah.
- [43:54]
A
I find I spend a lot of time with my clients, helping them try to identify the moments where they don't have pain. Like, being that. I think you say that, detective, for the opposite most of the time. And this is a challenge that I'm sure we encourage people. And I felt like this as a speech pathologist, every week. Tell me how you're doing. I encourage people almost to give me a list of your symptoms. Like, I want to hear about all the bad things. And then I started realizing, is that really helpful? Like, I know that they want to share these with me. Sometimes I'm the only person that is, you know, not tired of hearing about all the symptoms, but then also encouraging. Okay, let's have equal air time for the positive. So now tell me about the times when you didn't have the pain or this didn't happen or which is hard for some people, because right away there's. I find that there's a. They may identify a couple of times, but then be very careful to say, yeah, but I still have pain most of the time. Like, just like, yes, I understand, but can we start to have Start to notice, be a detective and find the moments of hope and go from there.
- [45:01]
B
Right. And if there's time when you don't have pain, maybe there could be more times of that.
- [45:06]
A
That's right.
- [45:07]
B
If there's time when you don't have pain, what's going on? Is that because your body suddenly changed in that moment or because the neural circuits change and it's the neural circuits that changed that opens up a whole range of possibility and that's what we're talking about.
- [45:27]
C
Yeah.
- [45:27]
A
Oh, I love that. Because that is such a hopeful message that there is possibility, you're not destined and like this is it for life. You just have to learn how to deal with it, how to live with. Opens up the door of the possibility that the brain can unlearn what it has learned.
- [45:45]
B
Yeah, exactly. Exactly. As you mentioned, I'm writing a new book that's going to be out in 2026, but I'm collecting the names of people in the book who have benefited from this work and we're going to have a list at the end. So if, you know, if anybody, listeners want to add their name and stand up and you don't have to use your real name. It could be a fictional name. But if you want to stand up and say I had X or Y or Z for X amount of years and I live in. I live in Canada or I live in Netherlands or I live in Pretoria, let us know. I can. I'll send you that.
- [46:19]
A
I love that. Yes, please. And I'll put all the information in the show notes for where people can learn more about your work. I know you have an amazing website with lots of different resources about learning about pain and meditations and learning about videos. There's some fascinating ones.
- [46:37]
B
I know, right, right. Yeah. And we belong to a non profit professional organization called the association for the Treatment of Neuroplastic Symptoms. And I'll send you that as well. And it's a nonprofit and we have an annual conference and we've got a lot of educational materials that are all free and there's a lot of resources out there. I have a course on Coursera that's completely free, a whole course.
- [47:00]
A
I am doing that course with one of my clients who's had a traumatic brain injury. It's a wonderful. It's a wonderful way for me to work on things like memory and listening and writing skills and all those cognitive communication as well as the education piece about the brain. Yeah, it's amazing for people to have.
- [47:17]
B
And there's some interviews there with people.
- [47:19]
A
Who'Ve recovered, which is some amazing, incredible interviews of people telling their story stories that you would think, like you said, it doesn't matter how long and the severity. There are all sorts of stories about people who are able to heal.
- [47:35]
B
Exactly.
- [47:35]
C
Yeah.
- [47:37]
A
One key thing that you would love for people to take away from the conversation, if they're feeling hopeless about their pain, what would you say to them?
- [47:46]
B
The two keys I would try to leave people with is one is don't give up. Don't give up hope. It's easy to be discouraged. It's easy to feel defeated. And of course everyone feels that way sometimes. But if you haven't looked at this model, just take a look, see if it resonates. Be open and be discerning. Maybe it doesn't fit for you, it doesn't fit for everyone. That's fine. But please don't give up hope. Be open, take a look and just be kind. Be kind to yourself. Catch times when you beat yourself up. It's. Yeah, it's not good for you.
- [48:17]
C
Yeah.
- [48:18]
A
I always say self compassion is like the most important ingredient in every meal. Everything that you have, dose it with self compassion because you need to have it everywhere. Thank you so much for taking the time to speak with me today and to share with my listeners. I'm so excited for people to learn more and for the hope that your work has provided. I'm so grateful to you for in this field to be pioneering and being the example. And I know that you get a lot pushback from all directions, but I know that you also have made such a difference in thousands and thousands of lives. So thank you.
- [48:56]
B
Oh thank you Leah. Such a pleasure. Thank you for what you do as well. I appreciate it.
- [49:03]
A
Thank you for listening to the Building Resilience podcast. If you're interested in learning a little bit more about managing stress, building resilience and leading a more purposeful life, then make sure we're to connected on Instagram and Facebook at Leah Davidson Life Coaching. You can also subscribe to my weekly newsletter at www.leahdavidsonlifecoaching.com newsletter. Looking forward to connecting.