January 13, 2025 • 51 mins
A significant portion of the population lives with chronic pain, yet its origins and effective treatments remain some of the least understood aspects of healthcare. Pain is inherently subjective—unique to every individual—and rarely attributable to a single cause. It is a multifaceted experience shaped by a combination of physical, emotional, and neurological factors.
When we peel back the layers of chronic pain, a compelling truth emerges: neuroscience plays a pivotal role. The deeper we explore its causes and remedies, the more evident the profound connection between the mind and body becomes.
In today’s episode, Elisabeth and Jennifer are joined by Matt Bush for a fascinating discussion on chronic pain and its intricate ties to nervous system health. Together, they explore how past experiences, unprocessed emotions, trauma, stress, and sensory input shape our perception of pain. They also examine pain as a protective mechanism and discuss how chronic pain impacts quality of life, often leading to avoidance behaviors and other challenges.
While chronic pain is complex, this conversation highlights how tuning into our body’s signals and understanding the mind-body connection can unlock transformative insights. Even if you’ve never experienced chronic pain, this episode offers valuable perspectives on the neuroscience behind this connection, providing tools to better understand your own well-being.
Don’t miss this episode—it’s packed with thought-provoking insights and practical takeaways!
Topics discussed in this episode:
-
The distinction between pain and injury
-
The "snake or stick" example: how the brain predicts pain
-
The various types of information the brain uses to interpret pain
-
Pain as a protective output of the nervous system
-
Understanding neurotags and their connection to pain
-
The link between complex trauma and chronic pain
-
What is central sensitization (also known as "sprouting")?
-
Protective outputs as distractions from unprocessed emotions
-
How unprocessed emotions manifest as physical pain
-
The deeply personal and unique nature of pain for each individual
-
Exploring the connection between perfectionism and chronic pain
-
How pain contributes to avoidance behaviors
Learn more about the Neuro-Somatic Intelligence Coaching program and sign up for the next cohort now! https://www.neurosomaticintelligence.com
Contact us about private Rewire Neuro-Somatic Coaching: https://brainbased-wellness.com/rewire-private-neuro-somatic-coaching/
Get started training your nervous system with our FREE 2-week offer on the Brain Based Membership site: https://www.rewiretrial.com
Connect with us on social media: @trauma.rewired
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
Okay, we going?
We ready?
Okay.
Chronic pain is deeply tied to the health of our nervous system, our ability to regulateemotions and the impact of past experiences.
It's more than just a response to injury.
It is an output from the brain.
It's shaped by sensory inputs, emotions, memories, and that's why understanding how traumaand stress impact the nervous system.
(00:29):
That's why understanding how trauma and stress impact the nervous system is so importantto addressing chronic pain and pain doesn't just affect the body.
It ripples out to influence our mental health, our social connections, our overall qualityof life.
And chronic pain often creates this feedback loop leading to isolation, depression, andeven changes in our brain function that then make the pain worse.
(00:52):
And even if you don't live with chronic pain, this episode is a really interestingexploration of the neuroscience of the mind-body connection.
And it's through the neuroscience of chronic pain that we've come to understand a lot ofconcepts like neuro tags the networks of neural connections that shape not just our pain
but also our beliefs our behavior our emotional responses in all areas of life and we'regonna dig into all of this today with Matt Bush from pain as an output to the emotional
(01:21):
and neurological underpinnings of human behavior and this conversation goes well beyondpain management.
So if you love neuro
and the science of how the brain and the body are interconnected.
Get ready, because we're going to take a deep exploration today.
Welcome to Trauma Rewired, the podcast that teaches you about your nervous system, howtrauma lives in the body, and what you can do to heal.
(01:41):
I'm your co-host, Elizabeth Kristof, founder of BrainBase.com.
an online platform for training the nervous system for resilience.
And I'm also the founder of the Neurosomatic Intelligence Coaching Certification, an ICFaccredited educational course to equip therapists and coaches to bring the brain and the
nervous system into their work for deeper levels of healing and really lastingtransformation.
(02:05):
And I'm your co-host Jennifer Wallace.
I'm a Neurosomatic Psychedelic Preparation and Integration Guide.
And I bring Neurosomatic Intelligence into your peak somatic experience.
And I'm also an educator at the Neurosomatic Intelligence Coaching Certification.
And today we are joined by Matt Bush of Next Level Neuro.
And he's also one of our lead educators at NSI.
(02:28):
Thank you for having me back.
I'm super excited for today's talk on the podcast.
This topic is near and dear to my heart because we've worked with so many people over theyears who have chronic pain and are able to really to reduce that and change it
drastically, even remove it completely based on neuro training.
So I think we all, individuals here on the podcast, but also listeners have someone in ourlives, a family member, a friend, a colleague.
(02:56):
who deals with some type of chronic pain.
And the more that we can understand the input interpretation output loop and how itbecomes chronic, the easier it is to be able to work with those issues and conditions and
really make a lasting difference.
So, glad to be here.
Yeah, I feel like this is a long overdue conversation.
(03:19):
And I think to start it out, we need to look at the work of Laura Mermozle, who has beenreally foundational in transforming how we understand chronic pain.
And Mermozle is a clinical scientist and a researcher in pain neuroscience that reallydemonstrated through the years of research that pain doesn't just come from a physical
(03:39):
injury or tissue damage.
And that
changed the way that we see this traditional view of pain and created a new perspectivewhere we're really looking at it as more of a complex experience that's shaped by our
brains interpretation of various inputs from sensory information or past experiences oremotional state and perceived threats.
(04:03):
And again, that brings us back to the input interpretation output loop that pain is notjust a response to physical damage, but
has everything to do with how we take in information about the world outside of us andinside of us, how our brain interprets that information and then the output that is
created.
And so I want to just, I guess, first dive a little bit more into that map, because Ithink sometimes it can be really hard for people to start to understand that pain is not
(04:35):
necessarily coming from a physical injury and that it is an output rather than an
input.
Yeah, certainly.
So as an easy example, you can think about if you've ever had to go into a reallystressful meeting, maybe with a boss or a subordinate, a partner, and you start to develop
(05:02):
pain before that meeting even happens.
Like, it could be stomach pain, neck pain, headache, all kinds of stuff that our body cancreate as a way of telling us, don't feel safe.
We need to slow down or be cautious.
And those examples of acute pain when there is no injury can become chronic as well.
(05:25):
That's not to say all chronic pain is coming from some type of perceived threat alone,like it's all in your head.
That's not what we mean to say at all.
But there is this very real sense that the brain is creating pain based on itspredictions.
and based on its previous experiences.
we'll talk a little bit about how those are integrated together.
(05:46):
But one other note I wanted to make here just at the very beginning is if you actuallylook at the research on what's called asymptomatic orthopedic injuries, which means
someone goes in for an MRI or an X-ray, not having any pain, no dysfunction, no movementproblems, but they're participating in a study, they go and take an MRI.
(06:07):
On the MRI, we can see potential damage to their joints or connective tissues that issevere enough that if they were experiencing pain, it would be surgically operable.
Like it would be recommended to have surgery to repair that damage that's inside theirbody.
But in these cases, in these research studies, these people are experiencing zero pain ona daily basis.
(06:31):
They don't even know that they have the injury.
And so this is kind of the flip of what we were just saying, right?
That pain doesn't come from injury, but it's important that we understand this because wewant to differentiate and dissociate the ideas of injury and pain.
So in these research studies, they're seeing very real injuries that are resulting in zeropain for the individuals that are experiencing them, ever.
(06:59):
On the flip side of the coin, the opposite is also true.
We can have pain
such as the examples before, when there is zero physical injury present in the body.
So we want to spread those ideas far apart.
Pain and injury are not the same thing.
They don't have to be connected in the human body and in the nervous system.
And the sooner we can grasp that, then we can dive into a little bit deeper conversationabout, well, then why is the brain generating pain?
(07:27):
And that's where we'll get into, you know, the interpretation, the processing, theprediction.
the previous experiences, and what makes it chronic rather than just acute, only coming upin a stressful situation, what makes it continue on an ongoing basis, day after day, month
after month, that we're not able to kind of get to it with our normal medical procedures.
(07:57):
E, can you check your mic?
It look on your settings, it says that your mic, it says, my, from what I see on yoursettings, it says you have no microphone.
Is that, is it hooked up on your side?
yeah, it says it's my sound is coming through.
(08:20):
Okay, it just popped back on again.
Maybe when you mute, will you mute?
okay, okay, just trying to get used to this software.
I thought maybe your mic dropped.
Okay, let me go back to my notes, please.
HUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUE
Okay, you know, I really enjoyed going down the rabbit hole of Laura Moore, Laura MooreMosley, because he has a really great Ted talk on pain that we will link to this.
(08:51):
And because he really says that pain is an illusion, like 100 % of the time that happensreally quickly.
And it's outside of your awareness.
And like Matt said, that's not to say that your experience of pain is not real.
It is real.
And it's also an illusion because your brain
being this incredible predictive machine, it's always going to choose the path that's mostbiologically advantageous for our survival.
(09:17):
And so I really love this example that he gives.
We're gonna call it the steak, we're gonna call it the.
We're gonna call it the snake stick.
example.
Why is that so hard to say?
(09:38):
me one second.
The snake stick sample?
That's the, that's what really wants to come out.
We're gonna call this the snake stick example.
So you're walking through a forest, you're in the greenbelt, you're taking a walk and youfeel a brush against your leg and your brain starts to put into context what's really
(10:06):
happening here.
Have I been here before?
What's happening?
It sends a signal really quickly from your skin and nociceptors travels all the way up tothe brain and then your brain starts to ask all these questions.
Where am I?
Have I been here before?
Am I in a safe environment?
Has anything ever happened to me here before?
And then through all of this deduction, you realize you've just hit a stick because you'rejust on your walk.
(10:32):
But the one time that you're walking in the path that you always walk through and you getbit by the snake, that is gonna send a completely different interpretation to your brain
that's really gonna be the memory that lasts.
So once you...
understand or once your brain understands and has received a danger message in the brainand like then your brain has to think what does this mean and what do I do here and so
(10:57):
pain is the end result designed to protect you and like we're talking about this is notabout your tissues.
So from a clinical perspective your brain is looking for this predictability and and anyand it's looking for any piece of credible evidence
that you are in danger and then it changes the pain on the spectrum of pain.
(11:22):
And so what's interesting here is that so the next time you're on this walk and yournormal path and you cross a stick instead of your brain going, yeah, that's just a stick.
It has the memory of the snake bite, which could have potentially killed you.
now the stick is inherently threatening and sends the pain threat.
(11:44):
way up like you just got bit by a snake and then maybe that lessens your world a littlebit where you don't go out and you do your hikes, where you do your walking anymore
because that equals pain.
And so maybe one of you wants to get into what nociceptors are.
(12:04):
You have a great.
I would love to follow up on that.
we've mentioned Lorimer Mosley now a few times.
He's a great presenter.
A lot of his work is on YouTube.
And so for his version, the snake and the stick story actually comes from him.
It's one of his personal experiences, walking through the jungle essentially of Australiaand bumping up against what he thought was a stick when it was actually a snake, didn't
(12:32):
feel any pain.
until it was almost too late and he got faint and had to sit down.
And then the next time brushes up against a stick, brain absolutely freaks out, thinksthat it's a snake, only to find nothing's really happening.
So how Jen just described the way that our brain can confuse the feelings and thepredictions is often based on previous experiences.
(12:55):
And a lot of that comes from this type of nerve receptor that we call a nociceptor.
So, noci is the same root as the word noxious.
It's something that's dangerous to the body or perceived as dangerous.
And the scepter part just means that it's a nerve ending, a receptor.
Okay, so it's bringing in sensory information.
So nociceptors or nociceptive signals are constantly being sent into the nervous systemfrom all parts of the body.
(13:23):
They never really turn off, which is quite interesting because we have to remember thatall nerves are always active in the human body.
Nerves never shut down.
They don't get turned off like a light switch because if they were to turn off, theyactually begin to die.
So nerves have to stay active.
Just like in your home, the electrical wires always have electricity running through them.
(13:45):
It's just a matter of whether they can reach their end target of a light bulb, atelevision, a microwave, or if that circuit has been cut.
But they're always activated, right?
You would never want to touch a hot wire in your home.
So in the body, nociceptors are always active as well.
But what makes a huge difference as to whether the nervous system really perceives them asa current threat or whether they're just maybe like a low grade buzz going on in the
(14:12):
background is the intensity of their activation or what's called their amplitude.
How much nociceptive signaling is coming in at any one time really is what the brain isbasing some of this predictive response on.
So Mosley actually published an article way back in
(14:34):
2007 called Reconceptualizing Pain According to Modern Pain Science.
This is way back when, you know, but he created this diagram in this graphic that I wantto talk us through really briefly because it encapsulates this whole idea of input,
interpretation, output, but it uses different terminology that really builds us a goodillustration and a good context to have the rest of our conversation.
(14:59):
So the graphic begins with a picture of a brain sitting at the top of the page and thebrain is asking how dangerous is this really?
Okay.
And you have these arrows that are pointing into the brain, they're giving it the inputs.
the inputs are these.
First of all, there's the sensory input coming from the body.
That would include proprioception, which is movement information, basic somatosensoryinputs, which is feelings of temperature, touch, pressure.
(15:28):
Right?
Things that our body and our skin can feel and also nociception, the current amount ofnociception coming in.
That's the sensory input that the brain is receiving.
Plus at the same time, it's also aware of and perceiving our previous experiences.
So in earlier podcast episodes, one of the things we've talked about is that our brain isa predictive organ.
(15:52):
It's not only looking at what has just happened or what is currently happening.
But it's actually trying to make some of these judgments about whether I'm safe or unsafebased on its prediction.
And the prediction that it accomplishes comes from a little equation.
We say prediction is equal to the current sensory inputs plus our previous experiences.
(16:16):
Right?
Another way to say that is it's interpreting the current sensory input through the lens ofprevious experience.
So when it feels that thing brush against your leg, it's like, is that a stick or is thata snake?
Depends on my previous experiences, how I'm going to answer that question, right?
So the brain is taking that overall prediction of what it's feeling in regard of answeringthis question of how dangerous is it really?
(16:43):
But it's also adding in five or six other things.
Okay, number one is cultural factors.
Like what's the culture that you were raised in?
What's the culture that you currently live in?
Because that really shapes your beliefs about danger and your perceptions about yourenvironment.
A quick example of this is I used to teach quite a lot in Denmark.
(17:07):
And if you've ever been to Denmark or ever read anything about it, it's kind of theoriginal home of the Vikings, right?
Denmark and Sweden and Norway.
And so a lot of the Danes currently living in country think of themselves as these
kind of tough Viking culture, which is cool to experience as an American going to visit.
It's very fun.
Wonderful people.
(17:28):
But there's this interesting divide.
If you're there for any amount of time, you start to learn it when you get to know thepeople.
There's a little bit of a divide between the older generations, say people who are olderthan in their 60s versus the younger generations.
And the older group looks down on the younger group.
(17:49):
and goes, you guys are not as tough as you think.
You're kind of soft.
You're kind of weak.
And when you start to under, like go, why would you think that?
Why would you say that?
They're like, well, when we grew up, there was no government to take care of us.
Like the modern Danish government is essentially a democratic socialist government.
(18:11):
And this is not a political statement, okay?
This is just a story.
But the older generation grew up under a monarchy that didn't have any socialist supportcoming from the government.
And these days, the Danish government pays for lot of education, a lot of holiday time,illness, work time, all kinds of stuff that the older generation just looks down on and
(18:34):
goes, you guys are being handed everything by the government.
You got to pay a lot of taxes, you know, but.
The government takes care of you when you're sick, when you lose your job, when you'regoing to have a baby, when you want to go on holiday, when you want to retire, like when
you want to buy a new home.
Everything is subsidized by the government.
And the older generation thinks that they're really soft because of that.
(18:55):
So there's this cultural difference, right, between those different age groups.
As I was growing up here in the States, my grandfather was born just before the GreatDepression.
here in the States.
And so he lived through the Great Depression.
He lived through World War II.
He served in the military.
He lived through the different wars that the US fought in.
(19:18):
growing up on a farm in South Georgia, the only food that they had to eat was food thatthey could raise themselves on the farm.
The only transportation they had was a mule to pull the wagon or their own two feet.
That was it.
And this is a family of 12 kids.
can imagine there were times where my grandfather, who was a really nice sweet man, wouldlook at myself and my brother and go, wow, you guys have it easy.
(19:44):
You're growing up in the 80s and 90s with all this technology and everybody has a car andyou have a grocery store on every corner to go buy whatever you want to eat.
Like everything's taken care of.
He never expressed that out loud, but I can just imagine some part of his brain might havesaid, life has gotten a lot easier in recent years.
(20:05):
And so,
All of that is to say cultural factors play a huge role in how your brain perceivesdanger.
Like what is danger is influenced by that, okay?
There's also your social and work environment.
Like what would happen socially or in my work if I were to be injured or if I were to bein pain?
There's expectations about consequences.
(20:27):
Like if I'm in pain all the time, what does that mean?
Am I gonna have to go on regular doctor visits?
Am I going to be able to do the things that I want to do?
Am I going to have to pay a lot of money to take care of this chronic illness or chronicpain?
And then there's also your beliefs.
That's kind of your worldview, your mindset of like how are things going to work out, youractual knowledge about how the body works and what pain is, what it means.
(20:53):
And then also a balance of your logical brain versus your emotional brain.
Like what...
which part of your brain becomes more loud and starts to run the show when you are inpain.
So all of that stuff is taken together, like put it all in a blender, mix it up.
Then your brain is presented with all of that combined information to try to answer thequestion, how dangerous is this really?
(21:18):
Okay, so it's not just about the sensory inputs from the body.
It's all of this stuff.
Based on all of that combined, your brain creates some type of meaning.
like a story of what does this mean, what's happening, that's going to generate itsexpectations, possibly some level of anxiety about what's going on.
And as that all filters back into this brain asking the question of how dangerous is itreally, if the brain says really dangerous, unsafe, high threat, then it's automatically
(21:50):
going to generate outputs to start to protect you.
The number one output there being pain.
Okay, but also
changes to your emotions, levels of anxiety or depression, hormone changes, immune systemchanges, changes to your sympathetic nervous system.
Basically all the stuff we talk about on this podcast as far as outputs, right?
(22:13):
It's gonna generate an output to protect you if it perceives your danger.
And if not, it's gonna go, yep, keep doing what you wanna do.
It's so interesting as you were talking and Jen was giving this steak.
As Jen was giving this snake stick example, I was just thinking so much about you canreally see how trauma patterning starts to come into this.
(22:40):
And when we're talking about all these different sensory inputs, it's not justsomatosensory or maybe just something that we see visually, but also, you know, our
movement patterns and giving that proprioceptive input, social cues, the environmentalcues, all of those different contexts that you were talking about.
how all of that can start to signal threat and pain could be just one protective outputthat comes from past experiences that are priming us to experience a lot of
(23:12):
that threat, you know, can be many other protective outputs as well.
And I just also couldn't help but think about how many clients we work with that havepelvic pain, persistent pelvic pain, even though there's no injury, TMJ and jaw clenching
in these patterns of bracing that are so associated with trauma.
And
(23:34):
the link, there's just so many links between our developmental trauma and thoseexperiences and then the outputs that we experience with pain or just the protective
outputs in general.
And I know we'll dive a little bit more into its connection to CPTS and mental health, butI want to talk a little bit about neuro tags as well, and how we can use this concept of
(23:54):
neuro tags that we talk about on here quite a bit to really understand these pain outputstoo.
And what I found is working with clients is that this is a really powerful reframe forclients because understanding that pain, that a pain neuro tag, wait a minute.
(24:21):
This is a really powerful reframe for the clients that we work with because dangersignals, they're really high priority from the brain.
so understanding pain neurotags has really transformed the way that I work with clients,especially when I'm addressing chronic pain and beliefs that are tied to chronic pain,
because by recognizing pain as a neural output shaped by perception, clients can reallystart to detach from a fear based relationship with pain.
(24:48):
And by educating clients about pain,
neuroscience, individuals can reduce pain related fear and reframe their understanding ofpain, which has been shown to improve pain outcomes.
Because when we're talking about the main contributors of pain and disability, we'rereally talking about the main contributors being anxiety, catastrophizing and nervous
(25:13):
system sensitization, which also I think could be interchangeable with nervous systemdysregulation.
And through
Lowering the threat, the overall threat with clients and working through emotionalexpression, we have really been able to diminish quite a bit of the pain that the body is
physically experiencing in really localized areas like Elizabeth just gave the example ofjaw, back, pelvic floor.
(25:39):
And so, you know, just having these reframes about what we believe, this can be reallypowerful.
And so.
based on the input that the brain makes and it has to make the decision for the output andthat output has a story around it.
And so if that story equals a danger output and it's gonna need protection, then theoutput is going to be pain.
(26:09):
Do we want to dive a little bit deeper into neurotags?
Do we feel like they need a little bit more of an explanation here?
Yeah, I would probably.
You head back up to that section.
and honestly, I think that should go before what I just said, but I'll just edit it likethat.
yeah, I think.
(26:29):
it back in there.
So let's talk a little bit about neurotags, which is this huge component of pain science,but it's also something that we use in an SI to understand a lot of different neural
patterning that happens in the brain and helps us to see that it's not so simple as like.
you know, survival brain, limbic system, frontal lobe, that all these things areinteracting together in these well myelinated pathways, responses of firing.
(26:57):
And we look at emotional flashbacks as a neuro tag, we look at how beliefs live in ourbody and our nervous system as a neuro tag.
So let's kind of lay that out for people a little bit as it relates to chronic pain.
But then also, it's this just this big foundational concept of understanding how to workwith the nervous system in the brain to create change in emotional
areas and in our beliefs as well.
(27:25):
Is my microphone auto-muting when I'm not talking or is someone controlling that?
Okay.
Just wanted to make sure it wasn't being funky.
Cool.
All right.
So NeuroTag is a term that was coined by Lorna Mosley and David Butler, another great painresearcher out of Australia.
(27:48):
They co-wrote a book called Explain Pain.
years ago and they created a new version just more recently called explain painsupercharged.
And this idea of a neuro tag, it came from a series of words and understandings throughoutthe years.
If we go back to the beginning, the idea was like a neuro signature, the terminology wasutilized.
(28:12):
And it was the idea that a neuro signature is an interconnected network of different brainareas and parts of the nervous system.
that are working to generate the experience of pain or really the experience of anyfeeling or sensation that we have, but pain in our case.
And they use signature with the idea that your signature on a piece of paper is differentthan every other person's signature.
(28:37):
So kind of like a neuro fingerprint would be unique, that your neuro signature of thesepathway activations or your neuro fingerprint would be unique to you.
And a neuro tag carries forward with that same idea of uniqueness.
But this idea of a tag is kind of like an imprint that can be activated over and over andover in exactly the same way.
(29:00):
So a neuro tag is a specific neuro network, these interconnected brain and nervous systemareas that all fire together as a group to create a particular experience.
So if you have a recurring pain in your low back, it's the same neuro tag firing over andover and over again to generate that recurring pain.
(29:21):
If you have a recurring migraine or recurring pain in your big toe, it's the same thing.
Okay.
So you could think of a neuro tag as each body area that hurts or each type of pain thatyou experience, but neuro tags aren't limited to only creating pain.
Neuro tags generate behaviors.
They generate the actions that we take.
(29:42):
They generate our feelings and emotions.
Like you could just as easily have a neuro tag for anxiety, or you could have a neuro tagfor your fear of public speaking, or you could have a neuro tag for, you know,
procrastination.
Like it could be virtually any output that the nervous system builds is based on a neurotag.
So these tags are not directly tied to injury, okay?
(30:05):
Rather, or instead, they're shaped by this sensory, emotional, and contextual input allhappening at the same time.
So the way we describe in a kind of normal language is to say every neuro tag, think of itas an active memory.
It's a previous experience that this tag or this network that has been built in the pastis now being activated again.
(30:27):
And it's being activated with three major components.
There's always a physical, emotional,
and cognitive component to every neuro tag.
So when you feel pain, yes, you feel the physical pain, but there's also an emotionalfeeling that goes with that and a series of cognitive thoughts that are layered on top and
(30:49):
you'll continue to experience or kind of loop through the cognitive thoughts and theemotions as you go through the physical pain at the same time.
So you stimulate any one part of the neuro tag, the whole thing comes back up to thesurface to be experienced.
by the nervous system as a whole.
And again, not triggered by injury, but triggered by the perception of threat and utilizedas an output that's gonna try to protect us from whatever the nervous system is perceiving
(31:16):
as that danger.
Yeah.
And that's why when we talk about emotional flashbacks as being when there's enoughtriggers or threshold, when an activation threshold has been reached for that neurotag,
we're cascade back into a whole different reality because there's that emotional, physicaland cognitive component of the neurotag that we then starts to change the filters the way
(31:43):
we see the world and pain can also be linked to to that experience that the pain
could be part of the emotional flashback as well as the thoughts and other behaviors oranxiety, as well as the somatic emotional experience.
And I feel like this kind of leads us into looking at the link between complex trauma andchronic pain, because people with an A score of four or higher are significantly more
(32:10):
likely to develop chronic pain.
And we can think about how those experiences have primed the nervous system,
experiences of threat to perceive pain signals maybe with more sensitivity to be morehyper vigilant and have that activation of that pain output more easily I think also too
(32:32):
though it could lead to desensitization of pain, especially if you have chronicdissociation and so we don't hear the protective signals coming from the body until they
have to get Louder to get our attention.
So sometimes that pushes us through into a state where
maybe there was subtle pain protective signals coming and we don't hear that until theexperience is really intense because ultimately our past experience, the developmental
(33:01):
trauma, the chronic stress is really changing the way that our brain and our nervoussystem process and respond to this stimulus from the environment, from social interactions
to the signals inside of ourselves.
And so that can keep us
stuck for lack of a better word, although we know we're never really stuck, we're alwaysadapting and changing, but stuck in the moment until we have new tools in a state of
(33:28):
hypervigilance, it can have our F responses being activated all the time and it can reallystart to amplify the pain signals and lead to the chronic pain experience over time.
And we know that a lot of the brain regions involved with the processing of pain, theamygdala, the insula,
(33:49):
all of these areas are also linked to our experience of a traumatic event as well.
They're also impacted, our hippocampus are impacted by the experience of a traumaticevent.
And so that overlap can lead to a situation where unresolved trauma can be exacerbating,heightening that pain perception.
(34:18):
And then
the pain is creating more threat, more dysregulation, than creating more pain, and itbecomes that cycle, that loop that we talk about a lot in here of the output becomes the
input, and then we get held in that pattern.
Dissociation and pain actually have a really interesting relationship.
(34:41):
And when I am working with clients and they relate to having that high pain threshold orlike high pain tolerance, it's really one of my first clues that we need to look at
dissociation and we also need to look at the lack of interoceptive awareness.
Interoception is the ability to perceive and interpret internal bodily signals.
(35:01):
And we talk about interoception on here a lot and interoception itself is also predictivein nature.
but it's not using real-time pattern recognition.
It's using that past experience to predict what's going to happen now in this experience.
And so this disconnection, this dissociation, can really make it harder to recognize andaddress early signs of dysregulation.
(35:28):
And this leads to more chronic stress and then which leads on typically to more chronicpain.
And so,
People with complex trauma often experience dissociation.
It dulls their sensitivity to bodily clues and this reduced interoceptive awareness, canlead people to push through pain, eventually resulting in other protective outputs like
(35:52):
exhaustion or immune dysregulation where we are eventually forced to rest, particularly ifsomething through that immune dysregulation leads to a chronic illness.
Yeah, so I agree and I want to connect the dots here between complex trauma and chronicpain.
We know from research and applying the ideas and concepts behind it that CPTSD is muchmore related to long-term somatic symptoms like chronic pain or gastrointestinal issues,
(36:25):
autoimmune disease, chronic fatigue, much more so than acute PTSD.
And one of the reasons that is, one the most important reasons is in a chronic painsituation, what allows chronic pain to become chronic, okay, is that the amygdala, where
(36:47):
our threat detection is happening, the insular cortex, the anterior cingulate cortex, thehippocampus, all of these areas, which are also activated during traumatic stress and
traumatic experiences,
They're tuned into a state of hypersensitivity.
And these are where tuned, you could also say they're conditioned into a state ofhypersensitivity, okay?
(37:10):
They've been kind of tweaked in the way that they function so that they're always on highalert, heightened state of vigilance, looking for and finding, perceiving threats more
easily because of the previous trauma that has happened.
And so from a state of complex PTS that is an ongoing environment or ongoing relationshipof trauma, it conditions and conditions and conditions those threat detection areas to be
(37:43):
more and more active.
But the survival brain, this threat detection area of the brain doesn't differentiatethreats from the environment, threats from other relationships, from threats coming from
inside my own body.
So it's quite easy for the nervous system to develop a hypersensitivity to internalthreats from nociception, from interoception, from poor or uncertain predictions that
(38:14):
might occur inside the body and interpret those as threats that need to be responded towith pain.
One of the ways I describe this for our students is to say,
Chronic pain occurs often when normal mechanoreceptive information, which is a type ofproprioception that tells us how we're moving and where we are in space, when
(38:38):
mechanoreceptive information starts to be misinterpreted as if it were nociception.
So the brain and central nervous system think all movement is threatening.
And when it starts to reinterpret normal signals as nociceptive signals,
That tells you really two things.
Number one, the nervous system had to be conditioned into that interpretation somehow.
(39:00):
Okay, it doesn't just wake up one day and decide from here forward, I'm gonna interpretall movement as if it's a threat.
That doesn't really occur unless there's some catalyst.
And it's far more likely to occur with a complex PTS situation than with an acute PTSevent that has occurred.
(39:22):
Second thing that it indicates is that that sensitization that has happened, it takes sometime to develop.
That was point number one.
But number two, it also takes some time to unwind it.
So there's actually a process that happens in the nervous system where the spinal cord andthe brain not only becomes more functionally sensitive to feeling or perceiving threat
(39:49):
signals,
But there's a physical change that happens too.
It's called sprouting inside the spinal cord where more nerve endings are grown in thespinal cord to pick up on nociceptive activity.
And the fancy term for this is called central sensitization.
But in order to get out of chronic pain, sometimes we have to desensitize the nervoussystem, which means having a physical adaptation to remove...
(40:18):
those extra sprouts that have been created.
And that's going to take some time of doing nervous system regulation, using retrainingsensory tools, working through lowering the threat and the stress that the nervous system
currently perceives.
So you're reconditioning the brain areas.
You're also retraining and adapting the physical structures of the nervous system at thesame time.
(40:44):
So CPTS is far more likely to
increase all of those changes and it makes it a little trickier to reverse them allbecause it takes a lot of time and a lot of regulation along the way.
as you
are talking, I just also want to always make sure I'm coming back to this idea too, thatit's crazy to think about how dynamic our body is and how it's adapting all of the time.
(41:13):
And to remind us all with CBTS that these adaptations were there for our protection,right?
And that our system was adapting in the best way that it could to keep us safe, to keep usalive.
And it is a process to repattern.
And there's
something to like be in touch with that, you know, there's nothing wrong with me for this.
(41:38):
It's the way that my system adapted given the experiences and I am neuroplastic dynamicbeing and we can start to create change with that too.
And I also want to make sure that we touch a little bit on the emotional expressioncomponents of pain too, because it's something that I see underneath a lot of chronic pain
(42:01):
clients is this.
real difficulty processing and being with emotions.
And there was another big influence on my work with emotional regulation, which was Dr.
John Sarno's work, where he really looks at how repressed emotions, anger, anxiety can...
(42:23):
lead to the manifestation of chronic pain and that especially individuals who haveperfectionistic or high achieving tendencies often experience pain as this subconscious
way to
avoid difficult emotions and that sometimes that is a protective output against theemotional experience, right?
(42:45):
It's a distraction to focus over here instead of feeling that emotional experience.
And I also think about all the constriction, embracing and the energy that's used in thebody when we aren't able to express and mobilize emotions.
And as I was reading Sarna's work a long time ago,
(43:05):
It was a big moment for me of connecting dots because I also saw other protective outputsas a distraction from experiencing emotions.
And I started to see my patterns of binging as a way to shift focus and repress emotionsand get out of that emotional experience.
And it wasn't until I started working with my body to be able to.
(43:29):
Feel the sensations without a lot of threat that interceptive awareness and accuracy to beable to mobilize that that I was able to really start to move out of those patterns and I
even find with clients a lot of times there's a certain amount we can do with nervoussystem regulation and neuro tools, but
(43:50):
Until there's also that ability to be with express and immobilize the emotions The painkeeps coming back up to the surface.
And so there's this real place I think to integrate the neuro and the somatics in You knowhelping the nervous system to regulate repatterning some of this these neurotags and
(44:12):
firing networks and also to Rehabilitate the emotional processing experience as well sothat we don't have to keep going into that
pathway of repression and we can have the skill to dynamically be able to feel and expressemotions and then we we aren't stuck in that loop from this other direction over here as
(44:33):
well.
Yeah, well said.
I the whole idea behind Sarno's work, and I'm going to grossly oversimplify this, soforgive me, but just in case there's people who are not familiar, the idea is that
suppressed or repressed emotions will create tension in the body.
Tension will reduce blood flow and reduced blood flow will eventually lead todysfunctional movement patterns or stabilization patterns in the musculature and in the
(45:02):
fascial tissues.
which is gonna lead to chronic pain.
Not a big stretch when you understand how all of these inputs and outputs work.
It really makes a lot of sense.
For that reason, I think, and we've talked about this, but emotional regulation is reallycrucial to managing chronic pain.
Because if you have unprocessed emotions, the nervous system can use pain as a way toprotect you against the overwhelming feelings that are
(45:33):
kind of stuck inside.
Okay.
And we already mentioned explained pain supercharged for Mosley and Butler, but theydiscussed there how like your emotional states paired with your past experiences and even
your personal beliefs can shape your experience of pain.
And this is really interesting to me as a practitioner working with clients because what Ihave to keep in mind and what all practitioners should keep in mind, I believe
(46:01):
is that each individual's experience of pain is unique.
There is no way for you to feel exactly what a client is feeling.
If you don't work with clients and you're listening today, think about family members orfriends who might be in pain.
There's no way you can ever experience exactly what their pain feels like because it's notonly based on the physicality of their body, it's not just physiology.
(46:28):
It's also based on beliefs.
and previous experiences.
And there's no way that we can share those with another person.
I can't go back in time and live through the experience that you lived through.
And because of that, I can't actually feel your pain.
The reason I bring that up is for us to understand that the emotional states, thepossibility of suppressed or repressed emotions, not regulating our own emotional state,
(46:59):
just adds more threat into the bucket.
It just adds more layers of challenge.
We'll use a nice word.
More layers of challenge for the nervous system to have to process through and interpreteverything else that's happening.
So it can really exacerbate pain when fear, anxiety, or negative beliefs are present, orwhen we have those emotions that we haven't expressed.
(47:28):
And I really wanna go back to perfectionism as a trauma response for a moment because Iwitnessed this in a client that I have and I've witnessed it in.
you know, people that I love who are in pain and just looking at their nervous systems andtheir outputs and, you know, like we have repeated so many times, like these protective
responses are not in our conscious awareness and neither is perfectionism.
(47:49):
And it is rooted in trauma as a survival strategy.
It's developed to manage the feelings of inadequacy, fears of rejection, the need tocontrol.
uncertain environments and we talk about that a lot on Heroin Trauma Rewired and so forpeople who have experienced complex trauma, especially in their development and early
(48:09):
relationships, they strive for that perfection because that becomes a way to secure love,approval, safety.
It's maybe a way to meet other people's needs.
or getting safety by trying to meet other people's needs or expectations in this likeflawless manner, but it also perpetuates emotional dysregulation, disassociation and self
(48:36):
abandonment.
all of this just leads to emotional dysregulation, leading to the repression of theemotional body.
And that is increasing emotional activity or reactivity really.
so individuals that suppress their needs and emotions and instead focus on performance or.
(49:00):
Individuals that suppress their needs and emotions and focus instead on performance orachievement as a way to avoid potential criticism or rejection.
This really overlaps with these high achievers and perfectionists and those unprocessedemotions contribute to physical symptoms like pain.
And in essence, perfectionism.
(49:20):
In essence, perfectionism acts as both a shield and a coping mechanism, divertingattention away from underlying emotional pain and creating patterns that may contribute to
chronic stress and somatic issues.
And I work with a client who really has a high perfectionistic drive and is oftendissociated, is very emotionally reactive because
(49:45):
They're not grounded and they don't express their needs and they really experience a lotof back pain and pain overall because like you said, all of that tension embracing in the
body and what this does is it impacts everything.
It really impacts their quality of life and keeps really not just in the physical painloops but in the loops of the emotional pain.
(50:15):
Should we go ahead and just jump to topic six impact on?
Yeah, I think so too.
Cool, awesome.
wanna, yeah, I think.
What Jen was just pointing to there is how all of this stuff compounds, right?
Our mental health is inextricably linked to our physical health and our physical healthhas impacts on our mental health.
(50:42):
And so there's so many ways that all of this gets enmeshed.
again, we're back in these loops that we want to start to find our way out of because theyimpact one another so much.
Yeah, so there's a really big impact on behavior.
And just want to kind of illuminate a couple of these just for coaches and therapists whoare working with clients that as a practitioner, you want to be aware of some of these
(51:12):
things because they can be tied to the chronic pain experience.
So avoidance or withdrawal is the first one.
So of course, like we all know pain kind of leads to avoidance behaviors.
You can interpret that a lot of ways, though.
So when I say we all know that.
What I mean to say is that if I have chronic pain, I might start to limit physicalactivity, but I also might start to limit social interactions.
(51:36):
I want to prevent discomfort overall, right?
So over time, that can result in higher levels of isolation, reduced mobility, evendeconditioning physically or mentally, that basically pain is slowing me down from doing
my life.
The second one is changes in emotional regulation.
Pain will increase stress.
(51:57):
Frustration, irritability can make it difficult to manage emotions effectively.
And then I can adopt other poor coping strategies or maladaptive coping strategies likesubstance abuse, self-medicating, over-reliance, even on prescription meds in cases like
that.
Or I can seek other emotional regulating activities that may not be helpful.
(52:24):
It can reduce cognitive function.
Like when we're in pain,
our pain experience occupies a lot of our brain.
It takes mental resources.
There's a phrase that I learned years and years ago that says pain will eventually becomethe cognitive output of highest priority, which means when pain gets bad enough, you can't
think of anything else.
(52:46):
So when we're in pain, we kind of get this brain fog or pain fog, maybe, right?
It reduces concentration, reduces our decision making capabilities, lowers our problemsolving ability.
And that can really impair our work, our productivity and things like that.
can disrupt our sleep for a fourth connection, creates a really nasty cycle where poorsleep creates more pain, more pain doesn't allow us to sleep well.
(53:11):
Emotional dysregulation can come into play at that point and further alter our behavior.
And then another one is hypervigilance.
Like chronic pain can heighten our nervous system's reactivity, kind of as we talked aboutbefore, making us more sensitive.
to perceived threats, including non-painful stimulus.
(53:32):
So there is a phrase used in the pain science world called non-nosusceptive pain.
And that's kind of what we've been talking around today is that when my nervous systemperceives a threat that's actually not coming from nosusception, but it's perceiving it as
if it were nosusception, that hypervigilance can turn into physical pain experiences quiteeasily.
(53:56):
So those, you want to be aware of them, know that they're possible and that they're justlayers upon layers that happen when we undergo this type of chronic pain adaptation.
I think the cool thing to think about here is because these things are so intertwined, wecan make a difference in some of these other areas by starting to rehabilitate our pain
(54:21):
through sensory input rehabilitation through repatterning our movement, our visual system,our interoceptive system.
Like if I start to work with the pain, this will also trickle out into these other areasof life where you're seeing these outputs and it can be a really
great way to create change in our emotional well-being, right?
(54:41):
We know our pain is closely linked to our mental health.
If we have a lot of chronic pain, we're much more likely to have depression and anxiety orfeelings of helplessness.
And that, of course, diminishes our emotional resilience.
But I can start to work physically at this pain level to start to create some change thererather than having to try to address these issues cognitively, like rather than going
(55:05):
after my anxiety or my depression from a cognitive lens.
And it really impacts our relationships too, because if we are in pain, that again, likeMatt was saying, it leads us to withdraw from social activities, it can also put a real
strain on our relationships because it limits our presence, right?
If we're always thinking about the pain and caught in that pain loop, and it can create arift between ourselves and other people, because they might not understand that experience
(55:33):
like Matt was talking about also.
And so I can also start to make some shifts really
and my ability to be present and show up in relationships differently when I start to workwith this.
And then, of course, there's many other areas of life that our pain impacts that increasesour stress load, like our work or economic stability.
You could even have loss of independence if you're experiencing a lot of chronic pain.
(55:57):
So there's a lot of reasons to start to rehab this that then again, they don't just affectour body physically, but our quality of life, our whole experience of the world.
This has just been such an eye-opening conversation.
I hope that our listeners are really feeling that way too.
And really just kind of coming into the awareness of what pain actually is.
(56:22):
And I just want to leave in some closing thoughts that oftentimes when people do havethese knowledges and awarenesses, they really want to go into change really quickly.
And change is possible.
That's why we work with our nervous system.
know, so much of our behavior, all of our behavior is not random.
Our habits are not random.
This is all at a subconscious level.
(56:42):
And like I was saying at the very beginning, like we've said this many times, is like thisis not happening with any of our control.
And so like a real daily habit of working with your nervous system, making your breathingbetter, making your vision better, improving your balance and your awareness of your body,
where it is in space, the internal sensations and information that's coming from yourbody.
(57:06):
It is really gonna help to give you that space.
that space that you want in a constant day to day to lower your stress load.
And when that stress load is reduced, you have resilience.
You're going to see a decrease in pain and you're gonna have the...
the capacity to adapt positively to the stress that's coming in and learning to slow downand having self-compassion.
(57:33):
These are two really integral parts of rehabbing and rewiring the pain protective output.
So thank you all for joining us today.
If you guys have any closing comments.
Yeah, thank you for having me today.
I just want to reaffirm that pain is an output that is coming from the nervous systemtrying to protect us.
(57:59):
But I want to also give a quick caveat because it's always multifactorial.
It's so tempting when you're in chronic pain and I've been in chronic pain myself, I'veworked with so many clients.
It's so tempting to look for just the one thing.
If I can just get the one thing that's gonna take away the pain, maybe it's thisinjection, maybe it's this treatment, maybe it's this therapy, maybe it's these emotions,
(58:24):
whatever.
Chronic pain is never a single factor problem.
It's always multifactorial.
And this last section that we talked about really illustrates that, it influences all theother parts of our life.
So if you're trying to work through chronic pain or work with other people who are,
Please be aware of the phrase when all you have is a hammer, everything looks like a nail.
(58:50):
Any practitioner who says, here's the one answer that you need, I would be cautious ofbecause there's so many parts of the nervous system from all the stuff Jen talked about,
sensory inputs, interoception, vision, balance, the emotional processing, the sleephygiene, everything that we've been talking about today is part of the rehab and the
(59:13):
adaptation.
It is possible to move out of chronic pain, 100%, I believe that.
But it's a multifactorial journey and it's one baby step at a time of regulating yournervous system and working with your tools and then finding some practitioners who can
help as well.
So hopefully today has created an empowering perspective shift for you as a listener and Ijust wanna thank you guys again for having me back.
(59:42):
Thank you so well said.
It's very true.
Yeah, amazing.
Thanks, y'all, so much.
Let me stop recording.
I'm gonna end the session, but if we leave altogether, let's come back on through the samelink because I wanna say something.
(01:00:03):
I just don't know what's gonna happen right now.
Okay, we going?
We ready?
Okay.
Chronic pain is deeply tied to the health of our nervous system, our ability to regulateemotions and the impact of past experiences.
It's more than just a response to injury.
It is an output from the brain.
It's shaped by sensory inputs, emotions, memories, and that's why understanding how traumaand stress impact the nervous system.
(00:29):
That's why understanding how trauma and stress impact the nervous system is so importantto addressing chronic pain and pain doesn't just affect the body.
It ripples out to influence our mental health, our social connections, our overall qualityof life.
And chronic pain often creates this feedback loop leading to isolation, depression, andeven changes in our brain function that then make the pain worse.
(00:52):
And even if you don't live with chronic pain, this episode is a really interestingexploration of the neuroscience of the mind-body connection.
And it's through the neuroscience of chronic pain that we've come to understand a lot ofconcepts like neuro tags the networks of neural connections that shape not just our pain
but also our beliefs our behavior our emotional responses in all areas of life and we'regonna dig into all of this today with Matt Bush from pain as an output to the emotional
(01:21):
and neurological underpinnings of human behavior and this conversation goes well beyondpain management.
So if you love neuro
and the science of how the brain and the body are interconnected.
Get ready, because we're going to take a deep exploration today.
Welcome to Trauma Rewired, the podcast that teaches you about your nervous system, howtrauma lives in the body, and what you can do to heal.
(01:41):
I'm your co-host, Elizabeth Kristof, founder of BrainBase.com.
an online platform for training the nervous system for resilience.
And I'm also the founder of the Neurosomatic Intelligence Coaching Certification, an ICFaccredited educational course to equip therapists and coaches to bring the brain and the
nervous system into their work for deeper levels of healing and really lastingtransformation.
(02:05):
And I'm your co-host Jennifer Wallace.
I'm a Neurosomatic Psychedelic Preparation and Integration Guide.
And I bring Neurosomatic Intelligence into your peak somatic experience.
And I'm also an educator at the Neurosomatic Intelligence Coaching Certification.
And today we are joined by Matt Bush of Next Level Neuro.
And he's also one of our lead educators at NSI.
(02:28):
Thank you for having me back.
I'm super excited for today's talk on the podcast.
This topic is near and dear to my heart because we've worked with so many people over theyears who have chronic pain and are able to really to reduce that and change it
drastically, even remove it completely based on neuro training.
So I think we all, individuals here on the podcast, but also listeners have someone in ourlives, a family member, a friend, a colleague.
(02:56):
who deals with some type of chronic pain.
And the more that we can understand the input interpretation output loop and how itbecomes chronic, the easier it is to be able to work with those issues and conditions and
really make a lasting difference.
So, glad to be here.
Yeah, I feel like this is a long overdue conversation.
(03:19):
And I think to start it out, we need to look at the work of Laura Mermozle, who has beenreally foundational in transforming how we understand chronic pain.
And Mermozle is a clinical scientist and a researcher in pain neuroscience that reallydemonstrated through the years of research that pain doesn't just come from a physical
(03:39):
injury or tissue damage.
And that
changed the way that we see this traditional view of pain and created a new perspectivewhere we're really looking at it as more of a complex experience that's shaped by our
brains interpretation of various inputs from sensory information or past experiences oremotional state and perceived threats.
(04:03):
And again, that brings us back to the input interpretation output loop that pain is notjust a response to physical damage, but
has everything to do with how we take in information about the world outside of us andinside of us, how our brain interprets that information and then the output that is
created.
And so I want to just, I guess, first dive a little bit more into that map, because Ithink sometimes it can be really hard for people to start to understand that pain is not
(04:35):
necessarily coming from a physical injury and that it is an output rather than an
input.
Yeah, certainly.
So as an easy example, you can think about if you've ever had to go into a reallystressful meeting, maybe with a boss or a subordinate, a partner, and you start to develop
(05:02):
pain before that meeting even happens.
Like, it could be stomach pain, neck pain, headache, all kinds of stuff that our body cancreate as a way of telling us, don't feel safe.
We need to slow down or be cautious.
And those examples of acute pain when there is no injury can become chronic as well.
(05:25):
That's not to say all chronic pain is coming from some type of perceived threat alone,like it's all in your head.
That's not what we mean to say at all.
But there is this very real sense that the brain is creating pain based on itspredictions.
and based on its previous experiences.
we'll talk a little bit about how those are integrated together.
(05:46):
But one other note I wanted to make here just at the very beginning is if you actuallylook at the research on what's called asymptomatic orthopedic injuries, which means
someone goes in for an MRI or an X-ray, not having any pain, no dysfunction, no movementproblems, but they're participating in a study, they go and take an MRI.
(06:07):
On the MRI, we can see potential damage to their joints or connective tissues that issevere enough that if they were experiencing pain, it would be surgically operable.
Like it would be recommended to have surgery to repair that damage that's inside theirbody.
But in these cases, in these research studies, these people are experiencing zero pain ona daily basis.
(06:31):
They don't even know that they have the injury.
And so this is kind of the flip of what we were just saying, right?
That pain doesn't come from injury, but it's important that we understand this because wewant to differentiate and dissociate the ideas of injury and pain.
So in these research studies, they're seeing very real injuries that are resulting in zeropain for the individuals that are experiencing them, ever.
(06:59):
On the flip side of the coin, the opposite is also true.
We can have pain
such as the examples before, when there is zero physical injury present in the body.
So we want to spread those ideas far apart.
Pain and injury are not the same thing.
They don't have to be connected in the human body and in the nervous system.
And the sooner we can grasp that, then we can dive into a little bit deeper conversationabout, well, then why is the brain generating pain?
(07:27):
And that's where we'll get into, you know, the interpretation, the processing, theprediction.
the previous experiences, and what makes it chronic rather than just acute, only coming upin a stressful situation, what makes it continue on an ongoing basis, day after day, month
after month, that we're not able to kind of get to it with our normal medical procedures.
(07:57):
E, can you check your mic?
It look on your settings, it says that your mic, it says, my, from what I see on yoursettings, it says you have no microphone.
Is that, is it hooked up on your side?
yeah, it says it's my sound is coming through.
(08:20):
Okay, it just popped back on again.
Maybe when you mute, will you mute?
okay, okay, just trying to get used to this software.
I thought maybe your mic dropped.
Okay, let me go back to my notes, please.
HUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUEHUE
Okay, you know, I really enjoyed going down the rabbit hole of Laura Moore, Laura MooreMosley, because he has a really great Ted talk on pain that we will link to this.
(08:51):
And because he really says that pain is an illusion, like 100 % of the time that happensreally quickly.
And it's outside of your awareness.
And like Matt said, that's not to say that your experience of pain is not real.
It is real.
And it's also an illusion because your brain
being this incredible predictive machine, it's always going to choose the path that's mostbiologically advantageous for our survival.
(09:17):
And so I really love this example that he gives.
We're gonna call it the steak, we're gonna call it the.
We're gonna call it the snake stick.
example.
Why is that so hard to say?
(09:38):
me one second.
The snake stick sample?
That's the, that's what really wants to come out.
We're gonna call this the snake stick example.
So you're walking through a forest, you're in the greenbelt, you're taking a walk and youfeel a brush against your leg and your brain starts to put into context what's really
(10:06):
happening here.
Have I been here before?
What's happening?
It sends a signal really quickly from your skin and nociceptors travels all the way up tothe brain and then your brain starts to ask all these questions.
Where am I?
Have I been here before?
Am I in a safe environment?
Has anything ever happened to me here before?
And then through all of this deduction, you realize you've just hit a stick because you'rejust on your walk.
(10:32):
But the one time that you're walking in the path that you always walk through and you getbit by the snake, that is gonna send a completely different interpretation to your brain
that's really gonna be the memory that lasts.
So once you...
understand or once your brain understands and has received a danger message in the brainand like then your brain has to think what does this mean and what do I do here and so
(10:57):
pain is the end result designed to protect you and like we're talking about this is notabout your tissues.
So from a clinical perspective your brain is looking for this predictability and and anyand it's looking for any piece of credible evidence
that you are in danger and then it changes the pain on the spectrum of pain.
(11:22):
And so what's interesting here is that so the next time you're on this walk and yournormal path and you cross a stick instead of your brain going, yeah, that's just a stick.
It has the memory of the snake bite, which could have potentially killed you.
now the stick is inherently threatening and sends the pain threat.
(11:44):
way up like you just got bit by a snake and then maybe that lessens your world a littlebit where you don't go out and you do your hikes, where you do your walking anymore
because that equals pain.
And so maybe one of you wants to get into what nociceptors are.
(12:04):
You have a great.
I would love to follow up on that.
we've mentioned Lorimer Mosley now a few times.
He's a great presenter.
A lot of his work is on YouTube.
And so for his version, the snake and the stick story actually comes from him.
It's one of his personal experiences, walking through the jungle essentially of Australiaand bumping up against what he thought was a stick when it was actually a snake, didn't
(12:32):
feel any pain.
until it was almost too late and he got faint and had to sit down.
And then the next time brushes up against a stick, brain absolutely freaks out, thinksthat it's a snake, only to find nothing's really happening.
So how Jen just described the way that our brain can confuse the feelings and thepredictions is often based on previous experiences.
(12:55):
And a lot of that comes from this type of nerve receptor that we call a nociceptor.
So, noci is the same root as the word noxious.
It's something that's dangerous to the body or perceived as dangerous.
And the scepter part just means that it's a nerve ending, a receptor.
Okay, so it's bringing in sensory information.
So nociceptors or nociceptive signals are constantly being sent into the nervous systemfrom all parts of the body.
(13:23):
They never really turn off, which is quite interesting because we have to remember thatall nerves are always active in the human body.
Nerves never shut down.
They don't get turned off like a light switch because if they were to turn off, theyactually begin to die.
So nerves have to stay active.
Just like in your home, the electrical wires always have electricity running through them.
(13:45):
It's just a matter of whether they can reach their end target of a light bulb, atelevision, a microwave, or if that circuit has been cut.
But they're always activated, right?
You would never want to touch a hot wire in your home.
So in the body, nociceptors are always active as well.
But what makes a huge difference as to whether the nervous system really perceives them asa current threat or whether they're just maybe like a low grade buzz going on in the
(14:12):
background is the intensity of their activation or what's called their amplitude.
How much nociceptive signaling is coming in at any one time really is what the brain isbasing some of this predictive response on.
So Mosley actually published an article way back in
(14:34):
2007 called Reconceptualizing Pain According to Modern Pain Science.
This is way back when, you know, but he created this diagram in this graphic that I wantto talk us through really briefly because it encapsulates this whole idea of input,
interpretation, output, but it uses different terminology that really builds us a goodillustration and a good context to have the rest of our conversation.
(14:59):
So the graphic begins with a picture of a brain sitting at the top of the page and thebrain is asking how dangerous is this really?
Okay.
And you have these arrows that are pointing into the brain, they're giving it the inputs.
the inputs are these.
First of all, there's the sensory input coming from the body.
That would include proprioception, which is movement information, basic somatosensoryinputs, which is feelings of temperature, touch, pressure.
(15:28):
Right?
Things that our body and our skin can feel and also nociception, the current amount ofnociception coming in.
That's the sensory input that the brain is receiving.
Plus at the same time, it's also aware of and perceiving our previous experiences.
So in earlier podcast episodes, one of the things we've talked about is that our brain isa predictive organ.
(15:52):
It's not only looking at what has just happened or what is currently happening.
But it's actually trying to make some of these judgments about whether I'm safe or unsafebased on its prediction.
And the prediction that it accomplishes comes from a little equation.
We say prediction is equal to the current sensory inputs plus our previous experiences.
(16:16):
Right?
Another way to say that is it's interpreting the current sensory input through the lens ofprevious experience.
So when it feels that thing brush against your leg, it's like, is that a stick or is thata snake?
Depends on my previous experiences, how I'm going to answer that question, right?
So the brain is taking that overall prediction of what it's feeling in regard of answeringthis question of how dangerous is it really?
(16:43):
But it's also adding in five or six other things.
Okay, number one is cultural factors.
Like what's the culture that you were raised in?
What's the culture that you currently live in?
Because that really shapes your beliefs about danger and your perceptions about yourenvironment.
A quick example of this is I used to teach quite a lot in Denmark.
(17:07):
And if you've ever been to Denmark or ever read anything about it, it's kind of theoriginal home of the Vikings, right?
Denmark and Sweden and Norway.
And so a lot of the Danes currently living in country think of themselves as these
kind of tough Viking culture, which is cool to experience as an American going to visit.
It's very fun.
Wonderful people.
(17:28):
But there's this interesting divide.
If you're there for any amount of time, you start to learn it when you get to know thepeople.
There's a little bit of a divide between the older generations, say people who are olderthan in their 60s versus the younger generations.
And the older group looks down on the younger group.
(17:49):
and goes, you guys are not as tough as you think.
You're kind of soft.
You're kind of weak.
And when you start to under, like go, why would you think that?
Why would you say that?
They're like, well, when we grew up, there was no government to take care of us.
Like the modern Danish government is essentially a democratic socialist government.
(18:11):
And this is not a political statement, okay?
This is just a story.
But the older generation grew up under a monarchy that didn't have any socialist supportcoming from the government.
And these days, the Danish government pays for lot of education, a lot of holiday time,illness, work time, all kinds of stuff that the older generation just looks down on and
(18:34):
goes, you guys are being handed everything by the government.
You got to pay a lot of taxes, you know, but.
The government takes care of you when you're sick, when you lose your job, when you'regoing to have a baby, when you want to go on holiday, when you want to retire, like when
you want to buy a new home.
Everything is subsidized by the government.
And the older generation thinks that they're really soft because of that.
(18:55):
So there's this cultural difference, right, between those different age groups.
As I was growing up here in the States, my grandfather was born just before the GreatDepression.
here in the States.
And so he lived through the Great Depression.
He lived through World War II.
He served in the military.
He lived through the different wars that the US fought in.
(19:18):
growing up on a farm in South Georgia, the only food that they had to eat was food thatthey could raise themselves on the farm.
The only transportation they had was a mule to pull the wagon or their own two feet.
That was it.
And this is a family of 12 kids.
can imagine there were times where my grandfather, who was a really nice sweet man, wouldlook at myself and my brother and go, wow, you guys have it easy.
(19:44):
You're growing up in the 80s and 90s with all this technology and everybody has a car andyou have a grocery store on every corner to go buy whatever you want to eat.
Like everything's taken care of.
He never expressed that out loud, but I can just imagine some part of his brain might havesaid, life has gotten a lot easier in recent years.
(20:05):
And so,
All of that is to say cultural factors play a huge role in how your brain perceivesdanger.
Like what is danger is influenced by that, okay?
There's also your social and work environment.
Like what would happen socially or in my work if I were to be injured or if I were to bein pain?
There's expectations about consequences.
(20:27):
Like if I'm in pain all the time, what does that mean?
Am I gonna have to go on regular doctor visits?
Am I going to be able to do the things that I want to do?
Am I going to have to pay a lot of money to take care of this chronic illness or chronicpain?
And then there's also your beliefs.
That's kind of your worldview, your mindset of like how are things going to work out, youractual knowledge about how the body works and what pain is, what it means.
(20:53):
And then also a balance of your logical brain versus your emotional brain.
Like what...
which part of your brain becomes more loud and starts to run the show when you are inpain.
So all of that stuff is taken together, like put it all in a blender, mix it up.
Then your brain is presented with all of that combined information to try to answer thequestion, how dangerous is this really?
(21:18):
Okay, so it's not just about the sensory inputs from the body.
It's all of this stuff.
Based on all of that combined, your brain creates some type of meaning.
like a story of what does this mean, what's happening, that's going to generate itsexpectations, possibly some level of anxiety about what's going on.
And as that all filters back into this brain asking the question of how dangerous is itreally, if the brain says really dangerous, unsafe, high threat, then it's automatically
(21:50):
going to generate outputs to start to protect you.
The number one output there being pain.
Okay, but also
changes to your emotions, levels of anxiety or depression, hormone changes, immune systemchanges, changes to your sympathetic nervous system.
Basically all the stuff we talk about on this podcast as far as outputs, right?
(22:13):
It's gonna generate an output to protect you if it perceives your danger.
And if not, it's gonna go, yep, keep doing what you wanna do.
It's so interesting as you were talking and Jen was giving this steak.
As Jen was giving this snake stick example, I was just thinking so much about you canreally see how trauma patterning starts to come into this.
(22:40):
And when we're talking about all these different sensory inputs, it's not justsomatosensory or maybe just something that we see visually, but also, you know, our
movement patterns and giving that proprioceptive input, social cues, the environmentalcues, all of those different contexts that you were talking about.
how all of that can start to signal threat and pain could be just one protective outputthat comes from past experiences that are priming us to experience a lot of
(23:12):
that threat, you know, can be many other protective outputs as well.
And I just also couldn't help but think about how many clients we work with that havepelvic pain, persistent pelvic pain, even though there's no injury, TMJ and jaw clenching
in these patterns of bracing that are so associated with trauma.
And
(23:34):
the link, there's just so many links between our developmental trauma and thoseexperiences and then the outputs that we experience with pain or just the protective
outputs in general.
And I know we'll dive a little bit more into its connection to CPTS and mental health, butI want to talk a little bit about neuro tags as well, and how we can use this concept of
(23:54):
neuro tags that we talk about on here quite a bit to really understand these pain outputstoo.
And what I found is working with clients is that this is a really powerful reframe forclients because understanding that pain, that a pain neuro tag, wait a minute.
(24:21):
This is a really powerful reframe for the clients that we work with because dangersignals, they're really high priority from the brain.
so understanding pain neurotags has really transformed the way that I work with clients,especially when I'm addressing chronic pain and beliefs that are tied to chronic pain,
because by recognizing pain as a neural output shaped by perception, clients can reallystart to detach from a fear based relationship with pain.
(24:48):
And by educating clients about pain,
neuroscience, individuals can reduce pain related fear and reframe their understanding ofpain, which has been shown to improve pain outcomes.
Because when we're talking about the main contributors of pain and disability, we'rereally talking about the main contributors being anxiety, catastrophizing and nervous
(25:13):
system sensitization, which also I think could be interchangeable with nervous systemdysregulation.
And through
Lowering the threat, the overall threat with clients and working through emotionalexpression, we have really been able to diminish quite a bit of the pain that the body is
physically experiencing in really localized areas like Elizabeth just gave the example ofjaw, back, pelvic floor.
(25:39):
And so, you know, just having these reframes about what we believe, this can be reallypowerful.
And so.
based on the input that the brain makes and it has to make the decision for the output andthat output has a story around it.
And so if that story equals a danger output and it's gonna need protection, then theoutput is going to be pain.
(26:09):
Do we want to dive a little bit deeper into neurotags?
Do we feel like they need a little bit more of an explanation here?
Yeah, I would probably.
You head back up to that section.
and honestly, I think that should go before what I just said, but I'll just edit it likethat.
yeah, I think.
(26:29):
it back in there.
So let's talk a little bit about neurotags, which is this huge component of pain science,but it's also something that we use in an SI to understand a lot of different neural
patterning that happens in the brain and helps us to see that it's not so simple as like.
you know, survival brain, limbic system, frontal lobe, that all these things areinteracting together in these well myelinated pathways, responses of firing.
(26:57):
And we look at emotional flashbacks as a neuro tag, we look at how beliefs live in ourbody and our nervous system as a neuro tag.
So let's kind of lay that out for people a little bit as it relates to chronic pain.
But then also, it's this just this big foundational concept of understanding how to workwith the nervous system in the brain to create change in emotional
areas and in our beliefs as well.
(27:25):
Is my microphone auto-muting when I'm not talking or is someone controlling that?
Okay.
Just wanted to make sure it wasn't being funky.
Cool.
All right.
So NeuroTag is a term that was coined by Lorna Mosley and David Butler, another great painresearcher out of Australia.
(27:48):
They co-wrote a book called Explain Pain.
years ago and they created a new version just more recently called explain painsupercharged.
And this idea of a neuro tag, it came from a series of words and understandings throughoutthe years.
If we go back to the beginning, the idea was like a neuro signature, the terminology wasutilized.
(28:12):
And it was the idea that a neuro signature is an interconnected network of different brainareas and parts of the nervous system.
that are working to generate the experience of pain or really the experience of anyfeeling or sensation that we have, but pain in our case.
And they use signature with the idea that your signature on a piece of paper is differentthan every other person's signature.
(28:37):
So kind of like a neuro fingerprint would be unique, that your neuro signature of thesepathway activations or your neuro fingerprint would be unique to you.
And a neuro tag carries forward with that same idea of uniqueness.
But this idea of a tag is kind of like an imprint that can be activated over and over andover in exactly the same way.
(29:00):
So a neuro tag is a specific neuro network, these interconnected brain and nervous systemareas that all fire together as a group to create a particular experience.
So if you have a recurring pain in your low back, it's the same neuro tag firing over andover and over again to generate that recurring pain.
(29:21):
If you have a recurring migraine or recurring pain in your big toe, it's the same thing.
Okay.
So you could think of a neuro tag as each body area that hurts or each type of pain thatyou experience, but neuro tags aren't limited to only creating pain.
Neuro tags generate behaviors.
They generate the actions that we take.
(29:42):
They generate our feelings and emotions.
Like you could just as easily have a neuro tag for anxiety, or you could have a neuro tagfor your fear of public speaking, or you could have a neuro tag for, you know,
procrastination.
Like it could be virtually any output that the nervous system builds is based on a neurotag.
So these tags are not directly tied to injury, okay?
(30:05):
Rather, or instead, they're shaped by this sensory, emotional, and contextual input allhappening at the same time.
So the way we describe in a kind of normal language is to say every neuro tag, think of itas an active memory.
It's a previous experience that this tag or this network that has been built in the pastis now being activated again.
(30:27):
And it's being activated with three major components.
There's always a physical, emotional,
and cognitive component to every neuro tag.
So when you feel pain, yes, you feel the physical pain, but there's also an emotionalfeeling that goes with that and a series of cognitive thoughts that are layered on top and
(30:49):
you'll continue to experience or kind of loop through the cognitive thoughts and theemotions as you go through the physical pain at the same time.
So you stimulate any one part of the neuro tag, the whole thing comes back up to thesurface to be experienced.
by the nervous system as a whole.
And again, not triggered by injury, but triggered by the perception of threat and utilizedas an output that's gonna try to protect us from whatever the nervous system is perceiving
(31:16):
as that danger.
Yeah.
And that's why when we talk about emotional flashbacks as being when there's enoughtriggers or threshold, when an activation threshold has been reached for that neurotag,
we're cascade back into a whole different reality because there's that emotional, physicaland cognitive component of the neurotag that we then starts to change the filters the way
(31:43):
we see the world and pain can also be linked to to that experience that the pain
could be part of the emotional flashback as well as the thoughts and other behaviors oranxiety, as well as the somatic emotional experience.
And I feel like this kind of leads us into looking at the link between complex trauma andchronic pain, because people with an A score of four or higher are significantly more
(32:10):
likely to develop chronic pain.
And we can think about how those experiences have primed the nervous system,
experiences of threat to perceive pain signals maybe with more sensitivity to be morehyper vigilant and have that activation of that pain output more easily I think also too
(32:32):
though it could lead to desensitization of pain, especially if you have chronicdissociation and so we don't hear the protective signals coming from the body until they
have to get Louder to get our attention.
So sometimes that pushes us through into a state where
maybe there was subtle pain protective signals coming and we don't hear that until theexperience is really intense because ultimately our past experience, the developmental
(33:01):
trauma, the chronic stress is really changing the way that our brain and our nervoussystem process and respond to this stimulus from the environment, from social interactions
to the signals inside of ourselves.
And so that can keep us
stuck for lack of a better word, although we know we're never really stuck, we're alwaysadapting and changing, but stuck in the moment until we have new tools in a state of
(33:28):
hypervigilance, it can have our F responses being activated all the time and it can reallystart to amplify the pain signals and lead to the chronic pain experience over time.
And we know that a lot of the brain regions involved with the processing of pain, theamygdala, the insula,
(33:49):
all of these areas are also linked to our experience of a traumatic event as well.
They're also impacted, our hippocampus are impacted by the experience of a traumaticevent.
And so that overlap can lead to a situation where unresolved trauma can be exacerbating,heightening that pain perception.
(34:18):
And then
the pain is creating more threat, more dysregulation, than creating more pain, and itbecomes that cycle, that loop that we talk about a lot in here of the output becomes the
input, and then we get held in that pattern.
Dissociation and pain actually have a really interesting relationship.
(34:41):
And when I am working with clients and they relate to having that high pain threshold orlike high pain tolerance, it's really one of my first clues that we need to look at
dissociation and we also need to look at the lack of interoceptive awareness.
Interoception is the ability to perceive and interpret internal bodily signals.
(35:01):
And we talk about interoception on here a lot and interoception itself is also predictivein nature.
but it's not using real-time pattern recognition.
It's using that past experience to predict what's going to happen now in this experience.
And so this disconnection, this dissociation, can really make it harder to recognize andaddress early signs of dysregulation.
(35:28):
And this leads to more chronic stress and then which leads on typically to more chronicpain.
And so,
People with complex trauma often experience dissociation.
It dulls their sensitivity to bodily clues and this reduced interoceptive awareness, canlead people to push through pain, eventually resulting in other protective outputs like
(35:52):
exhaustion or immune dysregulation where we are eventually forced to rest, particularly ifsomething through that immune dysregulation leads to a chronic illness.
Yeah, so I agree and I want to connect the dots here between complex trauma and chronicpain.
We know from research and applying the ideas and concepts behind it that CPTSD is muchmore related to long-term somatic symptoms like chronic pain or gastrointestinal issues,
(36:25):
autoimmune disease, chronic fatigue, much more so than acute PTSD.
And one of the reasons that is, one the most important reasons is in a chronic painsituation, what allows chronic pain to become chronic, okay, is that the amygdala, where
(36:47):
our threat detection is happening, the insular cortex, the anterior cingulate cortex, thehippocampus, all of these areas, which are also activated during traumatic stress and
traumatic experiences,
They're tuned into a state of hypersensitivity.
And these are where tuned, you could also say they're conditioned into a state ofhypersensitivity, okay?
(37:10):
They've been kind of tweaked in the way that they function so that they're always on highalert, heightened state of vigilance, looking for and finding, perceiving threats more
easily because of the previous trauma that has happened.
And so from a state of complex PTS that is an ongoing environment or ongoing relationshipof trauma, it conditions and conditions and conditions those threat detection areas to be
(37:43):
more and more active.
But the survival brain, this threat detection area of the brain doesn't differentiatethreats from the environment, threats from other relationships, from threats coming from
inside my own body.
So it's quite easy for the nervous system to develop a hypersensitivity to internalthreats from nociception, from interoception, from poor or uncertain predictions that
(38:14):
might occur inside the body and interpret those as threats that need to be responded towith pain.
One of the ways I describe this for our students is to say,
Chronic pain occurs often when normal mechanoreceptive information, which is a type ofproprioception that tells us how we're moving and where we are in space, when
(38:38):
mechanoreceptive information starts to be misinterpreted as if it were nociception.
So the brain and central nervous system think all movement is threatening.
And when it starts to reinterpret normal signals as nociceptive signals,
That tells you really two things.
Number one, the nervous system had to be conditioned into that interpretation somehow.
(39:00):
Okay, it doesn't just wake up one day and decide from here forward, I'm gonna interpretall movement as if it's a threat.
That doesn't really occur unless there's some catalyst.
And it's far more likely to occur with a complex PTS situation than with an acute PTSevent that has occurred.
(39:22):
Second thing that it indicates is that that sensitization that has happened, it takes sometime to develop.
That was point number one.
But number two, it also takes some time to unwind it.
So there's actually a process that happens in the nervous system where the spinal cord andthe brain not only becomes more functionally sensitive to feeling or perceiving threat
(39:49):
signals,
But there's a physical change that happens too.
It's called sprouting inside the spinal cord where more nerve endings are grown in thespinal cord to pick up on nociceptive activity.
And the fancy term for this is called central sensitization.
But in order to get out of chronic pain, sometimes we have to desensitize the nervoussystem, which means having a physical adaptation to remove...
(40:18):
those extra sprouts that have been created.
And that's going to take some time of doing nervous system regulation, using retrainingsensory tools, working through lowering the threat and the stress that the nervous system
currently perceives.
So you're reconditioning the brain areas.
You're also retraining and adapting the physical structures of the nervous system at thesame time.
(40:44):
So CPTS is far more likely to
increase all of those changes and it makes it a little trickier to reverse them allbecause it takes a lot of time and a lot of regulation along the way.
as you
are talking, I just also want to always make sure I'm coming back to this idea too, thatit's crazy to think about how dynamic our body is and how it's adapting all of the time.
(41:13):
And to remind us all with CBTS that these adaptations were there for our protection,right?
And that our system was adapting in the best way that it could to keep us safe, to keep usalive.
And it is a process to repattern.
And there's
something to like be in touch with that, you know, there's nothing wrong with me for this.
(41:38):
It's the way that my system adapted given the experiences and I am neuroplastic dynamicbeing and we can start to create change with that too.
And I also want to make sure that we touch a little bit on the emotional expressioncomponents of pain too, because it's something that I see underneath a lot of chronic pain
(42:01):
clients is this.
real difficulty processing and being with emotions.
And there was another big influence on my work with emotional regulation, which was Dr.
John Sarno's work, where he really looks at how repressed emotions, anger, anxiety can...
(42:23):
lead to the manifestation of chronic pain and that especially individuals who haveperfectionistic or high achieving tendencies often experience pain as this subconscious
way to
avoid difficult emotions and that sometimes that is a protective output against theemotional experience, right?
(42:45):
It's a distraction to focus over here instead of feeling that emotional experience.
And I also think about all the constriction, embracing and the energy that's used in thebody when we aren't able to express and mobilize emotions.
And as I was reading Sarna's work a long time ago,
(43:05):
It was a big moment for me of connecting dots because I also saw other protective outputsas a distraction from experiencing emotions.
And I started to see my patterns of binging as a way to shift focus and repress emotionsand get out of that emotional experience.
And it wasn't until I started working with my body to be able to.
(43:29):
Feel the sensations without a lot of threat that interceptive awareness and accuracy to beable to mobilize that that I was able to really start to move out of those patterns and I
even find with clients a lot of times there's a certain amount we can do with nervoussystem regulation and neuro tools, but
(43:50):
Until there's also that ability to be with express and immobilize the emotions The painkeeps coming back up to the surface.
And so there's this real place I think to integrate the neuro and the somatics in You knowhelping the nervous system to regulate repatterning some of this these neurotags and
(44:12):
firing networks and also to Rehabilitate the emotional processing experience as well sothat we don't have to keep going into that
pathway of repression and we can have the skill to dynamically be able to feel and expressemotions and then we we aren't stuck in that loop from this other direction over here as
(44:33):
well.
Yeah, well said.
I the whole idea behind Sarno's work, and I'm going to grossly oversimplify this, soforgive me, but just in case there's people who are not familiar, the idea is that
suppressed or repressed emotions will create tension in the body.
Tension will reduce blood flow and reduced blood flow will eventually lead todysfunctional movement patterns or stabilization patterns in the musculature and in the
(45:02):
fascial tissues.
which is gonna lead to chronic pain.
Not a big stretch when you understand how all of these inputs and outputs work.
It really makes a lot of sense.
For that reason, I think, and we've talked about this, but emotional regulation is reallycrucial to managing chronic pain.
Because if you have unprocessed emotions, the nervous system can use pain as a way toprotect you against the overwhelming feelings that are
(45:33):
kind of stuck inside.
Okay.
And we already mentioned explained pain supercharged for Mosley and Butler, but theydiscussed there how like your emotional states paired with your past experiences and even
your personal beliefs can shape your experience of pain.
And this is really interesting to me as a practitioner working with clients because what Ihave to keep in mind and what all practitioners should keep in mind, I believe
(46:01):
is that each individual's experience of pain is unique.
There is no way for you to feel exactly what a client is feeling.
If you don't work with clients and you're listening today, think about family members orfriends who might be in pain.
There's no way you can ever experience exactly what their pain feels like because it's notonly based on the physicality of their body, it's not just physiology.
(46:28):
It's also based on beliefs.
and previous experiences.
And there's no way that we can share those with another person.
I can't go back in time and live through the experience that you lived through.
And because of that, I can't actually feel your pain.
The reason I bring that up is for us to understand that the emotional states, thepossibility of suppressed or repressed emotions, not regulating our own emotional state,
(46:59):
just adds more threat into the bucket.
It just adds more layers of challenge.
We'll use a nice word.
More layers of challenge for the nervous system to have to process through and interpreteverything else that's happening.
So it can really exacerbate pain when fear, anxiety, or negative beliefs are present, orwhen we have those emotions that we haven't expressed.
(47:28):
And I really wanna go back to perfectionism as a trauma response for a moment because Iwitnessed this in a client that I have and I've witnessed it in.
you know, people that I love who are in pain and just looking at their nervous systems andtheir outputs and, you know, like we have repeated so many times, like these protective
responses are not in our conscious awareness and neither is perfectionism.
(47:49):
And it is rooted in trauma as a survival strategy.
It's developed to manage the feelings of inadequacy, fears of rejection, the need tocontrol.
uncertain environments and we talk about that a lot on Heroin Trauma Rewired and so forpeople who have experienced complex trauma, especially in their development and early
(48:09):
relationships, they strive for that perfection because that becomes a way to secure love,approval, safety.
It's maybe a way to meet other people's needs.
or getting safety by trying to meet other people's needs or expectations in this likeflawless manner, but it also perpetuates emotional dysregulation, disassociation and self
(48:36):
abandonment.
all of this just leads to emotional dysregulation, leading to the repression of theemotional body.
And that is increasing emotional activity or reactivity really.
so individuals that suppress their needs and emotions and instead focus on performance or.
(49:00):
Individuals that suppress their needs and emotions and focus instead on performance orachievement as a way to avoid potential criticism or rejection.
This really overlaps with these high achievers and perfectionists and those unprocessedemotions contribute to physical symptoms like pain.
And in essence, perfectionism.
(49:20):
In essence, perfectionism acts as both a shield and a coping mechanism, divertingattention away from underlying emotional pain and creating patterns that may contribute to
chronic stress and somatic issues.
And I work with a client who really has a high perfectionistic drive and is oftendissociated, is very emotionally reactive because
(49:45):
They're not grounded and they don't express their needs and they really experience a lotof back pain and pain overall because like you said, all of that tension embracing in the
body and what this does is it impacts everything.
It really impacts their quality of life and keeps really not just in the physical painloops but in the loops of the emotional pain.
(50:15):
Should we go ahead and just jump to topic six impact on?
Yeah, I think so too.
Cool, awesome.
wanna, yeah, I think.
What Jen was just pointing to there is how all of this stuff compounds, right?
Our mental health is inextricably linked to our physical health and our physical healthhas impacts on our mental health.
(50:42):
And so there's so many ways that all of this gets enmeshed.
again, we're back in these loops that we want to start to find our way out of because theyimpact one another so much.
Yeah, so there's a really big impact on behavior.
And just want to kind of illuminate a couple of these just for coaches and therapists whoare working with clients that as a practitioner, you want to be aware of some of these
(51:12):
things because they can be tied to the chronic pain experience.
So avoidance or withdrawal is the first one.
So of course, like we all know pain kind of leads to avoidance behaviors.
You can interpret that a lot of ways, though.
So when I say we all know that.
What I mean to say is that if I have chronic pain, I might start to limit physicalactivity, but I also might start to limit social interactions.
(51:36):
I want to prevent discomfort overall, right?
So over time, that can result in higher levels of isolation, reduced mobility, evendeconditioning physically or mentally, that basically pain is slowing me down from doing
my life.
The second one is changes in emotional regulation.
Pain will increase stress.
(51:57):
Frustration, irritability can make it difficult to manage emotions effectively.
And then I can adopt other poor coping strategies or maladaptive coping strategies likesubstance abuse, self-medicating, over-reliance, even on prescription meds in cases like
that.
Or I can seek other emotional regulating activities that may not be helpful.
(52:24):
It can reduce cognitive function.
Like when we're in pain,
our pain experience occupies a lot of our brain.
It takes mental resources.
There's a phrase that I learned years and years ago that says pain will eventually becomethe cognitive output of highest priority, which means when pain gets bad enough, you can't
think of anything else.
(52:46):
So when we're in pain, we kind of get this brain fog or pain fog, maybe, right?
It reduces concentration, reduces our decision making capabilities, lowers our problemsolving ability.
And that can really impair our work, our productivity and things like that.
can disrupt our sleep for a fourth connection, creates a really nasty cycle where poorsleep creates more pain, more pain doesn't allow us to sleep well.
(53:11):
Emotional dysregulation can come into play at that point and further alter our behavior.
And then another one is hypervigilance.
Like chronic pain can heighten our nervous system's reactivity, kind of as we talked aboutbefore, making us more sensitive.
to perceived threats, including non-painful stimulus.
(53:32):
So there is a phrase used in the pain science world called non-nosusceptive pain.
And that's kind of what we've been talking around today is that when my nervous systemperceives a threat that's actually not coming from nosusception, but it's perceiving it as
if it were nosusception, that hypervigilance can turn into physical pain experiences quiteeasily.
(53:56):
So those, you want to be aware of them, know that they're possible and that they're justlayers upon layers that happen when we undergo this type of chronic pain adaptation.
I think the cool thing to think about here is because these things are so intertwined, wecan make a difference in some of these other areas by starting to rehabilitate our pain
(54:21):
through sensory input rehabilitation through repatterning our movement, our visual system,our interoceptive system.
Like if I start to work with the pain, this will also trickle out into these other areasof life where you're seeing these outputs and it can be a really
great way to create change in our emotional well-being, right?
(54:41):
We know our pain is closely linked to our mental health.
If we have a lot of chronic pain, we're much more likely to have depression and anxiety orfeelings of helplessness.
And that, of course, diminishes our emotional resilience.
But I can start to work physically at this pain level to start to create some change thererather than having to try to address these issues cognitively, like rather than going
(55:05):
after my anxiety or my depression from a cognitive lens.
And it really impacts our relationships too, because if we are in pain, that again, likeMatt was saying, it leads us to withdraw from social activities, it can also put a real
strain on our relationships because it limits our presence, right?
If we're always thinking about the pain and caught in that pain loop, and it can create arift between ourselves and other people, because they might not understand that experience
(55:33):
like Matt was talking about also.
And so I can also start to make some shifts really
and my ability to be present and show up in relationships differently when I start to workwith this.
And then, of course, there's many other areas of life that our pain impacts that increasesour stress load, like our work or economic stability.
You could even have loss of independence if you're experiencing a lot of chronic pain.
(55:57):
So there's a lot of reasons to start to rehab this that then again, they don't just affectour body physically, but our quality of life, our whole experience of the world.
This has just been such an eye-opening conversation.
I hope that our listeners are really feeling that way too.
And really just kind of coming into the awareness of what pain actually is.
(56:22):
And I just want to leave in some closing thoughts that oftentimes when people do havethese knowledges and awarenesses, they really want to go into change really quickly.
And change is possible.
That's why we work with our nervous system.
know, so much of our behavior, all of our behavior is not random.
Our habits are not random.
This is all at a subconscious level.
(56:42):
And like I was saying at the very beginning, like we've said this many times, is like thisis not happening with any of our control.
And so like a real daily habit of working with your nervous system, making your breathingbetter, making your vision better, improving your balance and your awareness of your body,
where it is in space, the internal sensations and information that's coming from yourbody.
(57:06):
It is really gonna help to give you that space.
that space that you want in a constant day to day to lower your stress load.
And when that stress load is reduced, you have resilience.
You're going to see a decrease in pain and you're gonna have the...
the capacity to adapt positively to the stress that's coming in and learning to slow downand having self-compassion.
(57:33):
These are two really integral parts of rehabbing and rewiring the pain protective output.
So thank you all for joining us today.
If you guys have any closing comments.
Yeah, thank you for having me today.
I just want to reaffirm that pain is an output that is coming from the nervous systemtrying to protect us.
(57:59):
But I want to also give a quick caveat because it's always multifactorial.
It's so tempting when you're in chronic pain and I've been in chronic pain myself, I'veworked with so many clients.
It's so tempting to look for just the one thing.
If I can just get the one thing that's gonna take away the pain, maybe it's thisinjection, maybe it's this treatment, maybe it's this therapy, maybe it's these emotions,
(58:24):
whatever.
Chronic pain is never a single factor problem.
It's always multifactorial.
And this last section that we talked about really illustrates that, it influences all theother parts of our life.
So if you're trying to work through chronic pain or work with other people who are,
Please be aware of the phrase when all you have is a hammer, everything looks like a nail.
(58:50):
Any practitioner who says, here's the one answer that you need, I would be cautious ofbecause there's so many parts of the nervous system from all the stuff Jen talked about,
sensory inputs, interoception, vision, balance, the emotional processing, the sleephygiene, everything that we've been talking about today is part of the rehab and the
(59:13):
adaptation.
It is possible to move out of chronic pain, 100%, I believe that.
But it's a multifactorial journey and it's one baby step at a time of regulating yournervous system and working with your tools and then finding some practitioners who can
help as well.
So hopefully today has created an empowering perspective shift for you as a listener and Ijust wanna thank you guys again for having me back.
(59:42):
Thank you so well said.
It's very true.
Yeah, amazing.
Thanks, y'all, so much.
Let me stop recording.
I'm gonna end the session, but if we leave altogether, let's come back on through the samelink because I wanna say something.
(01:00:03):
I just don't know what's gonna happen right now.
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.