September 29, 2025 • 44 mins
Dr. Navidi is a GI psychologist and on this episode, he discusses the connection between GI disorders and psychology in children. Dr. Navidi explains that many GI issues in children, often fall under disorders of gut-brain interaction. He emphasizes the effectiveness of treatments like clinical hypnosis and cognitive behavioral therapy (CBT) over traditional dietary changes like the FODMAP diet. Dr. Navidi also discusses the potential side effects of restrictive diets and the potential benefit of positive expectancy and mindfulness techniques in managing GI disorders. The episode offers a potential effective treatment for children experiencing chronic stomach pain.
Dr Ali Navidi is a licensed clinical psychologist and the co-founder of GI Psychology, a clinic dedicated to helping children and adults with . His expertise lies in disorders of gut-brain interaction, where he works with children experiencing functional abdominal pain, IBS, constipation, and other GI-related concerns, helping families find safe and effective alternatives to restrictive diets.
You can learn more about his work at www.gipsychology.com
00:00 Introduction and Topic Overview
00:10 Meet Dr. Ali Navidi: GI Psychologist
00:16 Understanding Gut-Brain Interaction
00:47 Tiny Health: At-Home Microbiome Testing
01:30 Starting the Conversation with Dr. Navidi
02:42 Common GI Disorders in Children
03:11 Dr. Navidi's Journey into GI Psychology
05:14 Effective Treatments for GI Disorders
08:16 The Role of Diet in GI Disorders
12:54 The Brain-Gut Axis Explained
15:42 Hypnotherapy and Psychological Tools
19:56 Telehealth and Hypnosis Success
22:12 Challenges in Treating Difficult Patients
22:46 Integrating Hypnosis and CBT
23:23 Understanding Cognitive Behavioral Therapy (CBT)
24:09 Addressing Patient Concerns with CBT
25:47 Meditation and Breathing Techniques
30:03 The Power of Positive Expectancy
35:32 Collaborative Approach in Treatment
36:55 Normalizing Tummy Complaints in Children
40:30 Accessing GI Psychology Services
43:10 Conclusion and Final Thoughts
.
Your Child is Normal is the trusted podcast for parents, pediatricians, and child health experts who want smart, nuanced conversations about raising healthy, resilient kids. Hosted by Dr. Jessica Hochman — a board-certified practicing pediatrician — the show combines evidence-based medicine, expert interviews, and real-world parenting advice to help listeners navigate everything from sleep struggles to mental health, nutrition, screen time, and more.
Follow Dr Jessica Hochman:
Instagram: @AskDrJessica and Tiktok @askdrjessica
YouTube channel: Ask Dr Jessica
If you are interested in placing an ad on Your Child Is Normal click here or fill out our interest form.
-For a plant-based, USDA Organic certified vitamin supplement, check out : Llama Naturals Vitamin and use discount code: DRJESSICA20
-To test your child's microbiome and get recommendations, check out:
Tiny Health using code: DRJESSICA
The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditi...
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Unknown (00:00):
Hello listeners. This is Dr Jessica Hochman. I'm
(00:02):
excited to share that I am nowbooking sponsorships for your
child as normal for this fall.
If you have a product, serviceor a message that you think our
listeners would benefit from,whether it's for parents, kids,
healthcare or family life ingeneral, this could be a great
opportunity. You can finddetails on how to sponsor by
checking the show notes. Justclick the link that says how to
sponsor an episode, and I'll letyou know for a good match and
get back to you.
(00:31):
Hi everyone, and welcome back toyour child is normal. I'm your
host. Dr Jessica Hochman, todaywe're talking about something
that I see all the time inpediatrics, stomach aches and
digestive issues in kids. Myguest is Dr Ali navidi. He's a
GI psychologist who specializesin the connection between the
brain and the gut. He explainshow many children's stomach
problems fall under disorders ofgut brain interaction, and why
(00:53):
psychological therapies likehypnosis, Cognitive Behavioral
Therapy or CBT and mindfulnesscan also be effective tools. I
really enjoyed this conversationwith Dr navidi. His optimism and
guidance bring hope to an areaof health that can feel so
frustrating for families, andI'm so excited to share his
insights with you. And also,before we get started, if you
could take a moment and leave afive star review for your child
(01:14):
as normal wherever it is youlisten to podcasts, I would be
so appreciative. I want to takea moment to tell you about tiny
health. Tiny health is the firstand only at home microbiome test
designed specifically for kids.
So as a pediatrician, I'm oftenasked, Should I give my child
probiotics? And if so, whichone? And the truth is,
everyone's microbiome is unique.
So without testing, it's nearlyimpossible to know what your
(01:36):
child may actually need. Sothat's where tiny health comes
in. Their Easy at Home testgives you a clear snapshot of
your child's gut microbiome, andyou'll get back personalized
science based recommendations.
The results help you knowexactly what supports may be
helpful, and sometimes you'llfind that your child doesn't
need anything at all to try tinyhealth for your family, go to
tinyhealth.com and use the codeDr, Jessica, D, R, J, E, S, S,
(01:57):
I, C, A, for an exclusivediscount.
Dr navidi, welcome to your childis normal. Thank you so much for
being here. Oh, my pleasure. I'mreally looking forward to it.
Thank you. I'm so excited to getinto the work that you do,
because I have to tell you,every day I am talking to people
that have tummy troubles that Ibelieve are related to their
(02:19):
psychology. So I think the workthat you're doing is really
important. Thank you. And one ofthe things I guess, right off
the bat, once a pediatricianlike yourself has ruled out all
those red flags, those tummytroubles, are very treatable,
there's tons of research, andthe effectiveness of those
treatments is really high. SoI'm really excited to talk more
(02:41):
about that, because I think it'simportant for parents to know I
love that you say it'streatable, because I think
that's what's really difficultwhen parents hear that, the red
flags have been ruled out thatthere's no real bad illness
going on when it relates to thestomach, but a lot of parents
feel at a loss. They're not surehow to make their kid feel
(03:02):
better. So I'm so happy that youhave an optimistic perspective
on this absolutely and hey,don't take my word for it.
There's been research over thelast 40 years looking at the
types of treatments that we do.
These types of Gi disorders fallinto a larger category called
disorders of gut braininteraction, and that includes
things like irritable bowelsyndrome, that includes
(03:26):
functional abdominal pain, thatincludes functional dyspepsia or
nausea. There's about 20different disorders of gut brain
interaction. They're verycommon. A lot of kids will
develop them at some point intheir life, and they're also
very treatable. And I'm justcurious, how did you get into
this field? Can you tell us alittle bit about your
(03:47):
background? How did youspecialize in GI psychology? I'd
love to tell you I had, like,this amazing master plan, and
that this is what I was going todo, but I got into psychology,
and one of the tools I reallylove is clinical hypnosis. And
at the time, I wasn't aware thatit had been studied for a really
(04:09):
long time in terms of helpingpatients with GI problems. I
only discovered that later, andthen once, I started using
clinical hypnosis and cognitivebehavioral therapy in
conjunction with each other tohelp these gi patients. Then I
started getting more gipatients, and then the pediatric
gastroenterologist in the areadiscovered me. They started
(04:32):
referring more patients, andthey told other doctors, and
then before I knew it, it waspretty much like 80% of my
caseload, because it turns outthere are very few people that
are trained to see kids, alsotrained in clinical hypnosis,
also trained in working with GI.
(04:53):
So if you put all those threethings together, that's why I
started the bigger practicecalled Gi.
Psychology, I can see whydoctors would love to refer to
you, because if you're a primarycare physician and you only have
so much time per visit, andyou've ruled out things that we
can help in our medical toolbox,it's always very reassuring for
(05:14):
me to have someone to refer to,to know that with confidence
that they're going to getbetter. And what I would see,
especially early on, is parentswould get that diagnosis for
their child, but there reallywouldn't be options for them.
And so then they would go andget a second opinion and a third
opinion, and they'd get moretests, and they'd get scoped,
and they'd do the medical merrygo round for a year, two years,
(05:39):
and then they'd finally findtheir way to see me, and I
thought that was really sad,because these treatments
actually don't take that long.
On average, it's kind of likeeight to 12 sessions to help
somebody and kids respond betterthan adults. So about 70% of
adults will reach theirtreatment goals. About 80% of
kids are gonna reach theirtreatment goals. When you first
(06:01):
described the typical diagnosesthat you can help with, you
mentioned IBS or irritable bowelsyndrome, you mentioned
functional dyspepsia. Can youdescribe the symptoms to people
listening so that they mightrealize that their child may fit
into one of these categories?
Will you point out some of thesymptoms to think about. Yeah,
(06:22):
absolutely. So let's sayfunctional abdominal pain is a
super common one, and it's verystraightforward. It's abdominal
pain, pain in their stomach thatwhen you get checked out, they
can't find any structuralreason. There's no physical
problem that they can find, andthey're just frequently having
this pain, and it's not goingaway. After a week or a month,
(06:46):
they're still having it.
Irritable bowel syndrome iswhere you've got pain and then
you also have eitherconstipation or diarrhea or
both, in which they're kind ofcycling in between each other.
Functional dyspepsia is moreupper GI and so you get a lot
more of bloating, and sometimesthere's loss of appetite also,
(07:07):
which can be also scary forpatients, because their kids
might not be eating as much, andthat's always very scary. Do you
find that for a good percentageof the kids that you treat, they
also have more anxiety than youmight expect from the average
child? That's a great question.
Yes. So there's four conditionsthat kind of go along with these
(07:30):
types of Gi problems, kids withanxiety. So if they've already
gotten anxiety disorder, orthey're already anxious, they're
more likely to get one of thesegi disorders. Kids with a
history of trauma also are muchmore likely to have these kinds
of disorders. Kids that are onthe autism spectrum are also
(07:51):
much more likely to have theseand then finally, any kid that
has or has had an eatingdisorder is also very likely to
have one of these disorders ofgut, brain interaction. What I
so appreciate hearing from youis your optimistic perspective
that these conditions aretreatable, because I find
there's a lot of parents thatare very frustrated. They go to
(08:12):
the doctor, the doctor's ruledout run of the mill,
constipation, thankfully,there's no IBD, there's no
infection going on, and still,these tummy troubles persist,
and they may get the diagnosisof IBS or irritable bowel
syndrome, and parents andchildren feel frustrated because
they think there's no greatsolution. So my question to you
(08:33):
is, can you paint a picture forparents? Can you let parents
know if you suspect a gut brainproblem? What would be some
sample recommendations that youwould have for a family? Yeah,
so of course, they're gonna getmedically checked and rule out
anything red flag. Once you knowdr Hochman has given you that
diagnosis, then I think a lot ofpeople start looking at diet,
(08:58):
and I would not start there, andparadoxically, like, that's what
people think it's like, okay,stomach problems, let's look at
what they're eating. Maybethey're sensitive to something.
Maybe they're allergic veryinfrequently. Is that the case,
there are specialized diets tohelp with these kinds of
disorders. One of those diets iscalled the FODMAP diet.
(09:21):
I am very hesitant to start akid on a very strict diet,
because that just seems, look,adults can barely do strict
diets, and then they're veryhard diets to stand so that
would be something I might trylater. And that's so interesting
that you say that, because Iwill tell you that most gi
(09:42):
doctors or gastroenterologiststhat I talk to, I do believe
that's the first place that theystart. Yeah, you recommend the
FODMAP diet. There's some appsthat give parents direction on
what foods to avoid. But what Ifind is tricky with that. As you
mentioned, there's so many foodson that list, and part of me
wonders, okay.
If this was an easy fix, great.
Let's say a child finds outokay, when they have garlic and
(10:03):
broccoli, their stomach isupset. Okay, we can avoid these
foods, but it ends up being areally long list. I find it
typically there's not a clearcut solution, and then there's a
lot of uncertainty with how longthey're supposed to stay off of
these foods? Is it for a coupleof months? Is it for years?
There's not a lot of directionas to when to add those foods
(10:24):
back in. So I agree with yourpoint that this is a tempting
direction to go in if I couldchoose another place to start
and feel like the child mayimprove with symptoms, that
sounds like an easier place tobegin. Let's talk about the
FODMAP diet. One is you're notdealing with the underlying
problem. The underlying problemisn't that these foods are bad
(10:46):
for this child. The FODMAP foodswere chosen because they're the
foods most likely to cause gas,and when the system is
sensitized, then gas is going tobe causing discomfort. So the
idea is, if you remove the foodsthat are causing gas for this
person, there's going to be lessdisturbance in the system, and
(11:09):
it's going to bother them less.
But the underlying problem isthat the nervous system is
sensitized, and if you candesensitize the system. You can
eat all those FODMAP foods.
There's nothing wrong with them.
And then the other issue is whenyou take anxious kids and you
(11:31):
put them on a diet and you tellthem, Okay, stay away from all
these foods, because they'regoing to cause pain, they are
very likely to develop an eatingdisorder, specifically one
called arfid. So that'savoidant, restrictive food
intake disorder, and that's avery common disorder that we see
in many of our patients thathave these gi conditions,
(11:54):
they've also developed arfid,meaning their list of foods that
they're willing to eat is likeyou could fit it on a page. So
if I hear what you're sayingcorrectly, it's that if you find
certain foods that do cause moregas in the system, and you
remove them from the diet, youtake out dairy, you take out the
cruciferous vegetables, theyfeel better temporarily, but
you're not really getting to theroot of the issue. And then in
(12:16):
turn, by taking out these foodsand making a more restrictive
diet on a kid who may be on themore anxious side to begin with,
you may inadvertently make theiranxiety even worse, yeah, which
may make their symptoms in thelong term, not better, yeah, and
they're going to start applyingthat anxiety to the foods, which
is not a place you want them tobe okay. So that's a really
(12:38):
interesting perspective, and Ihave to admit, not one that I
typically hear, but it resonateswith me. Yeah, I'm not saying
there's a place for those diets.
I think if you've got a reallysevere case, maybe you're doing
both. You're working with a GIpsychologist, you're on the
diet, the diet is decreasingsymptoms while you're working on
the underlying effort todesensitize the system, and then
(13:00):
as you desensitize the system,you start adding food back.
Okay, I appreciate this a lot,because honestly, this
conversation is changing the wayI'm thinking about approaching
IBS, and it makes sense to me.
So now I'm curious the toolsthat you recommend for kids with
brain, gut, psychologicdisturbances. Can you explain
(13:23):
the rationale behind the toolsthat you're recommending? Right?
So basically, we want tounderstand three major things.
One is that there's a powerfulconnection between the brain and
the gut. It's called the braingut axis. It's the intersection
between the central nervoussystem and the enteric nervous
system. It's how they interactwith each other. And what that
(13:43):
means is that what happens inthe brain really does affect the
gut powerfully, and then whathappens in the gut can also
actually affect the brain. Butwhat we're talking about here is
more brain down. And so what'sgoing on in the brain that is
going to affect the gut? Well,one of those things is hyper
vigilance. And when you look atthese patients, almost every
(14:06):
single one of them is going tobe hyper vigilant. That means
it's kind of like this anxiety,where they're always scanning,
always checking their body, andif it's a GI issue, they're
always scanning their gut. Theywake up in the morning, how does
my stomach feel? You know, theyeat something. How am I feeling?
I'm not sure. And then if theynotice something off, then
(14:28):
they're catastrophizing. Thenit's like, oh my god, I'm not
going to make it. I can't go toschool today, soccer practice.
No, I can't do it. I don't wantto go for that long car ride,
right? And and so they're reallyscaring themselves and all that
anxiety, it goes right down thatbrain gut axis, and it actually
makes the symptoms worse. Sothey might have started off with
(14:50):
a little twinge, but now there'sa cramp. Now there's a pain
right the feedback from the gutback up to the brain goes.
Through something calledvisceral hypersensitivity. And
what that is, is that the brainis actually amplifying and
distorting the signal. And soI'll give you an example. A lot
(15:10):
of my patients, they'll say,after I eat, my stomach hurts.
And then after they'veprogressed through treatment,
then they're they're saying tome, oh, after I eat, I realized
that those are just thesensations of my stomach
digesting, and their brain wasmisinterpreting it, amplifying
(15:32):
and distorting it into pain. AndI think that's something that
people who've never dealt withthese kinds of problems before,
they don't really appreciate thepower of the brain to transform
signals. The brain can getthings wrong. The brain can
signal false alarms, and that'sa big part of these problems, is
(15:54):
that the brain is chronicallysending a false alarm. You know,
recently I had on my podcast.
Lynn Lyons, she has a wonderfulpodcast for parents who have
kids with anxiety. It's calledfluster klux, and she wrote a
book about hypnotherapy she wason just a few weeks ago. If
anyone's listening who hasn'tchecked it out yet, I would
definitely check it out. But shewas talking about how the basis
(16:15):
behind hypnotherapy isessentially delivering a
different message to patientsthan they were otherwise telling
themselves. So it sounds like inthis case, if you can deliver
that message to children, thatthese feelings that you're
having, these are normalsymptoms. This is just your body
doing what it's supposed to bedoing. It's digesting your food.
(16:37):
Would that be an example of howyou're delivering hypnotherapy
to children? Absolutely, yes.
How that message gets deliveredis the art and science of
hypnotherapy, right? Do we do itthrough stories? Do we do it
through images? Do we do itthrough words? And how do we do
that? That's why we train somuch. But essentially, the
(17:01):
message is your stomach is safe,your stomach is healthy. The
signals you're getting areuncomfortable, but they're fine.
It doesn't mean there's danger.
I wouldn't necessarily directlysay that, but that's what we're
conveying to them in variousways. It's so true that the
brain feeds the gut, and the gutsends signals back to the brain.
(17:24):
I think probably anybodylistening can think of a time
when they got butterflies intheir stomach before having a
nerve wracking conversation withsomebody, maybe some GI upset,
before taking a big exam incollege. I think it's very
common to think of how the brainaffects your stomach. It's
interesting, because I think weall kind of know that, and we
(17:45):
had many experiences of it. Butwhen it comes to these problems,
it seems like peopleautomatically go to the food, or
they go to I need some kind ofmedication. And I'm not saying
there isn't a place formedication, but in terms of
research, it's not nearly aseffective as the treatments that
(18:06):
we're talking about for thesetypes of Gi problem.
Interesting. And along the linesof food and medication,
probiotics often getrecommended, and peppermint oil
often gets recommended. Is thatsomething that you also
recommend? Or what are yourfeelings on those
recommendations? I mean,peppermint oil. I think there's
some research showing it can behelpful. I don't know if it's
(18:29):
super effective, but I thinkthat at least there's some, I
think, in terms of probiotics,that's a very complicated area.
And then we're dealing withanother area that can be tricky,
something called SIBO, smallintestine bacterial overgrowth.
And essentially, there isn'tsupposed to be a ton of bacteria
(18:50):
in the small intestines. Andthen if they find that there is
that can also cause similartypes of Gi problems. And so
that's usually something thatprobably should get looked at,
especially if you've got thesechronic gi problems.
(19:10):
Do you Do you have a lot ofpatients where there are mixed
diagnoses, for example, I have afair number of patients who have
celiac, for example, or lactoseintolerance, and they also have
some elements of brain gutdistress. Yeah, it's very
common. And the reason it'scommon when you're talking about
celiac or you're talking aboutinflammatory bowel disease
(19:31):
patients, is because anytime yougo through gi trauma, you're
more likely to develop a braingut problem. I think of it
almost as like PTSD of the gut,right? So let's say you've got
celiac, and you've spent yearseating foods that are causing
real problems in your gut, andyou just don't know it. Your kid
(19:51):
doesn't know it, your parentsdon't know it, but they've,
they've had all this pain anddiscomfort, and then suddenly
you figure it out, and yourestrict gluten. You.
Yeah, but there's still giproblems, but it's because all
of that trauma in the past hascreated this hyper vigilant
system where probably thatvisceral hypersensitivity is
(20:13):
happening also. So the idea ofhypnosis sounds really appealing
to me. I love medicalinterventions where there's
really no side effect that I canthink of, and potentially a big
upside. So for people that arelistening, can people use your
services? Yeah, so I gotfrustrated, and then five years
ago, started this biggerpractice, and we knew that this
(20:35):
is such a rare specialty that wewanted to make ourselves
available to people. So we'veworked really hard making all
the jigsaw puzzle of all thelicenses work so that we can see
patients in all 50 states,right? And we see them by
telehealth. And then the nextquestion a lot of people ask is,
Does hypnosis work bytelehealth? And it actually
(20:59):
works great. And they've donesome studies, and they find
hypnosis is also effective. Andalso anecdotally, do you find
yourself success with yourpatients? Oh, that's the reason
I love doing this work so much.
It's actually not terribly hardto treat these gi disorders
versus give me a functionalabdominal pain disorder any day
(21:20):
over, let's say, like a reallysevere generalized anxiety
that's going to take time, youknow, that's going to take a lot
of ups and downs in treatment,but a functional abdominal pain
and IBS, they respond fairlyquickly. And kids respond even
better than adults, because theyhaven't had the problems for as
(21:41):
long, and their minds are moreflexible, so they're often
seeing benefits after the fourthor fifth session, so a ton of
success, and also, just as atherapist, it also opens the
door for helping patients withother issues they might have,
because after you've helped themwith their GI disorder, there's
a lot of trust, there's a lot oftherapeutic momentum, and so you
(22:03):
can help them with their anxietyor their phobia, or talking
about someone the other daywho's got a really severe Wasp
phobia, and doesn't sound like abig deal, but if you live in an
area where there's bees andwasps, they don't like to go
outside, right? And so after youhelp them with their stomach,
you can also help them with thattoo. I love it. I love that you
(22:25):
say that you look forward andwant to treat kids with
functional abdominal pain,because I do honestly think a
lot of doctors don't want totreat those patients, because in
their minds and theirexperience, it's hard to see
them get better. So I'm reallyhappy too that someone like you
exist because just nice to havehope for families. And there's
so many people out there thatneed it, and that's the thing,
(22:45):
these are very difficultpatients. If you're not aiming
at the right parts of theproblem, and when you are,
they're not hard to treat atall. They respond really well.
And I like to joke that the oneside effect of learning how to
use clinical hypnosis is thatthey have a skill in terms of
self hypnosis that they can useto calm themselves down for the
(23:09):
rest of their life. And hearingyou talk so passionately about
hypnosis is that your favoritefirst go to for treating these
types of patients. Our model isto integrate so to kind of
simplify it, let's say we'reusing the clinical hypnosis to
help calm them down and reducethe visceral hypersensitivity
(23:30):
that distortion of thesensations, and then we're using
a special form of cognitiveBehavioral therapy to address
the hyper vigilance and thecatastrophizing, and then we're
also treating all the avoidancethat often comes with a lot of
these patients. So they'reavoiding situations, they're
avoiding foods. They have fearof their own body, essentially.
(23:54):
And can you explain for peoplewho may not be aware, what is
Cognitive Behavioral Therapy orCBT therapy. Yeah, cognitive
behavioral therapy is the ideathat what you think affects how
you feel, and that affects whatyou do and how you act, and any
one of those areas can betargets of intervention. So you
(24:16):
could work on helping them shifttheir emotions, and that's gonna
help change how they'rethinking. You can help them
learn to change how they'rethinking, and that'll influence
their emotions. You can helpthem change how they act. You
know what I mean, and socognitive behavioral therapy is
a collection of tools to helppatients make changes in those
three variables. So I thinksometimes it helps to paint a
(24:39):
picture with an example. What ifI come to you and I say, Dr
navidi, my stomach really hurts.
I noticed that my stomach alwayshurts right before I have a big
event. I'm starting college nextweek. How would you talk to a
patient like that? Yeah. So ifwe're going on the hypnosis
side, that would be one thing.
If we're going on the cognitivebehavioral therapy side.
(25:00):
So a lot of times, people justaren't aware of their thoughts.
Their thoughts are happeningreally fast, and what they
become aware of is that whenthey think of school, they feel
nervous, right? And they'remissing that piece of like, what
precisely are the thoughts? Andso maybe the thought is, you
know, I'm gonna have to go tothe bathroom in the middle of
(25:22):
the day, and I'm just gonna bereally embarrassing, and people
are gonna hear me making noisesin the bathroom, and then
they're gonna make fun of me,right? Like there's this whole
train of thoughts. And so nowimmediately, when they think of
school, they're thinking of allthat stuff super fast, and then
they're feeling anxious, andthen their stomach hurts worse.
(25:42):
And then they try to basicallystart talking themselves out of
going to school that day, right?
And then we start buildingawareness of that pattern, and
then giving them tools to shiftthose thoughts, to change the
way they're thinking, to thinkabout it in a more kind of
logical, clear way that isn'tblowing the problem up. It isn't
catastrophizing. I have a goodfriend who had a lot of
(26:06):
difficulty with IBS, a lot ofstomach discomfort, especially
around particular foods, and he,I'm happy to say, is now cured
of his IBS, and he creditsmeditation to helping his
symptoms. Have you ever triedimplementing techniques like
breathing exercises, meditation,mindfulness techniques to help
patients with their symptoms?
(26:27):
Absolutely, it's wonderful. Oneof the first skills we teach is
usually something very simple,like diaphragmatic breathing.
And I think if we're talking toall the parents out there and
they've got a kid who has someof these GI issues, a really
nice thing they can do withouteven having to come to somebody
like myself, is if you go toYouTube, there's a lot of good
(26:50):
videos for kids on how to dodiaphragmatic breathing. So
basically, it's a special way ofbreathing that activates the
vagus nerve, which then sendsyou into rest and digest mode in
terms of your nervous system.
And it's a very valuable skill,and pretty much, I think every
human should know how to dodiaphragmatic breathing. I'm
doing it right now. I'm puttingmy hands on my stomach and I'm
(27:12):
taking some deep breaths. Yeah,we put your hand on your stomach
sometimes, if you're justlearning, you put it on your
chest because you want to makesure your chest isn't moving a
lot, right, and if it is moving,then you want to shift it more
to your stomach, to yourdiaphragm, and then you just
kind of breathe in and out at anice, slow pace. And another
thing a lot of times people getwrong about diaphragmatic
(27:32):
breathing is that when theythink deep breathing, they think
a lot of air, and that's notwhat we want, because that's
when we get peoplehyperventilating, and they start
to feel a little dizzy, and theyfeel a little weird, and it's
not going to help them, right?
So we want, like, nice and slow,but we don't want to be taking
(27:53):
in a ton of air. And do yourecommend doing breathing like
this, symptoms or just sort ofhabitually as part of your
everyday routine, but all of theabove. Yeah, so you want to
start by training yourself to doit in a low stress time. So do
it when you don't have symptoms,and you start to get good at it
(28:14):
once you can reliably calmyourself down doing it, then
start using it during thosetimes when you have symptoms. I
find this such helpful advice,because you can do this
anywhere, anywhere you are. Youcan stop and take some breaths,
and if that works to calm youdown and help you feel better.
What a great tool. Yeah, andI'll give a little bonus. If you
(28:35):
go and do this with your kid,what you can teach them to do is
do something called an anchor.
So an anchor is, if youremember, in school, they taught
you about Pavlov and the dogs,it's like ringing the bell. They
start drooling. This is asimilar concept, but you're
linking some gesture or somemovement to relaxing. So what
you do is, every time you'regoing to practice your
(28:59):
diaphragmatic breathing. Let'ssay you make a fist like this,
and then you do your breathing,and you calm down. And then you
make a fist, you do yourbreathing, you calm down over
and over. Eventually, the brainlearns whenever you make the
fist, you're gonna calm down, sothat then you make the fist, and
you calm down without even doingthe breathing. What a great
tool. I think it's very helpfulto hear that there are many
(29:22):
options to consider, becausewhile one thing might not work
great for somebody, a differenttool may work better for
somebody else. So it's just niceto have a lot of options in the
toolkit, so to speak. Yeah, soit's like cognitive behavioral
therapy. A lot of doctors willhear that CBT is helpful. So
we'll say, Okay, go see yourlocal CBT, your cognitive
(29:42):
behavioral therapist in yourarea, and they're gonna treat
anxiety and they'll treatdepression. But there's a
specific way of using CBT totreat GI and most people aren't
trained to do that, so a lot oftimes.
Patients will come to us andthey'll say, Oh, we already
tried CBT. It didn't help. Andwe'll say, Well, maybe you
(30:06):
didn't try it like this, andthere's a specific way to kind
of apply it. So that being said,meditation also is a wonderful
tool. So you could say, CBT,meditation, clinical hypnosis.
It's an amazing toolkit, becausesome people might do better with
CBT. Other people respond betterto meditation. Other people for
(30:29):
them, clinical hypnosis is likethe thing, right? And so you
have different tools fordifferent folks. I've been
looking into your work, and Ilove that you stress the power
of positive expectancy, that ifthe mind is trained to think
positively, that our symptomswill follow suit and that things
will improve. Can you talk moreabout that? Because that that
(30:52):
way of thinking really resonateswith me. I think that a lot of
people, they just underestimatethe power of the mind. I find
that this way of thinking isreally powerful and has a lot of
potential to work. And I pointthis out because I have a lot of
people in my life that do theopposite. They try to think in
the negative. Because I thinkthey do it as a protective
(31:13):
mechanism, that if they thinkthrough the worst possible
outcomes, well, then ifsomething better than that
happens, they won't be sodisappointed in that. And
psychologically they think thatmakes them feel better in the
end. But I think the opposite.
If I really think the best thingis gonna happen, and I look for
the best things, those goodthings tend to happen, if that
makes sense, 100% and this iskind of a side, but I can
(31:36):
remember looking back at somejournal entries I had written,
and at one point I wrote, I wantto have my own private practice,
and that was years before I everwas close to doing that. And
then, oh, I want to have thisbigger group practice that
really helps people. Like it wasin my head, and I think I
probably forgot that I wrote it,but I think so all those people
(31:59):
in your life that do theopposite, I've got some advice
for them, and they don't have tostop doing all their negative
thinking. I just want to tweakit just a little, right? So you
can say, Okay, you're thinkingabout doing X or Y. Have all
your negative thoughts, and thenpause and think about the best
(32:21):
version of you, how you wouldhandle it if those negative
things happened. Then go on tothink about what would happen if
the best outcome occurred. I seeso let's say my worry is I have
stomach upset and I worry thatI'm gonna go to the bathroom at
(32:41):
school. Someone's gonna hear me,someone's gonna make fun of me.
If that were to happen, could Ihandle next master fire
scenario? And the answer is yes.
I think we all could play outthe worst case scenario and work
through it some way or another,and imagine your best self
walking out of that bathroomlooking at and say, Hey, some
days you have a bad day, andthen just keep on going, right.
(33:05):
But then also imagine you go toschool, and maybe you don't need
to go the bathroom, and you havea good time, and you chill out
with your friends, and then yougo home. Right? People are so
uneven in the way they thinkabout things, and they don't
even realize it. They thinkthey're being accurate, because
I've thought of all the worstthings, but have you really been
(33:29):
accurate? Because you haven'tthought of the good things and
you haven't thought through howyou would handle it if those bad
things happen, their thinkingjust stops at the worst part of
their imagination and doesn't goany further, yes, and I think,
you know the line, you fake ittill you make it, or you just
keep smiling through the thing,even if it's hard, and then
(33:51):
eventually you'll feel better. Ithink that's really true in a
lot of situations. So if you'resomebody listening and someone
in your family does have a lotof psychological gi
disturbances. Why not try totrain the brain to think that
even though it's hard right now,things are going to improve, you
will heal yourself. Why not? Youhave nothing to lose? Yeah, you
(34:11):
have nothing to lose. Andactually, that's probably a more
accurate view, based on all theresearch that we've done, is
that if you can begin to changethe way you think, about your
gut, about the pain, if you canbegin to shift your mindset,
you're very likely to get overit. And you know the issue is a
(34:35):
lot of times people have a lotof trouble doing it themselves,
so if they can't pull it offthemselves. There's people out
there who have spent their liveslearning how to help other
people do this. But like yousaid, meditation amazing tool.
There are great books oncognitive behavioral therapy for
kids. There's little workbooksyou can go and use that. There's
(34:57):
apps for hypnosis. There's lotsof things.
Things that you can try, and ifyou can't manage to do it
yourself, there's other peopleto help you.
I think your approach, whatyou're describing, it sounds
like there's very littledownside, and only a potential
big upside, and best casescenario, a big upside. So I
think that the work you're doingmakes a lot of sense to me.
(35:18):
Well, thank you. Yeah, and thebonus for me is it's it's very
satisfying to do this work. Ihad a 13 year old come and see
me the other day, and obviously,not going into details, there
was a lot of functionalabdominal pain, and we were able
to help him essentially get ridof that within two sessions, and
(35:42):
it was pain that was starting toseverely affect his life,
meaning weight loss, avoidingsituations, all kinds of
secondary problems coming fromit. And in just two sessions,
he's feeling better, like,what's better than that? Right
in terms of therapy? Oh, to feellike you're helping somebody and
you're making a meaningfuldifference. Nothing better. I
(36:04):
agree exactly. And I'm justcurious, as a clinical
psychologist, do you ever worrythat you're potentially missing
a medical diagnosis if a childisn't getting better? For
example, yeah, I think that'ssomething that's going through
our minds. We actually justtalking about this issue in our
case, consultation meetingearlier today. That's why we
(36:26):
make it a practice to get incontact with the doctors we want
to start out treatment, justchecking in and saying, Hey,
this is who we are. This is whatwe're doing. This is our plan.
Is there anything medically youthink we should know, right?
Because that's not ourexpertise, right? We rely on
you. And then if we're runninginto trouble, we want to check
(36:48):
in again. And then also,usually, at the end of
treatment, we want to let youknow how things went. I love
that you use a collaborativeapproach. I think that's a great
way to go. And I have to tellyou, it's so nice to meet
somebody who's so optimistic.
This is an optimism based onexperience. I have seen so many
kids come in with their lifekind of falling apart, not you
(37:08):
know, often essentiallyhomeschooled, not able to get to
school, not able to do thingsand to see them get better and
better pretty quickly, just overand over, seeing that happen
over the years. So this iscoming from just seeing so many
kids get better, amazing. And sothis podcast is called, your
(37:29):
child is normal. So just as afun question, or just as a
thought, are there any normaltummy complaints that you hear
from parents that you wishparents stopped worrying about,
yeah, I think to certain extent,especially when the parent can
see that there's a clearstressor, right? You know,
there's something going on atschool and their their tummy
(37:50):
hurts. I think that would be avery normal tummy complaint. And
I think what you want to do atthat point is reassure them and
explain to them in ageappropriate language. Hey,
sometimes when we're worriedhere, our tummy gets worried
also, and it starts hurting,right? And maybe we don't need
(38:14):
to be so scared about whateverit is because and then start
talking to them about the issuethat's scaring them, right? I
love that advice. It's so true.
Reassuring kids can go a longway. Hey, I see that your
stomach hurts. I get it. Thinkabout it. You're starting
school. It's a big deal. That'sa big transition, but once you
(38:34):
get into the routine, let's seehow things go, because I'll bet
your stomach will start to feelbetter. Because I think
sometimes parents will notknowing better, they'll get
really anxious about thestomach, and they'll kind of
transmit that anxiety andreinforce the kids anxiety.
Googling things, they findthings they're catastrophizing.
(38:55):
They can't help it, but theyleak it to their kids, and then
all of a sudden, everybody'sspiraling and worrying. So I
think that's a really, reallyhelpful piece of advice, that if
there's an explanation for thetummy upset, instead of
worrying, along with your kid,offer a reassuring, supportive
voice that this is normal. Whatis that medical saying? If you
hear hoof beats, think horses,not zebras. That I love that,
(39:21):
saying, I agree with that,saying, you want to look for
horses, not zebras, absolutely,yeah. And so you know your kid,
you know it's Sunday night orit's Monday morning and school's
restarting, and probably knowthey're anxious, and if they're
talking about their stomachhurting, it's probably a horse.
(39:42):
It's probably not a zebra. It'sprobably a brain, gut, stomach
ache, and I'm curious for you.
Dr navidi, if you are feelinganxious, what is your favorite
go to calming ritual foryourself? Do you listen to
music? Do you use hypnosis? Whatis your go to?
Relaxation. I used, I usehypnosis, and I've done exactly
(40:04):
what I was telling you about. SoI have created an anchor over
the years. And so right beforethis podcast, I was like, Oh, I
hope I do well. And then I waslike, Oh, I'm feeling a little
jittery. Let me calm down. So Idid my fist. I took a nice deep
breath, I did my fist, and thenI released it, and I just said,
(40:25):
Relax and and I did, and Irelaxed. And it happened because
I trained my brain that that wasthe cue, and it knew exactly
what to do. It knew exactly howto relax. That says a lot that
you practice what you preach,who wouldn't want a way to kind
of de stress within like lessthan 30 seconds. I'm biased, of
(40:50):
course, but I think all humansshould learn at least that
skill, which is to have a reallyreliable anchor to calm
themselves down. Yeah, Icouldn't agree with you more.
Now tell everybody, where canthey find you so they've
listened to you talk they'reconvinced they want to bring
their child to talk to you oruse your services. Remind
everybody your website, anyother resources that can steer
(41:13):
parents in your direction? Yeah.
So the website isgipsychology.com
and we offer a free phoneconsultation, and that's someone
who's clinically trained, whowill answer all your questions,
who will help you figure out ifthis is the right treatment for
you or your or your child. And Iencourage you, because there's
(41:37):
nothing to lose by just doingone of those phone consultations
and just seeing if it's rightfor you. And I'm just curious. I
find that a lot of parentswonder this question, but do you
take insurance, or is thisservice outside of insurance? So
we're out of network and butit's not as bad as you might
think, because there's twothings that actually make it a
(41:58):
lot better. The first is it'sreimbursable, so the parents pay
for the session. They get asuper bill, and they could
submit to their insurance andit's reimbursed, just like
mental health. And so we found,on average, they get about 50%
back. But there's also somethingcalled a single case agreement,
(42:20):
and that's something with aninsurance company, because we're
such a rare specialty, we helpthe parents do this. You're
submitting to the insurance andyou're saying, hey, insurance
company, do you have a gut braintherapist in network for me to
see? And the answer is alwaysno. And so about 90% of people
(42:42):
who apply for these things getthem approved. So yes, we're out
of network, but it's actuallynot as bad as you might think,
if you kind of go through thisprocess, and we help them go
through the process. I love thatyou work to make things more
affordable for families, and Ireally appreciate that gi
psychology offers virtual careacross the United States. What a
wonderful service. So thank youvery much. I'm really proud of
(43:04):
the work that you've done. Ohwell, thank you so much, and it
was a pleasure talking with you,and you're really helping us in
our mission. Our mission isreally to get the word out,
because I think there's so manypeople whose kids will go
through a very long time ofbouncing around treatments and
getting treatment by Dr Googlewhen there's actually a
(43:26):
treatment out there that's goingto work for them, but they just
don't know about it. I'm sohappy to help get the word out.
So I wish you more continuedsuccess, more growth, and
hopefully you'll write a booksoon. I think that would be good
too. Well. Thank you so much. Itwas really a pleasure talking
with you. Likewise. Thank you somuch. Thank you so much for
listening to your child asnormal. I'm so grateful you're
(43:47):
here and part of this community.
If you're enjoying this podcast,it would mean the world if you
shared an episode with a friendsubscribed and left a five star
review. And don't forget tofollow me on Instagram at ask Dr
Jessica for parenting tips andupdates. See you next Monday.
You.
Hello listeners. This is Dr Jessica Hochman. I'm
(00:02):
excited to share that I am nowbooking sponsorships for your
child as normal for this fall.
If you have a product, serviceor a message that you think our
listeners would benefit from,whether it's for parents, kids,
healthcare or family life ingeneral, this could be a great
opportunity. You can finddetails on how to sponsor by
checking the show notes. Justclick the link that says how to
sponsor an episode, and I'll letyou know for a good match and
get back to you.
(00:31):
Hi everyone, and welcome back toyour child is normal. I'm your
host. Dr Jessica Hochman, todaywe're talking about something
that I see all the time inpediatrics, stomach aches and
digestive issues in kids. Myguest is Dr Ali navidi. He's a
GI psychologist who specializesin the connection between the
brain and the gut. He explainshow many children's stomach
problems fall under disorders ofgut brain interaction, and why
(00:53):
psychological therapies likehypnosis, Cognitive Behavioral
Therapy or CBT and mindfulnesscan also be effective tools. I
really enjoyed this conversationwith Dr navidi. His optimism and
guidance bring hope to an areaof health that can feel so
frustrating for families, andI'm so excited to share his
insights with you. And also,before we get started, if you
could take a moment and leave afive star review for your child
(01:14):
as normal wherever it is youlisten to podcasts, I would be
so appreciative. I want to takea moment to tell you about tiny
health. Tiny health is the firstand only at home microbiome test
designed specifically for kids.
So as a pediatrician, I'm oftenasked, Should I give my child
probiotics? And if so, whichone? And the truth is,
everyone's microbiome is unique.
So without testing, it's nearlyimpossible to know what your
(01:36):
child may actually need. Sothat's where tiny health comes
in. Their Easy at Home testgives you a clear snapshot of
your child's gut microbiome, andyou'll get back personalized
science based recommendations.
The results help you knowexactly what supports may be
helpful, and sometimes you'llfind that your child doesn't
need anything at all to try tinyhealth for your family, go to
tinyhealth.com and use the codeDr, Jessica, D, R, J, E, S, S,
(01:57):
I, C, A, for an exclusivediscount.
Dr navidi, welcome to your childis normal. Thank you so much for
being here. Oh, my pleasure. I'mreally looking forward to it.
Thank you. I'm so excited to getinto the work that you do,
because I have to tell you,every day I am talking to people
that have tummy troubles that Ibelieve are related to their
(02:19):
psychology. So I think the workthat you're doing is really
important. Thank you. And one ofthe things I guess, right off
the bat, once a pediatricianlike yourself has ruled out all
those red flags, those tummytroubles, are very treatable,
there's tons of research, andthe effectiveness of those
treatments is really high. SoI'm really excited to talk more
(02:41):
about that, because I think it'simportant for parents to know I
love that you say it'streatable, because I think
that's what's really difficultwhen parents hear that, the red
flags have been ruled out thatthere's no real bad illness
going on when it relates to thestomach, but a lot of parents
feel at a loss. They're not surehow to make their kid feel
(03:02):
better. So I'm so happy that youhave an optimistic perspective
on this absolutely and hey,don't take my word for it.
There's been research over thelast 40 years looking at the
types of treatments that we do.
These types of Gi disorders fallinto a larger category called
disorders of gut braininteraction, and that includes
things like irritable bowelsyndrome, that includes
(03:26):
functional abdominal pain, thatincludes functional dyspepsia or
nausea. There's about 20different disorders of gut brain
interaction. They're verycommon. A lot of kids will
develop them at some point intheir life, and they're also
very treatable. And I'm justcurious, how did you get into
this field? Can you tell us alittle bit about your
(03:47):
background? How did youspecialize in GI psychology? I'd
love to tell you I had, like,this amazing master plan, and
that this is what I was going todo, but I got into psychology,
and one of the tools I reallylove is clinical hypnosis. And
at the time, I wasn't aware thatit had been studied for a really
(04:09):
long time in terms of helpingpatients with GI problems. I
only discovered that later, andthen once, I started using
clinical hypnosis and cognitivebehavioral therapy in
conjunction with each other tohelp these gi patients. Then I
started getting more gipatients, and then the pediatric
gastroenterologist in the areadiscovered me. They started
(04:32):
referring more patients, andthey told other doctors, and
then before I knew it, it waspretty much like 80% of my
caseload, because it turns outthere are very few people that
are trained to see kids, alsotrained in clinical hypnosis,
also trained in working with GI.
(04:53):
So if you put all those threethings together, that's why I
started the bigger practicecalled Gi.
Psychology, I can see whydoctors would love to refer to
you, because if you're a primarycare physician and you only have
so much time per visit, andyou've ruled out things that we
can help in our medical toolbox,it's always very reassuring for
(05:14):
me to have someone to refer to,to know that with confidence
that they're going to getbetter. And what I would see,
especially early on, is parentswould get that diagnosis for
their child, but there reallywouldn't be options for them.
And so then they would go andget a second opinion and a third
opinion, and they'd get moretests, and they'd get scoped,
and they'd do the medical merrygo round for a year, two years,
(05:39):
and then they'd finally findtheir way to see me, and I
thought that was really sad,because these treatments
actually don't take that long.
On average, it's kind of likeeight to 12 sessions to help
somebody and kids respond betterthan adults. So about 70% of
adults will reach theirtreatment goals. About 80% of
kids are gonna reach theirtreatment goals. When you first
(06:01):
described the typical diagnosesthat you can help with, you
mentioned IBS or irritable bowelsyndrome, you mentioned
functional dyspepsia. Can youdescribe the symptoms to people
listening so that they mightrealize that their child may fit
into one of these categories?
Will you point out some of thesymptoms to think about. Yeah,
(06:22):
absolutely. So let's sayfunctional abdominal pain is a
super common one, and it's verystraightforward. It's abdominal
pain, pain in their stomach thatwhen you get checked out, they
can't find any structuralreason. There's no physical
problem that they can find, andthey're just frequently having
this pain, and it's not goingaway. After a week or a month,
(06:46):
they're still having it.
Irritable bowel syndrome iswhere you've got pain and then
you also have eitherconstipation or diarrhea or
both, in which they're kind ofcycling in between each other.
Functional dyspepsia is moreupper GI and so you get a lot
more of bloating, and sometimesthere's loss of appetite also,
(07:07):
which can be also scary forpatients, because their kids
might not be eating as much, andthat's always very scary. Do you
find that for a good percentageof the kids that you treat, they
also have more anxiety than youmight expect from the average
child? That's a great question.
Yes. So there's four conditionsthat kind of go along with these
(07:30):
types of Gi problems, kids withanxiety. So if they've already
gotten anxiety disorder, orthey're already anxious, they're
more likely to get one of thesegi disorders. Kids with a
history of trauma also are muchmore likely to have these kinds
of disorders. Kids that are onthe autism spectrum are also
(07:51):
much more likely to have theseand then finally, any kid that
has or has had an eatingdisorder is also very likely to
have one of these disorders ofgut, brain interaction. What I
so appreciate hearing from youis your optimistic perspective
that these conditions aretreatable, because I find
there's a lot of parents thatare very frustrated. They go to
(08:12):
the doctor, the doctor's ruledout run of the mill,
constipation, thankfully,there's no IBD, there's no
infection going on, and still,these tummy troubles persist,
and they may get the diagnosisof IBS or irritable bowel
syndrome, and parents andchildren feel frustrated because
they think there's no greatsolution. So my question to you
(08:33):
is, can you paint a picture forparents? Can you let parents
know if you suspect a gut brainproblem? What would be some
sample recommendations that youwould have for a family? Yeah,
so of course, they're gonna getmedically checked and rule out
anything red flag. Once you knowdr Hochman has given you that
diagnosis, then I think a lot ofpeople start looking at diet,
(08:58):
and I would not start there, andparadoxically, like, that's what
people think it's like, okay,stomach problems, let's look at
what they're eating. Maybethey're sensitive to something.
Maybe they're allergic veryinfrequently. Is that the case,
there are specialized diets tohelp with these kinds of
disorders. One of those diets iscalled the FODMAP diet.
(09:21):
I am very hesitant to start akid on a very strict diet,
because that just seems, look,adults can barely do strict
diets, and then they're veryhard diets to stand so that
would be something I might trylater. And that's so interesting
that you say that, because Iwill tell you that most gi
(09:42):
doctors or gastroenterologiststhat I talk to, I do believe
that's the first place that theystart. Yeah, you recommend the
FODMAP diet. There's some appsthat give parents direction on
what foods to avoid. But what Ifind is tricky with that. As you
mentioned, there's so many foodson that list, and part of me
wonders, okay.
If this was an easy fix, great.
Let's say a child finds outokay, when they have garlic and
(10:03):
broccoli, their stomach isupset. Okay, we can avoid these
foods, but it ends up being areally long list. I find it
typically there's not a clearcut solution, and then there's a
lot of uncertainty with how longthey're supposed to stay off of
these foods? Is it for a coupleof months? Is it for years?
There's not a lot of directionas to when to add those foods
(10:24):
back in. So I agree with yourpoint that this is a tempting
direction to go in if I couldchoose another place to start
and feel like the child mayimprove with symptoms, that
sounds like an easier place tobegin. Let's talk about the
FODMAP diet. One is you're notdealing with the underlying
problem. The underlying problemisn't that these foods are bad
(10:46):
for this child. The FODMAP foodswere chosen because they're the
foods most likely to cause gas,and when the system is
sensitized, then gas is going tobe causing discomfort. So the
idea is, if you remove the foodsthat are causing gas for this
person, there's going to be lessdisturbance in the system, and
(11:09):
it's going to bother them less.
But the underlying problem isthat the nervous system is
sensitized, and if you candesensitize the system. You can
eat all those FODMAP foods.
There's nothing wrong with them.
And then the other issue is whenyou take anxious kids and you
(11:31):
put them on a diet and you tellthem, Okay, stay away from all
these foods, because they'regoing to cause pain, they are
very likely to develop an eatingdisorder, specifically one
called arfid. So that'savoidant, restrictive food
intake disorder, and that's avery common disorder that we see
in many of our patients thathave these gi conditions,
(11:54):
they've also developed arfid,meaning their list of foods that
they're willing to eat is likeyou could fit it on a page. So
if I hear what you're sayingcorrectly, it's that if you find
certain foods that do cause moregas in the system, and you
remove them from the diet, youtake out dairy, you take out the
cruciferous vegetables, theyfeel better temporarily, but
you're not really getting to theroot of the issue. And then in
(12:16):
turn, by taking out these foodsand making a more restrictive
diet on a kid who may be on themore anxious side to begin with,
you may inadvertently make theiranxiety even worse, yeah, which
may make their symptoms in thelong term, not better, yeah, and
they're going to start applyingthat anxiety to the foods, which
is not a place you want them tobe okay. So that's a really
(12:38):
interesting perspective, and Ihave to admit, not one that I
typically hear, but it resonateswith me. Yeah, I'm not saying
there's a place for those diets.
I think if you've got a reallysevere case, maybe you're doing
both. You're working with a GIpsychologist, you're on the
diet, the diet is decreasingsymptoms while you're working on
the underlying effort todesensitize the system, and then
(13:00):
as you desensitize the system,you start adding food back.
Okay, I appreciate this a lot,because honestly, this
conversation is changing the wayI'm thinking about approaching
IBS, and it makes sense to me.
So now I'm curious the toolsthat you recommend for kids with
brain, gut, psychologicdisturbances. Can you explain
(13:23):
the rationale behind the toolsthat you're recommending? Right?
So basically, we want tounderstand three major things.
One is that there's a powerfulconnection between the brain and
the gut. It's called the braingut axis. It's the intersection
between the central nervoussystem and the enteric nervous
system. It's how they interactwith each other. And what that
(13:43):
means is that what happens inthe brain really does affect the
gut powerfully, and then whathappens in the gut can also
actually affect the brain. Butwhat we're talking about here is
more brain down. And so what'sgoing on in the brain that is
going to affect the gut? Well,one of those things is hyper
vigilance. And when you look atthese patients, almost every
(14:06):
single one of them is going tobe hyper vigilant. That means
it's kind of like this anxiety,where they're always scanning,
always checking their body, andif it's a GI issue, they're
always scanning their gut. Theywake up in the morning, how does
my stomach feel? You know, theyeat something. How am I feeling?
I'm not sure. And then if theynotice something off, then
(14:28):
they're catastrophizing. Thenit's like, oh my god, I'm not
going to make it. I can't go toschool today, soccer practice.
No, I can't do it. I don't wantto go for that long car ride,
right? And and so they're reallyscaring themselves and all that
anxiety, it goes right down thatbrain gut axis, and it actually
makes the symptoms worse. Sothey might have started off with
(14:50):
a little twinge, but now there'sa cramp. Now there's a pain
right the feedback from the gutback up to the brain goes.
Through something calledvisceral hypersensitivity. And
what that is, is that the brainis actually amplifying and
distorting the signal. And soI'll give you an example. A lot
(15:10):
of my patients, they'll say,after I eat, my stomach hurts.
And then after they'veprogressed through treatment,
then they're they're saying tome, oh, after I eat, I realized
that those are just thesensations of my stomach
digesting, and their brain wasmisinterpreting it, amplifying
(15:32):
and distorting it into pain. AndI think that's something that
people who've never dealt withthese kinds of problems before,
they don't really appreciate thepower of the brain to transform
signals. The brain can getthings wrong. The brain can
signal false alarms, and that'sa big part of these problems, is
(15:54):
that the brain is chronicallysending a false alarm. You know,
recently I had on my podcast.
Lynn Lyons, she has a wonderfulpodcast for parents who have
kids with anxiety. It's calledfluster klux, and she wrote a
book about hypnotherapy she wason just a few weeks ago. If
anyone's listening who hasn'tchecked it out yet, I would
definitely check it out. But shewas talking about how the basis
(16:15):
behind hypnotherapy isessentially delivering a
different message to patientsthan they were otherwise telling
themselves. So it sounds like inthis case, if you can deliver
that message to children, thatthese feelings that you're
having, these are normalsymptoms. This is just your body
doing what it's supposed to bedoing. It's digesting your food.
(16:37):
Would that be an example of howyou're delivering hypnotherapy
to children? Absolutely, yes.
How that message gets deliveredis the art and science of
hypnotherapy, right? Do we do itthrough stories? Do we do it
through images? Do we do itthrough words? And how do we do
that? That's why we train somuch. But essentially, the
(17:01):
message is your stomach is safe,your stomach is healthy. The
signals you're getting areuncomfortable, but they're fine.
It doesn't mean there's danger.
I wouldn't necessarily directlysay that, but that's what we're
conveying to them in variousways. It's so true that the
brain feeds the gut, and the gutsends signals back to the brain.
(17:24):
I think probably anybodylistening can think of a time
when they got butterflies intheir stomach before having a
nerve wracking conversation withsomebody, maybe some GI upset,
before taking a big exam incollege. I think it's very
common to think of how the brainaffects your stomach. It's
interesting, because I think weall kind of know that, and we
(17:45):
had many experiences of it. Butwhen it comes to these problems,
it seems like peopleautomatically go to the food, or
they go to I need some kind ofmedication. And I'm not saying
there isn't a place formedication, but in terms of
research, it's not nearly aseffective as the treatments that
(18:06):
we're talking about for thesetypes of Gi problem.
Interesting. And along the linesof food and medication,
probiotics often getrecommended, and peppermint oil
often gets recommended. Is thatsomething that you also
recommend? Or what are yourfeelings on those
recommendations? I mean,peppermint oil. I think there's
some research showing it can behelpful. I don't know if it's
(18:29):
super effective, but I thinkthat at least there's some, I
think, in terms of probiotics,that's a very complicated area.
And then we're dealing withanother area that can be tricky,
something called SIBO, smallintestine bacterial overgrowth.
And essentially, there isn'tsupposed to be a ton of bacteria
(18:50):
in the small intestines. Andthen if they find that there is
that can also cause similartypes of Gi problems. And so
that's usually something thatprobably should get looked at,
especially if you've got thesechronic gi problems.
(19:10):
Do you Do you have a lot ofpatients where there are mixed
diagnoses, for example, I have afair number of patients who have
celiac, for example, or lactoseintolerance, and they also have
some elements of brain gutdistress. Yeah, it's very
common. And the reason it'scommon when you're talking about
celiac or you're talking aboutinflammatory bowel disease
(19:31):
patients, is because anytime yougo through gi trauma, you're
more likely to develop a braingut problem. I think of it
almost as like PTSD of the gut,right? So let's say you've got
celiac, and you've spent yearseating foods that are causing
real problems in your gut, andyou just don't know it. Your kid
(19:51):
doesn't know it, your parentsdon't know it, but they've,
they've had all this pain anddiscomfort, and then suddenly
you figure it out, and yourestrict gluten. You.
Yeah, but there's still giproblems, but it's because all
of that trauma in the past hascreated this hyper vigilant
system where probably thatvisceral hypersensitivity is
(20:13):
happening also. So the idea ofhypnosis sounds really appealing
to me. I love medicalinterventions where there's
really no side effect that I canthink of, and potentially a big
upside. So for people that arelistening, can people use your
services? Yeah, so I gotfrustrated, and then five years
ago, started this biggerpractice, and we knew that this
(20:35):
is such a rare specialty that wewanted to make ourselves
available to people. So we'veworked really hard making all
the jigsaw puzzle of all thelicenses work so that we can see
patients in all 50 states,right? And we see them by
telehealth. And then the nextquestion a lot of people ask is,
Does hypnosis work bytelehealth? And it actually
(20:59):
works great. And they've donesome studies, and they find
hypnosis is also effective. Andalso anecdotally, do you find
yourself success with yourpatients? Oh, that's the reason
I love doing this work so much.
It's actually not terribly hardto treat these gi disorders
versus give me a functionalabdominal pain disorder any day
(21:20):
over, let's say, like a reallysevere generalized anxiety
that's going to take time, youknow, that's going to take a lot
of ups and downs in treatment,but a functional abdominal pain
and IBS, they respond fairlyquickly. And kids respond even
better than adults, because theyhaven't had the problems for as
(21:41):
long, and their minds are moreflexible, so they're often
seeing benefits after the fourthor fifth session, so a ton of
success, and also, just as atherapist, it also opens the
door for helping patients withother issues they might have,
because after you've helped themwith their GI disorder, there's
a lot of trust, there's a lot oftherapeutic momentum, and so you
(22:03):
can help them with their anxietyor their phobia, or talking
about someone the other daywho's got a really severe Wasp
phobia, and doesn't sound like abig deal, but if you live in an
area where there's bees andwasps, they don't like to go
outside, right? And so after youhelp them with their stomach,
you can also help them with thattoo. I love it. I love that you
(22:25):
say that you look forward andwant to treat kids with
functional abdominal pain,because I do honestly think a
lot of doctors don't want totreat those patients, because in
their minds and theirexperience, it's hard to see
them get better. So I'm reallyhappy too that someone like you
exist because just nice to havehope for families. And there's
so many people out there thatneed it, and that's the thing,
(22:45):
these are very difficultpatients. If you're not aiming
at the right parts of theproblem, and when you are,
they're not hard to treat atall. They respond really well.
And I like to joke that the oneside effect of learning how to
use clinical hypnosis is thatthey have a skill in terms of
self hypnosis that they can useto calm themselves down for the
(23:09):
rest of their life. And hearingyou talk so passionately about
hypnosis is that your favoritefirst go to for treating these
types of patients. Our model isto integrate so to kind of
simplify it, let's say we'reusing the clinical hypnosis to
help calm them down and reducethe visceral hypersensitivity
(23:30):
that distortion of thesensations, and then we're using
a special form of cognitiveBehavioral therapy to address
the hyper vigilance and thecatastrophizing, and then we're
also treating all the avoidancethat often comes with a lot of
these patients. So they'reavoiding situations, they're
avoiding foods. They have fearof their own body, essentially.
(23:54):
And can you explain for peoplewho may not be aware, what is
Cognitive Behavioral Therapy orCBT therapy. Yeah, cognitive
behavioral therapy is the ideathat what you think affects how
you feel, and that affects whatyou do and how you act, and any
one of those areas can betargets of intervention. So you
(24:16):
could work on helping them shifttheir emotions, and that's gonna
help change how they'rethinking. You can help them
learn to change how they'rethinking, and that'll influence
their emotions. You can helpthem change how they act. You
know what I mean, and socognitive behavioral therapy is
a collection of tools to helppatients make changes in those
three variables. So I thinksometimes it helps to paint a
(24:39):
picture with an example. What ifI come to you and I say, Dr
navidi, my stomach really hurts.
I noticed that my stomach alwayshurts right before I have a big
event. I'm starting college nextweek. How would you talk to a
patient like that? Yeah. So ifwe're going on the hypnosis
side, that would be one thing.
If we're going on the cognitivebehavioral therapy side.
(25:00):
So a lot of times, people justaren't aware of their thoughts.
Their thoughts are happeningreally fast, and what they
become aware of is that whenthey think of school, they feel
nervous, right? And they'remissing that piece of like, what
precisely are the thoughts? Andso maybe the thought is, you
know, I'm gonna have to go tothe bathroom in the middle of
(25:22):
the day, and I'm just gonna bereally embarrassing, and people
are gonna hear me making noisesin the bathroom, and then
they're gonna make fun of me,right? Like there's this whole
train of thoughts. And so nowimmediately, when they think of
school, they're thinking of allthat stuff super fast, and then
they're feeling anxious, andthen their stomach hurts worse.
(25:42):
And then they try to basicallystart talking themselves out of
going to school that day, right?
And then we start buildingawareness of that pattern, and
then giving them tools to shiftthose thoughts, to change the
way they're thinking, to thinkabout it in a more kind of
logical, clear way that isn'tblowing the problem up. It isn't
catastrophizing. I have a goodfriend who had a lot of
(26:06):
difficulty with IBS, a lot ofstomach discomfort, especially
around particular foods, and he,I'm happy to say, is now cured
of his IBS, and he creditsmeditation to helping his
symptoms. Have you ever triedimplementing techniques like
breathing exercises, meditation,mindfulness techniques to help
patients with their symptoms?
(26:27):
Absolutely, it's wonderful. Oneof the first skills we teach is
usually something very simple,like diaphragmatic breathing.
And I think if we're talking toall the parents out there and
they've got a kid who has someof these GI issues, a really
nice thing they can do withouteven having to come to somebody
like myself, is if you go toYouTube, there's a lot of good
(26:50):
videos for kids on how to dodiaphragmatic breathing. So
basically, it's a special way ofbreathing that activates the
vagus nerve, which then sendsyou into rest and digest mode in
terms of your nervous system.
And it's a very valuable skill,and pretty much, I think every
human should know how to dodiaphragmatic breathing. I'm
doing it right now. I'm puttingmy hands on my stomach and I'm
(27:12):
taking some deep breaths. Yeah,we put your hand on your stomach
sometimes, if you're justlearning, you put it on your
chest because you want to makesure your chest isn't moving a
lot, right, and if it is moving,then you want to shift it more
to your stomach, to yourdiaphragm, and then you just
kind of breathe in and out at anice, slow pace. And another
thing a lot of times people getwrong about diaphragmatic
(27:32):
breathing is that when theythink deep breathing, they think
a lot of air, and that's notwhat we want, because that's
when we get peoplehyperventilating, and they start
to feel a little dizzy, and theyfeel a little weird, and it's
not going to help them, right?
So we want, like, nice and slow,but we don't want to be taking
(27:53):
in a ton of air. And do yourecommend doing breathing like
this, symptoms or just sort ofhabitually as part of your
everyday routine, but all of theabove. Yeah, so you want to
start by training yourself to doit in a low stress time. So do
it when you don't have symptoms,and you start to get good at it
(28:14):
once you can reliably calmyourself down doing it, then
start using it during thosetimes when you have symptoms. I
find this such helpful advice,because you can do this
anywhere, anywhere you are. Youcan stop and take some breaths,
and if that works to calm youdown and help you feel better.
What a great tool. Yeah, andI'll give a little bonus. If you
(28:35):
go and do this with your kid,what you can teach them to do is
do something called an anchor.
So an anchor is, if youremember, in school, they taught
you about Pavlov and the dogs,it's like ringing the bell. They
start drooling. This is asimilar concept, but you're
linking some gesture or somemovement to relaxing. So what
you do is, every time you'regoing to practice your
(28:59):
diaphragmatic breathing. Let'ssay you make a fist like this,
and then you do your breathing,and you calm down. And then you
make a fist, you do yourbreathing, you calm down over
and over. Eventually, the brainlearns whenever you make the
fist, you're gonna calm down, sothat then you make the fist, and
you calm down without even doingthe breathing. What a great
tool. I think it's very helpfulto hear that there are many
(29:22):
options to consider, becausewhile one thing might not work
great for somebody, a differenttool may work better for
somebody else. So it's just niceto have a lot of options in the
toolkit, so to speak. Yeah, soit's like cognitive behavioral
therapy. A lot of doctors willhear that CBT is helpful. So
we'll say, Okay, go see yourlocal CBT, your cognitive
(29:42):
behavioral therapist in yourarea, and they're gonna treat
anxiety and they'll treatdepression. But there's a
specific way of using CBT totreat GI and most people aren't
trained to do that, so a lot oftimes.
Patients will come to us andthey'll say, Oh, we already
tried CBT. It didn't help. Andwe'll say, Well, maybe you
(30:06):
didn't try it like this, andthere's a specific way to kind
of apply it. So that being said,meditation also is a wonderful
tool. So you could say, CBT,meditation, clinical hypnosis.
It's an amazing toolkit, becausesome people might do better with
CBT. Other people respond betterto meditation. Other people for
(30:29):
them, clinical hypnosis is likethe thing, right? And so you
have different tools fordifferent folks. I've been
looking into your work, and Ilove that you stress the power
of positive expectancy, that ifthe mind is trained to think
positively, that our symptomswill follow suit and that things
will improve. Can you talk moreabout that? Because that that
(30:52):
way of thinking really resonateswith me. I think that a lot of
people, they just underestimatethe power of the mind. I find
that this way of thinking isreally powerful and has a lot of
potential to work. And I pointthis out because I have a lot of
people in my life that do theopposite. They try to think in
the negative. Because I thinkthey do it as a protective
(31:13):
mechanism, that if they thinkthrough the worst possible
outcomes, well, then ifsomething better than that
happens, they won't be sodisappointed in that. And
psychologically they think thatmakes them feel better in the
end. But I think the opposite.
If I really think the best thingis gonna happen, and I look for
the best things, those goodthings tend to happen, if that
makes sense, 100% and this iskind of a side, but I can
(31:36):
remember looking back at somejournal entries I had written,
and at one point I wrote, I wantto have my own private practice,
and that was years before I everwas close to doing that. And
then, oh, I want to have thisbigger group practice that
really helps people. Like it wasin my head, and I think I
probably forgot that I wrote it,but I think so all those people
(31:59):
in your life that do theopposite, I've got some advice
for them, and they don't have tostop doing all their negative
thinking. I just want to tweakit just a little, right? So you
can say, Okay, you're thinkingabout doing X or Y. Have all
your negative thoughts, and thenpause and think about the best
(32:21):
version of you, how you wouldhandle it if those negative
things happened. Then go on tothink about what would happen if
the best outcome occurred. I seeso let's say my worry is I have
stomach upset and I worry thatI'm gonna go to the bathroom at
(32:41):
school. Someone's gonna hear me,someone's gonna make fun of me.
If that were to happen, could Ihandle next master fire
scenario? And the answer is yes.
I think we all could play outthe worst case scenario and work
through it some way or another,and imagine your best self
walking out of that bathroomlooking at and say, Hey, some
days you have a bad day, andthen just keep on going, right.
(33:05):
But then also imagine you go toschool, and maybe you don't need
to go the bathroom, and you havea good time, and you chill out
with your friends, and then yougo home. Right? People are so
uneven in the way they thinkabout things, and they don't
even realize it. They thinkthey're being accurate, because
I've thought of all the worstthings, but have you really been
(33:29):
accurate? Because you haven'tthought of the good things and
you haven't thought through howyou would handle it if those bad
things happen, their thinkingjust stops at the worst part of
their imagination and doesn't goany further, yes, and I think,
you know the line, you fake ittill you make it, or you just
keep smiling through the thing,even if it's hard, and then
(33:51):
eventually you'll feel better. Ithink that's really true in a
lot of situations. So if you'resomebody listening and someone
in your family does have a lotof psychological gi
disturbances. Why not try totrain the brain to think that
even though it's hard right now,things are going to improve, you
will heal yourself. Why not? Youhave nothing to lose? Yeah, you
(34:11):
have nothing to lose. Andactually, that's probably a more
accurate view, based on all theresearch that we've done, is
that if you can begin to changethe way you think, about your
gut, about the pain, if you canbegin to shift your mindset,
you're very likely to get overit. And you know the issue is a
(34:35):
lot of times people have a lotof trouble doing it themselves,
so if they can't pull it offthemselves. There's people out
there who have spent their liveslearning how to help other
people do this. But like yousaid, meditation amazing tool.
There are great books oncognitive behavioral therapy for
kids. There's little workbooksyou can go and use that. There's
(34:57):
apps for hypnosis. There's lotsof things.
Things that you can try, and ifyou can't manage to do it
yourself, there's other peopleto help you.
I think your approach, whatyou're describing, it sounds
like there's very littledownside, and only a potential
big upside, and best casescenario, a big upside. So I
think that the work you're doingmakes a lot of sense to me.
(35:18):
Well, thank you. Yeah, and thebonus for me is it's it's very
satisfying to do this work. Ihad a 13 year old come and see
me the other day, and obviously,not going into details, there
was a lot of functionalabdominal pain, and we were able
to help him essentially get ridof that within two sessions, and
(35:42):
it was pain that was starting toseverely affect his life,
meaning weight loss, avoidingsituations, all kinds of
secondary problems coming fromit. And in just two sessions,
he's feeling better, like,what's better than that? Right
in terms of therapy? Oh, to feellike you're helping somebody and
you're making a meaningfuldifference. Nothing better. I
(36:04):
agree exactly. And I'm justcurious, as a clinical
psychologist, do you ever worrythat you're potentially missing
a medical diagnosis if a childisn't getting better? For
example, yeah, I think that'ssomething that's going through
our minds. We actually justtalking about this issue in our
case, consultation meetingearlier today. That's why we
(36:26):
make it a practice to get incontact with the doctors we want
to start out treatment, justchecking in and saying, Hey,
this is who we are. This is whatwe're doing. This is our plan.
Is there anything medically youthink we should know, right?
Because that's not ourexpertise, right? We rely on
you. And then if we're runninginto trouble, we want to check
(36:48):
in again. And then also,usually, at the end of
treatment, we want to let youknow how things went. I love
that you use a collaborativeapproach. I think that's a great
way to go. And I have to tellyou, it's so nice to meet
somebody who's so optimistic.
This is an optimism based onexperience. I have seen so many
kids come in with their lifekind of falling apart, not you
(37:08):
know, often essentiallyhomeschooled, not able to get to
school, not able to do thingsand to see them get better and
better pretty quickly, just overand over, seeing that happen
over the years. So this iscoming from just seeing so many
kids get better, amazing. And sothis podcast is called, your
(37:29):
child is normal. So just as afun question, or just as a
thought, are there any normaltummy complaints that you hear
from parents that you wishparents stopped worrying about,
yeah, I think to certain extent,especially when the parent can
see that there's a clearstressor, right? You know,
there's something going on atschool and their their tummy
(37:50):
hurts. I think that would be avery normal tummy complaint. And
I think what you want to do atthat point is reassure them and
explain to them in ageappropriate language. Hey,
sometimes when we're worriedhere, our tummy gets worried
also, and it starts hurting,right? And maybe we don't need
(38:14):
to be so scared about whateverit is because and then start
talking to them about the issuethat's scaring them, right? I
love that advice. It's so true.
Reassuring kids can go a longway. Hey, I see that your
stomach hurts. I get it. Thinkabout it. You're starting
school. It's a big deal. That'sa big transition, but once you
(38:34):
get into the routine, let's seehow things go, because I'll bet
your stomach will start to feelbetter. Because I think
sometimes parents will notknowing better, they'll get
really anxious about thestomach, and they'll kind of
transmit that anxiety andreinforce the kids anxiety.
Googling things, they findthings they're catastrophizing.
(38:55):
They can't help it, but theyleak it to their kids, and then
all of a sudden, everybody'sspiraling and worrying. So I
think that's a really, reallyhelpful piece of advice, that if
there's an explanation for thetummy upset, instead of
worrying, along with your kid,offer a reassuring, supportive
voice that this is normal. Whatis that medical saying? If you
hear hoof beats, think horses,not zebras. That I love that,
(39:21):
saying, I agree with that,saying, you want to look for
horses, not zebras, absolutely,yeah. And so you know your kid,
you know it's Sunday night orit's Monday morning and school's
restarting, and probably knowthey're anxious, and if they're
talking about their stomachhurting, it's probably a horse.
(39:42):
It's probably not a zebra. It'sprobably a brain, gut, stomach
ache, and I'm curious for you.
Dr navidi, if you are feelinganxious, what is your favorite
go to calming ritual foryourself? Do you listen to
music? Do you use hypnosis? Whatis your go to?
Relaxation. I used, I usehypnosis, and I've done exactly
(40:04):
what I was telling you about. SoI have created an anchor over
the years. And so right beforethis podcast, I was like, Oh, I
hope I do well. And then I waslike, Oh, I'm feeling a little
jittery. Let me calm down. So Idid my fist. I took a nice deep
breath, I did my fist, and thenI released it, and I just said,
(40:25):
Relax and and I did, and Irelaxed. And it happened because
I trained my brain that that wasthe cue, and it knew exactly
what to do. It knew exactly howto relax. That says a lot that
you practice what you preach,who wouldn't want a way to kind
of de stress within like lessthan 30 seconds. I'm biased, of
(40:50):
course, but I think all humansshould learn at least that
skill, which is to have a reallyreliable anchor to calm
themselves down. Yeah, Icouldn't agree with you more.
Now tell everybody, where canthey find you so they've
listened to you talk they'reconvinced they want to bring
their child to talk to you oruse your services. Remind
everybody your website, anyother resources that can steer
(41:13):
parents in your direction? Yeah.
So the website isgipsychology.com
and we offer a free phoneconsultation, and that's someone
who's clinically trained, whowill answer all your questions,
who will help you figure out ifthis is the right treatment for
you or your or your child. And Iencourage you, because there's
(41:37):
nothing to lose by just doingone of those phone consultations
and just seeing if it's rightfor you. And I'm just curious. I
find that a lot of parentswonder this question, but do you
take insurance, or is thisservice outside of insurance? So
we're out of network and butit's not as bad as you might
think, because there's twothings that actually make it a
(41:58):
lot better. The first is it'sreimbursable, so the parents pay
for the session. They get asuper bill, and they could
submit to their insurance andit's reimbursed, just like
mental health. And so we found,on average, they get about 50%
back. But there's also somethingcalled a single case agreement,
(42:20):
and that's something with aninsurance company, because we're
such a rare specialty, we helpthe parents do this. You're
submitting to the insurance andyou're saying, hey, insurance
company, do you have a gut braintherapist in network for me to
see? And the answer is alwaysno. And so about 90% of people
(42:42):
who apply for these things getthem approved. So yes, we're out
of network, but it's actuallynot as bad as you might think,
if you kind of go through thisprocess, and we help them go
through the process. I love thatyou work to make things more
affordable for families, and Ireally appreciate that gi
psychology offers virtual careacross the United States. What a
wonderful service. So thank youvery much. I'm really proud of
(43:04):
the work that you've done. Ohwell, thank you so much, and it
was a pleasure talking with you,and you're really helping us in
our mission. Our mission isreally to get the word out,
because I think there's so manypeople whose kids will go
through a very long time ofbouncing around treatments and
getting treatment by Dr Googlewhen there's actually a
(43:26):
treatment out there that's goingto work for them, but they just
don't know about it. I'm sohappy to help get the word out.
So I wish you more continuedsuccess, more growth, and
hopefully you'll write a booksoon. I think that would be good
too. Well. Thank you so much. Itwas really a pleasure talking
with you. Likewise. Thank you somuch. Thank you so much for
listening to your child asnormal. I'm so grateful you're
(43:47):
here and part of this community.
If you're enjoying this podcast,it would mean the world if you
shared an episode with a friendsubscribed and left a five star
review. And don't forget tofollow me on Instagram at ask Dr
Jessica for parenting tips andupdates. See you next Monday.
You.
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!
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.