January 22, 2025 • 26 mins
In this episode, Dr. David Hanscom continues his discussion with Mags Clark Smith, a specialist in somatic work and mindfulness, and a contributor to a textbook on psychophysiological disorders. She highlights how guided movement can alleviate chronic pain by reducing fear and anxiety, which amplify pain responses. She emphasizes creating safety and trust to help individuals reconnect with their bodies and overcome resistance to movement. Her work has proven particularly impactful in areas like pregnancy-related pelvic pain, where fear worsens discomfort. She explains how her approach combines reducing fear and fostering movement to promote healing, setting it apart from traditional pain management methods that often overlook the emotional and neurological dimensions of chronic pain. Download the transcript. Mags draws on her extensive knowledge of the body through dance, psychology and non-verbal communication to empower people to move with confidence and resolve chronic pain. Mags offers one-to-one Resolving Chronic Pain consultations and Body Control Pilates classes, as well as taking part in chronic pain research and giving guest talks and lectures on chronic pain. Mags lectures on University Edinburgh Dance Science Masters course. For more information, visit: https://www.resolvingchronicpain.com/teaching-movement Learn more about your ad choices. Visit megaphone.fm/adchoices
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Please note that all XZBN radio and/or television shows are Copyright © REL-MAR McConnell Meda Company, Niagara, Ontario, Canada – www.rel-mar.com. For more Episodes of this show and all shows produced, broadcasted and syndicated from REL-MAR McConell Media Company and The 'X' Zone Broadcast Network and the 'X' Zone TV Channell, visit www.xzbn.net. For programming, distribution, and syndication inquiries, email programming@xzbn.net.
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Episode Transcript
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Speaker 1 (00:01):
The following podcast is part of the Mind, Body, Spirit
dot fm podcast network.
Speaker 2 (00:12):
Hello and welcome to Back in Control Radio with Doctor
David Hanscombe.
Speaker 1 (00:23):
Hello everybody, and welcome to another episode of Back in
Control Radio with Doctor David Hanscombe. I'm your host, Tom Masters,
and our guest today is Mags Clark Smith. She draws
on her extensive knowledge of the body through dance, psychology
and nonverbal communications to empower people to move with confidence
(00:45):
and resolve chronic pain. She offers one to one resolving
chronic pain consultations and body control plates classes, as well
as taking part in chronic pain research and giving guest
talks and lectures on chronic pain.
Speaker 3 (01:00):
Welcome, Thank you, Tom.
Speaker 4 (01:03):
I would like to welcome Max Clark Smith to her
podcast today. I just did a podcast with her which
gave her background on being a somatic well. She has
lots of talents, but she works with somatic work, mindfulness, dance, art,
relaxation tools. She's an instructor and she's also one of
(01:23):
the editors of a textbook on PPDA which the psycho
Physiological Disorders Association Textbook has now been changed to the
Neuropast Plastic Pain Society, but The bottom line is whatever
we name, you give it. Both of us have come
to the conclusion that the body knows how to heal
itself and we just need to give the body cues
of safety to heal itself. And Max are good friends.
(01:47):
We've known each other for a long time. We talk
every month. She does live in Scotland. She's from Ireland.
I didn't make that clear in the last podcast. But
she does online work and she just offers a whole
line of therapy that really quite relevant, to put it,
mildly and quite effective and also quite different. So marriage,
(02:10):
welcome back to the show. And did I get to
the introduction close enough today?
Speaker 2 (02:16):
You certainly did. Yes. So I do use movement, and
I use movement because, as you will know, when people
for us come to us, they're often very scared of moving.
And that may be because they've been to a health
(02:36):
practitioner who has said, no, you need to be very careful,
don't move that limb. Oh yeah, I can see your
back is very stiff. You best not use that. And
so one of the first things that I want to
discuss with people is how that information may well have
been extraordinarily helpful at the time but as the pain
(03:01):
that they're experiencing now is chronic, it's been around for
over three months, and that means that that initial piece
of advice probably isn't relevant anymore. And then there is
a huge resistance that I see in the nonverbal communication
of who error I am working with, because that may
(03:25):
well have been something that has created a form of
safety in their mind that they won't be moving that
part because they were told not to and life will
be better if they don't. And so then what needs
to happen, in my view, is a building of trust
(03:48):
between myself and whoever it is that I'm teaching to
come to a point where I can suggest to them
that it is safe to move and to actually encourage
them to move that body part in a way that
(04:10):
continues to feel safe to them. And so that requires
me to talk through specifically how to improve body awareness,
and that means noting where body parts are in space
and to draw attention to internal sensations what the body
(04:34):
is doing internally, and sometimes that might require closing the
eyes so that they can focus more on what they're
feeling internally. And then we need to kind of look
at the connection between those sensations and the possibility that
(04:57):
they link with emotions that they might light feel at
the time, and that then is a very gentle introduction
to moving from a place where they have appeared initially
to be very resistant to moving.
Speaker 4 (05:16):
Well, you bring up some very interesting points that we
will talk about more later. But this is not psychological.
Because I spent a good part of my practice taking
people have been told they had the genitive disease, that
they should move it was dangerous.
Speaker 3 (05:33):
Back pain, of course hurts.
Speaker 4 (05:35):
But what happens to call it the no cebo effect,
and it's not psychological. What happens, Okay, sit down, My
back hurts, So my brain's saying that I shouldn't sit
down because it's going to hurt and it's dangerous. Well,
the fact that your body now takes that signal says
it's danger fires up your fire or flight mechanism, which
increases neuro conduction, which increases the neurotransmitters in the brain,
(05:58):
which increases inflammation in the brain. He sentitized to the brain,
and you actually feel the pain more because you are afraid.
So people came into my office terrified all the time
because of they were totally of degenitive disease, and they
had to be careful. Well, actually, when your spine is
degenerated is actually more stable and safer to move.
Speaker 3 (06:17):
The pain is just pain.
Speaker 4 (06:18):
It's not dangerous, even though we equate it with danger.
But I'll give you one quick story that illustrates what
you talked about. One gentleman from New York in his
mid forties, extremely wealthy, very competent, great looking guy, super
nice guy, and he had multiple level degeneration is in
his thoracic spine, normally aging spine, but in nothing out
(06:38):
of the ordinary. He'd been told by a surgeon that
he had the spine of an eighty year old. He
was in chronic pain for nine years. Within six weeks
after understanding that his pain was dangerous at all, his
pain disappeared again. Not mind ever, matter, not psychological, because
you calm down, you go from a threat or fighterfly
physiology to safety and what you're doing. In addition to
(07:03):
me just telling this person, you're actually helping embody that
feeling of safety. Yeah, and it's very powerful.
Speaker 2 (07:13):
It's so powerful. It's so powerful. So I use movement
to develop an emotional lexicon and also to develop empathy
empathy is very difficult. It's a difficult one to sort
of develop because when you've got somebody who's coming to
(07:37):
you because they are at the end of their tether,
because this pain has been gnawing away at them for
however long and they've gone to this number of practitioners
and have had no success. They're very focused on what
the pain is doing all the time, and what the
(08:01):
movement work does is it helps them to park that
for a bit and start to move their body safely,
and it does require quite a bit of reassurance, but
that doesn't seem to be a problem. They will move,
(08:22):
and they're often astounded that they'll move, like I'll get
them to walk across the clinic if it's an in
presson session, and they're often just a standard that they've
done that. But they've started by understanding the body internally
(08:43):
and then they move, and then that leads to them
understanding that that focus of pain is very limited limiting,
and so that's where the end empathy comes in because
they can then they've got the sort of capacity to
(09:07):
think about other people and what they might be feeling,
and that then helps enormously with whatever has kicked off
the chronic pain in the first place.
Speaker 4 (09:21):
Well, that's also very interesting that you're actually connecting to
your body sensations. But at the same time you're turning
your attention outward to other people and so again your
brain's coming.
Speaker 3 (09:34):
See by trying.
Speaker 4 (09:35):
Yeah, I mean what you're saying is simple but complicated
because you're learning to be with the pain, but learning
not to fear the pain. And more like, fear and
anxiety are the same thing, and it is the pain.
Anxiety is the pain is just as danger. So it's
a physical signal or an emotional signal is still fear
(09:55):
slash anxiety slash pain. So anxiety actually is the pain.
So by decreasing anxiety, you're actually decreasing pain and again
logically response to that. But when you reach outward, and
there's lots of data on this, that altruism giving back
is actually anti inflammatory, actually more inflammatory markers.
Speaker 3 (10:20):
So if I came to you with chronic back pain.
Speaker 4 (10:24):
Or let's say, lots of anxiety, lots of just general
life issues in general, where do you start? I mean,
how do you get me calmed down enough? So let's
just pretend I'm a rugby player pretty wire, and you'll
being a spine short in his own version of rugby
and medicine. So my whole thing, my attitude life was
I mean, honestly, my skills for dealing stress were very crude,
(10:48):
and that was bringing on. You cannot hurt me, and
I did, I would. I was under a perverse amount
of stress. I took a huge amount of pride in
taking on anything, and you couldn't. You couldn't hurt me.
My nickname in high school was the brick, which I
took as a badge of honor. It didn't really work
in marriage very well, and I didn't understand this. I
(11:10):
still thought this was a badge of honor. But yeah,
I was really really tough, and I also get really
really sick. Okay, so I'm walking into your office. I'm
having some ring in my ears, my feet are burning.
I don't have anxiety because I can't feel anxiety. But
I don't want to feel anxiety, so I don't. So
was a master of suppressing stress. And you would use
(11:32):
the word disconnected or disassociated for my body.
Speaker 3 (11:35):
Really, but I do ten to twelve hour surgeries.
Speaker 4 (11:38):
I would do ridiculous amount, sixteen eighteen hours a day,
and it was all it was all a badge of honor.
So I was more than disconnected and having multiple physical
mental symptoms. So, okay, I walk into your office, I'm
the brick.
Speaker 3 (11:52):
What are you going to do with me?
Speaker 2 (11:55):
So the very first thing I would do, if I'm
assuming you're not as fine certain, I would Often people
arrive and they've got a whole bunch of MRIs. I
will get them checked first to just make sure that
there is nothing untoward going on. And that's all about
meeting the patient where they're at, because even though the
(12:19):
anxiety might not be showing, it's definitely there. So if
somebody is arriving and they've they've gone to all these
other practitioners, then we need to acknowledge that they've gone
to those practitioners, and we need to acknowledge that they
haven't made any significant progress so far and that it's
(12:40):
safe for me to continue. As soon as that's established,
then I normally ask people what is what is the
biggest fear you have in moving? Or oftentimes I don't
have to ask it because I'm being told, and then
(13:01):
I get you to move immediately those body parts. So
you've come into my office and back is giving you
all sorts of pain and you're saying, I can't move it,
it's completely stiff. Then I will get you to do
a roll down, and I will get you to do
(13:23):
that in a very very detailed manner, without any expectation
of you rolling down to any particular point, but just
moving this mine a little bit and then coming back up.
(13:44):
And that can be the most reassuring small exercise that
helps clients to understand that they're they're going to be
able to control the process to a certain extent, and
that's very important when they first come in and that
(14:04):
they're in safe hands. They need to feel safe.
Speaker 4 (14:19):
Well, it's interesting that you see that because as they
study an orthodoctor Danter out of Bustin, Texas, who's actually
shown in the laboratory that a sense of control lawers
inflammatory markers called cytocins direct link between a sense of
control and decrease information.
Speaker 2 (14:38):
So in any of the movements that I ask people
to do, I explained beforehand that they're in control, and
that would it be possible for them to just do
this little bit and then stop. Listen to the body
when the body doesn't want to move anymore, just pause,
take a breath, in, breathe O, and then return to
(15:01):
your standing position, and that's allowing the person to feel Okay,
I don't have to panic, I don't have to try
and second guess what I've got to do next. I
have to stay in the moment, and that's the important piece.
And all the time I'm asking them how they feel,
(15:22):
what sensations are coming up. And oftentimes people with that
particular movement of rolling down will roll down quite some
way the third time that we do it, because they've
forgotten that they'd explained that they couldn't do that, because
they've told they've been told way back when that they
(15:44):
mustn't move their spine. And so it's very rewarding because
you then see people's faces when they realize that they
can do that. And one of the things that you
asked me at the beginning was how did I get
into this and how I got into actual this line
(16:05):
of work, specifically when I realized I wasn't working on
my own was through pelvic girdle pregnancy paint. And I
have many many stories of women coming to me using
crutches and having a sorolla band because they've been told
that this was the only way that their pelvis would
(16:27):
stay together, and being able to ease that off by suggesting,
let's just see what it feels like to breathe without
that constriction, and they take it off.
Speaker 3 (16:41):
And then I've not heard of that.
Speaker 4 (16:43):
You're saying women would come indo with bands holding their
pelvis together.
Speaker 2 (16:49):
Well, it's called a ciola band, and their understanding of
it was that it was holding their pelvis together. In fact,
it's creating a support for the pelvis. And usually physiotherapists
who would give people these to wear.
Speaker 4 (17:06):
I mean, I hate to be clinical, but as an
orthopedic surgeon who used to do trauma, pelvis has these
massively powerful ligaments and anything you put in externally is
not going to make any difference at.
Speaker 2 (17:16):
All, absolutely, and you know that and I know that.
But physiotherapists are at a loss to know what to
do with this particular condition, which is pervoc pain and pregnancy,
and so that is one of the things that they
have routinely suggested, and also the crutches, because clearly it
(17:40):
is extraordinarily painful. But the point I wanted to make
was that oftentimes, and we've we've done pilot studies on
this particular condition and that we've had one hundred percent
success rate, and they would discard, there's a roller band,
discard the crutches without actually acknowledging that they'd done it
(18:04):
so consciously they wouldn't recognize it done, that they were
just following the prompts for movement, and then they would
I have so many memories of women turning around and
their faces lighting up and saying, I just walked all
the way over here and I didn't use my crutches,
(18:25):
and it's like, right, how does it feel? It seems
really good. How does it feel to be able to
breathe deeply and have no constriction? It's great. I don't
ever want to put that sorolla band on again.
Speaker 4 (18:40):
You describe that for me a little bit. I don't
know what it looks like or where it goes.
Speaker 2 (18:44):
So a sorollar band is made of a very firm material.
It's maybe twelve centimeters in width, and it goes all
the way around your pelvis. These pregnancy related perfect girdle
pain can come at any point in pregnancy, so if
(19:06):
it's very late in pregnancy, they simply can't get it
on because there isn't room to put it on.
Speaker 3 (19:13):
You're basically like a girdle then in a way like.
Speaker 2 (19:15):
A yes, but it's around that I just.
Speaker 4 (19:18):
War to review for this audience a couple of details. So, okay,
let's take back pain. I mean, maybe from a tweaked
back or strain muscle or torn anulis and it hurts
a lot, But then it's that fear of the pain
that keeps it going on way past the injury. Then
your brain actually memorizes the pain and again bear is
(19:38):
inflammatory and you actually feel the pain, not imaginary, no psychological.
And I'm guessing with your situation, you have some big,
big ligaments which have lots of pain vibers in them
in pregnancy that do soften the pelvis does widen a bit,
and the pelvic pain originally has a structural source just
from the ligaments, et ceter. But it's not unstable, it's
(20:01):
not dangerous, but it is painful. But that ongoing fear
of the pain, then we have all these things that
we do to cool get rid of the pain that
actually makes the problem way worse.
Speaker 3 (20:11):
Did I get that right?
Speaker 2 (20:13):
That's right, and that's correct. And oftentimes pregnancy related PERVT
pain may well be with first pregnancies, and I have
had women say, are you sure it's safe for me
to take this off? Like it won't fall out? And
I said, if you think giving birth is going to
(20:35):
be that easy, we have some things to talk about. Yes,
you can definitely take it off and everything will be grand.
Don't worry about it. But that is very much speaking
to your point. The fear of not knowing how this
is going to go is huge in it with a
(20:56):
first pregnancy because people react into different ways. Some might
read copious books and just terrify themselves through horror stories
of different births, or they may be unable to process
any information about it, and so the fear is fear
of the unknown, And so that may well be what's
(21:21):
driving the palette pain in the first place, coming from fear,
it's coming from anxiety.
Speaker 4 (21:30):
So again, we could talk for days on pain and
jurnal because we have talked for days on pain in journals.
So again you've opened up a whole bunch of topics
I hadn't even thought about. So let's just summarize what
we've talked about today about Really it's the fear that
(21:52):
is not psychological. It's your body's total body response. To
anything that is perceived as dangerous, whether it's your thoughts
or physical pain or circumstance. That fear is supposed to
be extremely unpleasant and gives our signals to the whole body.
And so with mental pain, for instance, there's no structural damage,
but that mental pain is just as better worse than
(22:14):
physical pain. So in general, what you're doing is just
helping people calm down in a very powerful way.
Speaker 2 (22:25):
That's right, they're calming down, but they're also gaining skills
about their own body, understanding their presence in the world
in a way that they perhaps haven't understood that previously.
And I sometimes say to them when they're struggling to
(22:49):
explain the difference that it's made. Perhaps when you first
started this work, you regard guarded your body as a
vehicle to carry your brain and your head, and that's
what's different. Now you understand your body and you understand
(23:13):
that there is a communication between your body and your brain.
And we know that people give these examples all the
time in this area of work, of how when you're
embarrassed there is a red flushing that takes place. But
this is a much deeper level of understanding of the
(23:34):
body and how that body is part of them and
that helps with the whole calming down and giving the
body opportunity to heal and respect for the body, which
perhaps if we go all the way back to the
(23:55):
first podcast we did with the rugby players, that attitude
of treating the body like a bull in a china
shop didn't have respect for the body, whereas at the
end of the master's course, every single one of those
(24:15):
men had respect for their body. I was interested to
challenge the body to see what it could do and
to find out more about what it could do, and
also to find out the connection between emotions and the
sensations that they felt and feel internally.
Speaker 3 (24:36):
Wow. Well, Max, thank you very much.
Speaker 4 (24:39):
And even though Marriage lives in Scotland, originally from Ireland,
she does online work. She's worked with patients of mind,
had nice successes and so Marriage we finished up with
just as how to access your services?
Speaker 2 (24:52):
Okay, so you can get hold of me if you
look for resolving chronic pain. That's my website or you
could you can put in Max Clarksmith dot com and
that will take you to the website as well. And
the other thing I guess I should just add is
I do teach an Ireland a lot, and my family
(25:15):
is in Ireland, so I kind of I have a
very strong connection to Ireland.
Speaker 4 (25:23):
Well, Max, thank you, and as you and the audience
can tell I, MAXI and I talked a lot. I
enjoy her insights. Has been hugely helpful for me in
my work and understanding of pain in general. But I mean,
I tell you as a surgeon, you know, fifteen years
ago I no clue that this stuff was so effective.
Plus you know, as a true surge, I just would
blow it off. Is this whatever just didn't make any
(25:45):
sense if you understand the physiology the body. This makes
way more sense than doing spine tutrey on a nonstructural problem.
So fantastic work and Max, thank you very much, and
I encourage you to access your resources you find her
delightful work with and thank you.
Speaker 2 (26:00):
Thank you so much, and pleasure Thank youth.
Speaker 1 (26:05):
I'd like to thank our guest Mags Clark Smith for
being on the show today and explaining how she uses
mindful movement to reduce fear, alleviate chronic pain, and promote healing.
I'm your host, Tom Masters, reminding you to be back
next week for another episode of Back in Control Radio
with Doctor David Hanscomb, and in the meantime, be sure
(26:26):
to visit the website at www dot back incontrol dot com.
Speaker 4 (26:33):
Thanks for listening today and join us next week for
Back in Control Radio
The following podcast is part of the Mind, Body, Spirit
dot fm podcast network.
Speaker 2 (00:12):
Hello and welcome to Back in Control Radio with Doctor
David Hanscombe.
Speaker 1 (00:23):
Hello everybody, and welcome to another episode of Back in
Control Radio with Doctor David Hanscombe. I'm your host, Tom Masters,
and our guest today is Mags Clark Smith. She draws
on her extensive knowledge of the body through dance, psychology
and nonverbal communications to empower people to move with confidence
(00:45):
and resolve chronic pain. She offers one to one resolving
chronic pain consultations and body control plates classes, as well
as taking part in chronic pain research and giving guest
talks and lectures on chronic pain.
Speaker 3 (01:00):
Welcome, Thank you, Tom.
Speaker 4 (01:03):
I would like to welcome Max Clark Smith to her
podcast today. I just did a podcast with her which
gave her background on being a somatic well. She has
lots of talents, but she works with somatic work, mindfulness, dance, art,
relaxation tools. She's an instructor and she's also one of
(01:23):
the editors of a textbook on PPDA which the psycho
Physiological Disorders Association Textbook has now been changed to the
Neuropast Plastic Pain Society, but The bottom line is whatever
we name, you give it. Both of us have come
to the conclusion that the body knows how to heal
itself and we just need to give the body cues
of safety to heal itself. And Max are good friends.
(01:47):
We've known each other for a long time. We talk
every month. She does live in Scotland. She's from Ireland.
I didn't make that clear in the last podcast. But
she does online work and she just offers a whole
line of therapy that really quite relevant, to put it,
mildly and quite effective and also quite different. So marriage,
(02:10):
welcome back to the show. And did I get to
the introduction close enough today?
Speaker 2 (02:16):
You certainly did. Yes. So I do use movement, and
I use movement because, as you will know, when people
for us come to us, they're often very scared of moving.
And that may be because they've been to a health
(02:36):
practitioner who has said, no, you need to be very careful,
don't move that limb. Oh yeah, I can see your
back is very stiff. You best not use that. And
so one of the first things that I want to
discuss with people is how that information may well have
been extraordinarily helpful at the time but as the pain
(03:01):
that they're experiencing now is chronic, it's been around for
over three months, and that means that that initial piece
of advice probably isn't relevant anymore. And then there is
a huge resistance that I see in the nonverbal communication
of who error I am working with, because that may
(03:25):
well have been something that has created a form of
safety in their mind that they won't be moving that
part because they were told not to and life will
be better if they don't. And so then what needs
to happen, in my view, is a building of trust
(03:48):
between myself and whoever it is that I'm teaching to
come to a point where I can suggest to them
that it is safe to move and to actually encourage
them to move that body part in a way that
(04:10):
continues to feel safe to them. And so that requires
me to talk through specifically how to improve body awareness,
and that means noting where body parts are in space
and to draw attention to internal sensations what the body
(04:34):
is doing internally, and sometimes that might require closing the
eyes so that they can focus more on what they're
feeling internally. And then we need to kind of look
at the connection between those sensations and the possibility that
(04:57):
they link with emotions that they might light feel at
the time, and that then is a very gentle introduction
to moving from a place where they have appeared initially
to be very resistant to moving.
Speaker 4 (05:16):
Well, you bring up some very interesting points that we
will talk about more later. But this is not psychological.
Because I spent a good part of my practice taking
people have been told they had the genitive disease, that
they should move it was dangerous.
Speaker 3 (05:33):
Back pain, of course hurts.
Speaker 4 (05:35):
But what happens to call it the no cebo effect,
and it's not psychological. What happens, Okay, sit down, My
back hurts, So my brain's saying that I shouldn't sit
down because it's going to hurt and it's dangerous. Well,
the fact that your body now takes that signal says
it's danger fires up your fire or flight mechanism, which
increases neuro conduction, which increases the neurotransmitters in the brain,
(05:58):
which increases inflammation in the brain. He sentitized to the brain,
and you actually feel the pain more because you are afraid.
So people came into my office terrified all the time
because of they were totally of degenitive disease, and they
had to be careful. Well, actually, when your spine is
degenerated is actually more stable and safer to move.
Speaker 3 (06:17):
The pain is just pain.
Speaker 4 (06:18):
It's not dangerous, even though we equate it with danger.
But I'll give you one quick story that illustrates what
you talked about. One gentleman from New York in his
mid forties, extremely wealthy, very competent, great looking guy, super
nice guy, and he had multiple level degeneration is in
his thoracic spine, normally aging spine, but in nothing out
(06:38):
of the ordinary. He'd been told by a surgeon that
he had the spine of an eighty year old. He
was in chronic pain for nine years. Within six weeks
after understanding that his pain was dangerous at all, his
pain disappeared again. Not mind ever, matter, not psychological, because
you calm down, you go from a threat or fighterfly
physiology to safety and what you're doing. In addition to
(07:03):
me just telling this person, you're actually helping embody that
feeling of safety. Yeah, and it's very powerful.
Speaker 2 (07:13):
It's so powerful. It's so powerful. So I use movement
to develop an emotional lexicon and also to develop empathy
empathy is very difficult. It's a difficult one to sort
of develop because when you've got somebody who's coming to
(07:37):
you because they are at the end of their tether,
because this pain has been gnawing away at them for
however long and they've gone to this number of practitioners
and have had no success. They're very focused on what
the pain is doing all the time, and what the
(08:01):
movement work does is it helps them to park that
for a bit and start to move their body safely,
and it does require quite a bit of reassurance, but
that doesn't seem to be a problem. They will move,
(08:22):
and they're often astounded that they'll move, like I'll get
them to walk across the clinic if it's an in
presson session, and they're often just a standard that they've
done that. But they've started by understanding the body internally
(08:43):
and then they move, and then that leads to them
understanding that that focus of pain is very limited limiting,
and so that's where the end empathy comes in because
they can then they've got the sort of capacity to
(09:07):
think about other people and what they might be feeling,
and that then helps enormously with whatever has kicked off
the chronic pain in the first place.
Speaker 4 (09:21):
Well, that's also very interesting that you're actually connecting to
your body sensations. But at the same time you're turning
your attention outward to other people and so again your
brain's coming.
Speaker 3 (09:34):
See by trying.
Speaker 4 (09:35):
Yeah, I mean what you're saying is simple but complicated
because you're learning to be with the pain, but learning
not to fear the pain. And more like, fear and
anxiety are the same thing, and it is the pain.
Anxiety is the pain is just as danger. So it's
a physical signal or an emotional signal is still fear
(09:55):
slash anxiety slash pain. So anxiety actually is the pain.
So by decreasing anxiety, you're actually decreasing pain and again
logically response to that. But when you reach outward, and
there's lots of data on this, that altruism giving back
is actually anti inflammatory, actually more inflammatory markers.
Speaker 3 (10:20):
So if I came to you with chronic back pain.
Speaker 4 (10:24):
Or let's say, lots of anxiety, lots of just general
life issues in general, where do you start? I mean,
how do you get me calmed down enough? So let's
just pretend I'm a rugby player pretty wire, and you'll
being a spine short in his own version of rugby
and medicine. So my whole thing, my attitude life was
I mean, honestly, my skills for dealing stress were very crude,
(10:48):
and that was bringing on. You cannot hurt me, and
I did, I would. I was under a perverse amount
of stress. I took a huge amount of pride in
taking on anything, and you couldn't. You couldn't hurt me.
My nickname in high school was the brick, which I
took as a badge of honor. It didn't really work
in marriage very well, and I didn't understand this. I
(11:10):
still thought this was a badge of honor. But yeah,
I was really really tough, and I also get really
really sick. Okay, so I'm walking into your office. I'm
having some ring in my ears, my feet are burning.
I don't have anxiety because I can't feel anxiety. But
I don't want to feel anxiety, so I don't. So
was a master of suppressing stress. And you would use
(11:32):
the word disconnected or disassociated for my body.
Speaker 3 (11:35):
Really, but I do ten to twelve hour surgeries.
Speaker 4 (11:38):
I would do ridiculous amount, sixteen eighteen hours a day,
and it was all it was all a badge of honor.
So I was more than disconnected and having multiple physical
mental symptoms. So, okay, I walk into your office, I'm
the brick.
Speaker 3 (11:52):
What are you going to do with me?
Speaker 2 (11:55):
So the very first thing I would do, if I'm
assuming you're not as fine certain, I would Often people
arrive and they've got a whole bunch of MRIs. I
will get them checked first to just make sure that
there is nothing untoward going on. And that's all about
meeting the patient where they're at, because even though the
(12:19):
anxiety might not be showing, it's definitely there. So if
somebody is arriving and they've they've gone to all these
other practitioners, then we need to acknowledge that they've gone
to those practitioners, and we need to acknowledge that they
haven't made any significant progress so far and that it's
(12:40):
safe for me to continue. As soon as that's established,
then I normally ask people what is what is the
biggest fear you have in moving? Or oftentimes I don't
have to ask it because I'm being told, and then
(13:01):
I get you to move immediately those body parts. So
you've come into my office and back is giving you
all sorts of pain and you're saying, I can't move it,
it's completely stiff. Then I will get you to do
a roll down, and I will get you to do
(13:23):
that in a very very detailed manner, without any expectation
of you rolling down to any particular point, but just
moving this mine a little bit and then coming back up.
(13:44):
And that can be the most reassuring small exercise that
helps clients to understand that they're they're going to be
able to control the process to a certain extent, and
that's very important when they first come in and that
(14:04):
they're in safe hands. They need to feel safe.
Speaker 4 (14:19):
Well, it's interesting that you see that because as they
study an orthodoctor Danter out of Bustin, Texas, who's actually
shown in the laboratory that a sense of control lawers
inflammatory markers called cytocins direct link between a sense of
control and decrease information.
Speaker 2 (14:38):
So in any of the movements that I ask people
to do, I explained beforehand that they're in control, and
that would it be possible for them to just do
this little bit and then stop. Listen to the body
when the body doesn't want to move anymore, just pause,
take a breath, in, breathe O, and then return to
(15:01):
your standing position, and that's allowing the person to feel Okay,
I don't have to panic, I don't have to try
and second guess what I've got to do next. I
have to stay in the moment, and that's the important piece.
And all the time I'm asking them how they feel,
(15:22):
what sensations are coming up. And oftentimes people with that
particular movement of rolling down will roll down quite some
way the third time that we do it, because they've
forgotten that they'd explained that they couldn't do that, because
they've told they've been told way back when that they
(15:44):
mustn't move their spine. And so it's very rewarding because
you then see people's faces when they realize that they
can do that. And one of the things that you
asked me at the beginning was how did I get
into this and how I got into actual this line
(16:05):
of work, specifically when I realized I wasn't working on
my own was through pelvic girdle pregnancy paint. And I
have many many stories of women coming to me using
crutches and having a sorolla band because they've been told
that this was the only way that their pelvis would
(16:27):
stay together, and being able to ease that off by suggesting,
let's just see what it feels like to breathe without
that constriction, and they take it off.
Speaker 3 (16:41):
And then I've not heard of that.
Speaker 4 (16:43):
You're saying women would come indo with bands holding their
pelvis together.
Speaker 2 (16:49):
Well, it's called a ciola band, and their understanding of
it was that it was holding their pelvis together. In fact,
it's creating a support for the pelvis. And usually physiotherapists
who would give people these to wear.
Speaker 4 (17:06):
I mean, I hate to be clinical, but as an
orthopedic surgeon who used to do trauma, pelvis has these
massively powerful ligaments and anything you put in externally is
not going to make any difference at.
Speaker 2 (17:16):
All, absolutely, and you know that and I know that.
But physiotherapists are at a loss to know what to
do with this particular condition, which is pervoc pain and pregnancy,
and so that is one of the things that they
have routinely suggested, and also the crutches, because clearly it
(17:40):
is extraordinarily painful. But the point I wanted to make
was that oftentimes, and we've we've done pilot studies on
this particular condition and that we've had one hundred percent
success rate, and they would discard, there's a roller band,
discard the crutches without actually acknowledging that they'd done it
(18:04):
so consciously they wouldn't recognize it done, that they were
just following the prompts for movement, and then they would
I have so many memories of women turning around and
their faces lighting up and saying, I just walked all
the way over here and I didn't use my crutches,
(18:25):
and it's like, right, how does it feel? It seems
really good. How does it feel to be able to
breathe deeply and have no constriction? It's great. I don't
ever want to put that sorolla band on again.
Speaker 4 (18:40):
You describe that for me a little bit. I don't
know what it looks like or where it goes.
Speaker 2 (18:44):
So a sorollar band is made of a very firm material.
It's maybe twelve centimeters in width, and it goes all
the way around your pelvis. These pregnancy related perfect girdle
pain can come at any point in pregnancy, so if
(19:06):
it's very late in pregnancy, they simply can't get it
on because there isn't room to put it on.
Speaker 3 (19:13):
You're basically like a girdle then in a way like.
Speaker 2 (19:15):
A yes, but it's around that I just.
Speaker 4 (19:18):
War to review for this audience a couple of details. So, okay,
let's take back pain. I mean, maybe from a tweaked
back or strain muscle or torn anulis and it hurts
a lot, But then it's that fear of the pain
that keeps it going on way past the injury. Then
your brain actually memorizes the pain and again bear is
(19:38):
inflammatory and you actually feel the pain, not imaginary, no psychological.
And I'm guessing with your situation, you have some big,
big ligaments which have lots of pain vibers in them
in pregnancy that do soften the pelvis does widen a bit,
and the pelvic pain originally has a structural source just
from the ligaments, et ceter. But it's not unstable, it's
(20:01):
not dangerous, but it is painful. But that ongoing fear
of the pain, then we have all these things that
we do to cool get rid of the pain that
actually makes the problem way worse.
Speaker 3 (20:11):
Did I get that right?
Speaker 2 (20:13):
That's right, and that's correct. And oftentimes pregnancy related PERVT
pain may well be with first pregnancies, and I have
had women say, are you sure it's safe for me
to take this off? Like it won't fall out? And
I said, if you think giving birth is going to
(20:35):
be that easy, we have some things to talk about. Yes,
you can definitely take it off and everything will be grand.
Don't worry about it. But that is very much speaking
to your point. The fear of not knowing how this
is going to go is huge in it with a
(20:56):
first pregnancy because people react into different ways. Some might
read copious books and just terrify themselves through horror stories
of different births, or they may be unable to process
any information about it, and so the fear is fear
of the unknown, And so that may well be what's
(21:21):
driving the palette pain in the first place, coming from fear,
it's coming from anxiety.
Speaker 4 (21:30):
So again, we could talk for days on pain and
jurnal because we have talked for days on pain in journals.
So again you've opened up a whole bunch of topics
I hadn't even thought about. So let's just summarize what
we've talked about today about Really it's the fear that
(21:52):
is not psychological. It's your body's total body response. To
anything that is perceived as dangerous, whether it's your thoughts
or physical pain or circumstance. That fear is supposed to
be extremely unpleasant and gives our signals to the whole body.
And so with mental pain, for instance, there's no structural damage,
but that mental pain is just as better worse than
(22:14):
physical pain. So in general, what you're doing is just
helping people calm down in a very powerful way.
Speaker 2 (22:25):
That's right, they're calming down, but they're also gaining skills
about their own body, understanding their presence in the world
in a way that they perhaps haven't understood that previously.
And I sometimes say to them when they're struggling to
(22:49):
explain the difference that it's made. Perhaps when you first
started this work, you regard guarded your body as a
vehicle to carry your brain and your head, and that's
what's different. Now you understand your body and you understand
(23:13):
that there is a communication between your body and your brain.
And we know that people give these examples all the
time in this area of work, of how when you're
embarrassed there is a red flushing that takes place. But
this is a much deeper level of understanding of the
(23:34):
body and how that body is part of them and
that helps with the whole calming down and giving the
body opportunity to heal and respect for the body, which
perhaps if we go all the way back to the
(23:55):
first podcast we did with the rugby players, that attitude
of treating the body like a bull in a china
shop didn't have respect for the body, whereas at the
end of the master's course, every single one of those
(24:15):
men had respect for their body. I was interested to
challenge the body to see what it could do and
to find out more about what it could do, and
also to find out the connection between emotions and the
sensations that they felt and feel internally.
Speaker 3 (24:36):
Wow. Well, Max, thank you very much.
Speaker 4 (24:39):
And even though Marriage lives in Scotland, originally from Ireland,
she does online work. She's worked with patients of mind,
had nice successes and so Marriage we finished up with
just as how to access your services?
Speaker 2 (24:52):
Okay, so you can get hold of me if you
look for resolving chronic pain. That's my website or you
could you can put in Max Clarksmith dot com and
that will take you to the website as well. And
the other thing I guess I should just add is
I do teach an Ireland a lot, and my family
(25:15):
is in Ireland, so I kind of I have a
very strong connection to Ireland.
Speaker 4 (25:23):
Well, Max, thank you, and as you and the audience
can tell I, MAXI and I talked a lot. I
enjoy her insights. Has been hugely helpful for me in
my work and understanding of pain in general. But I mean,
I tell you as a surgeon, you know, fifteen years
ago I no clue that this stuff was so effective.
Plus you know, as a true surge, I just would
blow it off. Is this whatever just didn't make any
(25:45):
sense if you understand the physiology the body. This makes
way more sense than doing spine tutrey on a nonstructural problem.
So fantastic work and Max, thank you very much, and
I encourage you to access your resources you find her
delightful work with and thank you.
Speaker 2 (26:00):
Thank you so much, and pleasure Thank youth.
Speaker 1 (26:05):
I'd like to thank our guest Mags Clark Smith for
being on the show today and explaining how she uses
mindful movement to reduce fear, alleviate chronic pain, and promote healing.
I'm your host, Tom Masters, reminding you to be back
next week for another episode of Back in Control Radio
with Doctor David Hanscomb, and in the meantime, be sure
(26:26):
to visit the website at www dot back incontrol dot com.
Speaker 4 (26:33):
Thanks for listening today and join us next week for
Back in Control Radio
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