Unlearning Negative Mind Body Patterns That Create Pain and Illness: Part 2

Posted on September 26, 2021March 3, 2024 by Andrew David Shiller, MD

For more videos subscribe to our YouTube channel

Summary:

In this video series we’ve been learning about how chronic pain and associated suffering develop. The idea is to understand the chronic processes, so that you can make choices about how to reverse them and reclaim your sense of well-being and ability to function and live your life. The previous videos in this series shared how the body-mind “learns” chronic pain. You can also “unlearn” chronic pain. This video continues to explain how that process works. I spoke in previous videos about the biological processes that are involved in the development of chronic pain. Have a look at those if you haven’t seen them yet. You can see those posts HERE. We discussed how protective responses are built into the pain processing and movement control systems of your body-mind. These processes get knocked “off the rails” by certain factors. And persistent pain leads to gradual changes in those systems that can unfortunately make pain worse. It’s like vicious cycles, where the pain system gets sensitized, and the movement control system stops working as well. So movement hurts, and pain spreads. It’s richer than that, as persistent pain and the resulting stress-response lead to measurable changes in gene expression, hormonal regulation, cellular energy production, emotional regulation, immune balance, and gastrointestinal function. And these all feed back into one another and can increase pain. So there is this snowball effect, where vicious cycles of biological relationships propagate forward and create the disease of chronic pain. The good news is that many of those changes can be reversed. In my experience, your own mind/body connection is a crucial place to start the changes. One great place to start is by developing the quality of ‘mindfulness”, which starts to shift the reactivity of the protective responses. Just like your brain-body learns chronic pain, mindfulness can start the process of unlearning.

Did You Know:

Dr Shiller is available for telemedicine consultation in CT, NJ, and Florida, as well as worldwide regarding chronic pain, fibromyalgia, autoimmune disease, fatigue, and stress-related illness. His US-based consultations are offered in conjunction with Rose Wellness to enhance the quality of care and ease of your experience as a patient. Contact the office or schedule a consultation at Rose Wellness. For international consultations contact www.drshiller.com.

Movement Toward Health is an affordable and effective training program to teach you to heal and feel better and improve your functioning. It will teach you to integrate breathing techniques, mindfulness, and mindful movement techniques that are drawn from Dr Shiller’s 30+ years learning, practicing, and teaching these approaches to people suffering chronic pain and chronic illness. To get more info and be notified of the next start date CLICK HERE.
Dr Shiller gives regular free mind-body training sessions on zoom. You can get the schedule and register at www.mindbodygroove.com

Full Transcript:

As mindfulness develops, you start to notice stuff, you become more aware, because you start to develop your ability to pay attention and receive what is there. You start to notice, “Gosh, I’m spending most of my life filtering through my thoughts and beliefs about what’s going to happen instead of actually seeing what’s going to happen” and almost everybody that goes down this path is like struck by that, “Oh my gosh, I was living in fantasy and I’m starting to touch living in reality” and part of that is you start to touch the sweetness and goodness of life, you start to smell and touch and taste things that are beautiful. We will talk about that in the next part, because that is really important, but for now, we are talking about kind of inhibiting the negative patterns, because that is the other aspect of what we do, it is kind of like I said, stopping these unproductive reactive habits about your mind and your thinking, your nutritional habits, your posture, your bodily habits, what you do in the world, and it is not like you are being forced by some sort of blaming conscious and shitting yourself, like what is wrong with you, do not you know you should not do that, that is not the game, because what happens is you just start to pay attention and you just forgive everything and you just choose to be grateful and you let go and you practice letting go and being present, and what arises naturally is just a clear choice, like, “I don’t want to eat that stuff or gosh this person in my life is toxic. I want to do something different because I’m, so much negativity there or gosh look at all my own toxic thoughts, how can I be with that and let go of them” S Mindfulness practice develops this observer, that starts to notice the negativity and you naturally start to just say, “No, thank you” and you naturally become more forgiving with yourself and forgiving with other people. You naturally start to like accept your life as it is and that does not mean it is never going to change, but you are less reactive to the things that are difficult, that used to grab you and pull you into severe suffering, and it is remarkable the changes that just happen naturally that I have been privileged to witness with other people. You know it is kind of like there is concrete and then suddenly the grass grows through the crack somehow, like there is life in there that wants to come out. One example, there is a fellow that I worked with, his name is Bill, and he was a recovered alcoholic, but really struggling with cravings, a lot of difficult emotional stuff in his life, and every day was like a war to not drink, and you know we were practicing one day and Bill basically says, “I really have the urge to drink” and I said, well, okay, so what else are you experiencing? He said, well, I feel tight in my chest and I feel irritable, my back hurts. Okay, and what about the emotions? I feel irritated, I feel angry with you for asking me all these stupid questions. So, I said okay, so how about just sit with what you are experiencing, sit with the difficult emotions, just observe them and be with them, notice what they feel like, do not try to change them, just agree because that is what is happening. He sits there for like a minute and a half and then like a smile comes on his face, like why are you smiling? He’s like, well those emotions were really hard and then they just kind of went away, and I do not feel like I need to drink anymore. That was a discovery, it was something that just came to him through observing his own life, and I could give you so many examples of things like that in my own life, in the life of so many patients, where it just comes from paying attention with compassion, dropping the judgment, forgiving, being present and cultivating this part of you that actually kind of hovers above your emotional self and your bodily self and is with you all the time, and it is an expression of a deep inner intelligence, and it is your healing intelligence and that is the power of doing that kind of training to unwind these pathways of mind, emotion, and physiologic reactivity that perpetuate and develop this process of chronic pain and chronic illness, and so, as you practice and train yourself to be aware with compassion and with discernment, things start to change spontaneously, you start to just, you know, you may have lived your whole life in patterns of reactivity that are mental, emotional, and physical, and you start to notice them and they start to kind of get lighter and get less heavy and you start to have more freedom of choice, and it is from practice, it is relearning, it is rewiring, nerves that fire together wire together. When I have that experience of tasting the irritation that once created reactivity, and I choose to just be with it and let it be there and say yes, it is happening, I agree this is what is up, letting go the judgment, then I am turning off the reactivity, it is like, I am uncoupling it, you know, it is those two nerves, there is the irritated and then there is the reactive nerve, right? I am irritated, so then I get emotional, and I am basically saying, “No, I’m not believing you anymore, you are just a habit. I don’t need to get reactive when that happens” and then you start to actually uncouple your physical, emotional, mental experience from your ability to choose to have the kind of experience you want to have, and that changes your physiology, it changes your neural networks, it changes your gene expression, because you are living in a more calm, clear, connected state, where you are not as reactive. We talked about how there can be setbacks and how a person can be learning to live in a calm or clear state of mind and body but then something happens that like knocks him on the ground, knocks him back into the hole or they fall in the water, so to speak metaphorically, so what is that about, how do you deal with that? We talked a bit how just being mindful gradually that happens less and you develop the capacity to respond more effectively when it does happen, but the other thing is that there is deeper kinds of work than just sitting there and being mindful of what is going on. There is deeper work that involves getting therapeutic support, whether it is with an individual or a group or in your own inner work and intentionally going in and meeting the dark places inside, because a lot of us, most human beings, we have had experiences of profound disappointment of hurt, of trauma, of fear, times when we felt like we were disconnected and it just was not okay and, you know, there is a language for this in various psychotherapeutic and spiritual traditions, but the point is meeting those places and evoking various tools for actually doing a deeper level of work, to reclaim that part of yourself and to free up the deeply held protective responses that you might have in your heart or your body, that is profound work as well. It is a little bit beyond the context or it is a little bit beyond the scope of this video. So, I am not going to go there now, but that is something else to think about and talk about, because a lot of people with chronic pain and illness have trauma. We know that early life trauma is a huge part of what influences people to develop chronic pain and chronic illness and healing that trauma can be a profound influence on all of these physiologic processes, because what it does is sort of uncouples or discharges or disengages these deeply held patterns that said, “danger” and it is about healing those, so that your whole system can be more at ease in that rest, and there is techniques for learning that. Okay, so let us make a break now and we have talked really about the process of sort of saying no and uncoupling and unlearning negative protective responses, and we also want the process of installing and learning and actually awakening healing responses. So, we will talk about that in the next vid, hope you tune in.

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Unlearning Negative Mind Body Patterns That Create Pain and Illness: Part 1

Posted on September 22, 2021March 3, 2024 by Andrew David Shiller, MD

Watch Part 2 HERE

For more videos subscribe to our YouTube channel

Summary:

In this video series we’ve been learning about how chronic pain and associated suffering develop. The idea is to understand the chronic processes, so that you can make choices about how to reverse them and reclaim your sense of well-being and ability to function and live your life. The previous videos in this series shared how the body-mind “learns” chronic pain. You can also “unlearn” chronic pain. This video begins to explain how. I spoke in previous videos about the biological processes that are involved in the development of chronic pain. Have a look at those if you haven’t seen them yet. You can see those posts HERE. We discussed how protective responses are built into the pain processing and movement control systems of your body-mind. These processes get knocked “off the rails” by certain factors. And persistent pain leads to gradual changes in those systems that can unfortunately make pain worse. It’s like vicious cycles, where the pain system gets sensitized, and the movement control system stops working as well. So movement hurts, and pain spreads. It’s richer than that, as persistent pain and the resulting stress-response lead to measurable changes in gene expression, hormonal regulation, cellular energy production, emotional regulation, immune balance, and gastrointestinal function. And these all feed back into one another and can increase pain. So there is this snowball effect, where vicious cycles of biological relationships propagate forward and create the disease of chronic pain. The good news is that many of those changes can be reversed. In my experience, your own mind/body connection is a crucial place to start the changes. One great place to start is by developing the quality of ‘mindfulness”, which starts to shift the reactivity of the protective responses. Just like your brain-body learns chronic pain, mindfulness can start the process of unlearning.

Did You Know:

Dr Shiller is available for telemedicine consultation in CT, NJ, and Florida. worldwide regarding chronic pain, fibromyalgia, autoimmune disease, fatigue, and stress-related illness. His US-based consultations are offered in conjunction with Rose Wellness to enhance the quality of care and ease of your experience as a patient. Contact the office or schedule a consultation at Rose Wellness.

Movement Toward Health is an affordable and effective training program to teach you to heal and feel better and improve your functioning. It will teach you to integrate breathing techniques, mindfulness, and mindful movement techniques that are drawn from Dr Shiller’s 30+ years learning, practicing, and teaching these approaches to people suffering chronic pain and chronic illness. To get more info and be notified of the next start date CLICK HERE.

Dr Shiller gives regular free mind-body training sessions on zoom. You can get the schedule and register at www.mindbodygroove.com

Full Transcript:

All right, so in the last video, we talked about how chronic pain and illness are processes that gradually develop over time, that genetics and life experiences and various triggers can start this process, and that your biology shifts, your system, your mind body system so to speak practices various protective and maladaptive responses and that is built into your neural networks, so practicing it over time, your system learns it and it becomes kind of set, and that is affecting your neurologic activities and emotional and mental responses, your neuromuscular functioning of your motor system, your gastrointestinal system, your hormones, your immune system. To varying degrees, those are all influenced, because it is all one system, and it is all working together, presumably to protect you from danger but effectively to generate these secondary problems of chronic pain and chronic illness. The system gets unbalanced, the neural networks change, gene expression can change, and the outcome is chronic pain and chronic illness, and just like it can be learned, it can be unlearned, and so this video is going to start talking about how do you help the healing process, how do you unlearn chronic pain, how do you relearn health? Healing is a learning process, it is about the conscious choices that you make on a daily basis, lifestyle, behavior, habits, thought patterns, mindset. You could break it into three parts, because I like to do that to make it easier and they are called three M’s, there is your mind body system, your metabolic or biochemical system, and your motor or your movement system, and all of those are ways that you can kind of grab hold of your physiology and on a regular consistent basis start to shift your physiology towards health. Obviously there is a lot to unpack there, but the point is that you really need to think about it as I am taking charge of my health. I am not expecting someone to fix me. I am not looking for an overnight miracle that suddenly I am going to be better. What I am looking for is gradual change over time that happens, because I have made conscious choices, and I have been doing stuff to help my mind body system to optimize my metabolic system, nutrition, inflammation, all of that, and to actually use the power of my movement system to help my body heal. This whole aspect of retraining and unlearning pain and illness and relearning health. There are these two parts of aspects of unlearning the bad stuff and learning the good stuff, pretty simple, right? Let us start by talking about unlearning the bad stuff and you got to start that conversation by talking about stress and almost everybody now knows that you have a stress response and you have a relaxation response, this is physiology that has been demonstrated for 50 years and interventions to evoke the relaxation response have been tested over and over and over again in so many different realms of health and showing their benefit, because they balance that system out. You are meant to go through stress in life, life is not meant to be stress-free despite what the magazines tell you, but the point is, you have stress and then you have relaxation, and the system is in balance. Most of us in our current time are stressed, there is a lot of difficult things going on in the world, and if you have got chronic pain, chronic illness, there is a protective stress response going on and you probably like overdoing it on the stress response and under-doing the relaxation response. Simple techniques, there is a bunch of different ones, can actually evoke the relaxation response, and lots of research showing us that those are beneficial in a variety of different kinds of conditions and situations, to enhance well-being, to help people cope with pain, to reduce the effects of chronic illness in various ways on various organ systems. The key is consistency. We are talking about a learning model. We are talking about the body has practiced for months or years, an unbalanced stress response and all of that influences in the whole body-wide system, and so what you are looking at doing is shifting that, and that means consistency, nerves that fire together wire together, you want to shift your neural networks, you want to bathe your whole body and mind in biochemistry that starts to shift gene expression overtime. You want to try to do it on a regular basis. Hopefully that all makes sense, but there are a couple of problems with relaxation training. I have been teaching meditation for a lot of years, and what I hear over and over again from a lot of people is, “doc, I try to relax and I get more tense.” It is a really common thing, because you know what, if I am trying to do something, I am not relaxing, effort is the opposite of relaxing, and what you could say is stress is when we are trying to put an unbalanced force on something, an absence of stress is just stopping, it is effortless, there is no effort, there is no trying to get anywhere, and so a lot of the relaxation response methods that are sort of like active, “Hey, you are going to relax,” they can trip a person up that way. If it works for you, great, do it. In my own experience, just simply bringing the awareness to the present moment, bringing awareness to the sensual experience of life, bodily sensations, breathing, sounds, textures, even the taste of food, that is all about bringing your awareness and your consciousness into the here and now, and there is not stress here and now. Mental emotional stress comes from future and past; it comes from comparing and thinking and striving and yearning and trying, and when you just bring your awareness into the here and now, the whole system starts to calm down and relax. In my experience, that is often a big change for people who are sort of stuck in the “I can’t meditate, I can’t relax.” Okay, so do not meditate, do not relax, just pay attention in a structured way, just notice what you are experiencing, notice your breathing, let your breathing be like waves coming in from the sea and rolling up on the shore and rolling out to the sea. It is an experiential process. The second big challenge with relaxation and stress management in general is what I have heard from so many people, which is, “I feel great when I am doing it, but then as soon as I get back to life, wow, everything hits me and suddenly like I am back into the vortex, and I am into the reactivity” and you know whatever it is, like the wife or the husband or the co-worker who does something unkind or the pain flare or the financial issues that trigger something, and before you know it, you have fallen back in the hole. So, what do you do about that? One of the first things you do about that is realize that it is totally normal, if you have been practicing being in a reactive stress state for months or years, then your body is used to it, that is what we are talking about here, we are trying to change physiologic habits, and it can take time, and it is totally normal that you get pulled back into the challenging stuff. There is a deeper level to this if you start really thinking about the structure of a human being and a human soul, which is that we often have areas in our deeply held experience in our heart, even in our bodily memory that are associated with painful traumatic experiences, and until we start to actually unravel that and unwind that, they are going to still pull, they are going to pull our attention, they are going to pull our physiology, they are going to have a pull on your emotional experiences. That is where it gets a bit deeper, because the idea of bringing your attention and your awareness to the present moment experience, yes, it can be very relaxing, but there is a deeper process. What happens is you develop this quality of your own mind that is able to be present, and you actually gradually condition your mind and your emotions to observe what is going on without getting sucked into the drama, without getting sucked into the judgments and the habits of self-blame, self-judgment, criticism of self or others and the emotional reactivity that they create. In my own experience and what I have witnessed with so many people, there is this process by which the awareness develops overtime, there is a part of your mind and soul that is elevated above your emotional reactivity, and you develop it, you build it, you condition it, you teach it, you learn it by practicing it, and that is why the real benefits from meditation happen from practice. By doing it on a consistent basis, by observing, by being present, by letting go of the reactivity, by falling off and getting sucked into it and then letting go again. It is a training process whereby you are essentially saying to your whole being, I am paying attention, and I am here, and I am not going to go down those pathways, I am saying no essentially to the normal reactivity, like I am sitting there and breathing, and I am paying attention, and I notice the thought that comes up that often triggers me, and I choose to just let it go. I notice an emotion that might come up, that might trigger me, maybe it is sadness or fear, and I just choose to hold it; I decide to compassionately relate to it. Okay, there is a difficult emotion, I am feeling fear, I am experiencing pain, let me just be present to that as if it was a little child who needed my loving care and attention and hold it in my heart without getting into the whole reactive, oh my gosh, how’s it going to change, I can’t live like this. The things, the habits of reactivity that naturally become part of our being when we are dealing with chronic pain and illness can be unlearned and that is really what mindfulness training is about, there is a lot of different layers to it, but the basic idea is developing awareness and consciousness that are present, discerning, and compassionate. Which means I understand why this could happen, with all the different things that have gone on in life that have happened to me, that have happened to the world, of course, this is what is happening right now. I am falling back into fear and irritation and anger. I am slipping into chronic pain. I have been rehearsing it for 10 years. Okay, I am noticing it, I am letting go, I am not getting caught in the spiral, and what happens is that there is this part of your mind or your brain or your being depending on who you want to think about it, that you develop, and it gets called mindfulness in some circles, in the teachings of Torah and Kabbalah, it is the higher soul, it is the Neshama, the part of us that is just present to our life experience and can connect our sort of lower needs and drives with our higher aspirations, and it is your biggest ally in healing. Many of the people who I serve appreciate shorter videos, because it is easy to absorb that way, and we are going to continue to learn about unlearning pain, but I am we will just to take a break here and continue in the next video, you can find that whether on the blog or on the YouTube page or elsewhere, just look for the next number in the sequence and please join me there, please share if you find this interesting, and talk to you soon.

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Don’t Miss These 3 Things That Can Prevent Healing from IBS, Fatigue, and Chronic Pain: Part 3b

Posted on December 23, 2020March 3, 2024 by Andrew David Shiller, MD

See the other parts of this lecture series here:

Part 1

Part 2

Part 3

Summary:

Your Mind-Body connection is almost certainly part of what drives your IBS, chronic pain, fatigue, or chronic illness. You can mobilize your mind-body connection to help yourself heal. One of the most common mistakes that I see people make is to do all the dietary, nutritional, and exercise stuff, while they don’t adequately take charge of the power of their mind-body connection. This lesson answers crucial questions that you should understand, if you want to heal:

How does the Brain-Immune-Gut-Hormonal integration create and perpetuate chronic illness and chronic pain?
What is the influence of the vagus nerve on all this?
How can you stimulate the vagus nerve to start reversing the disease process?
Why should you care that your brain and stress-response has cognitive, emotional, and physiologic aspects to it’s function?
What is the cell danger response, and why is it important in your healing process?
What are the six steps of mind-body healing?

In the near future, we will talk about the healing power of movement. Even if you feel too tired, weak, or have too much pain to move, there are things you can do to build your freedom and capacity for movement. And movement is one of the best medicines we know! Please comment or reply and share your thoughts, questions, and comments. I look forward to hearing from you. Scroll down for full transcript SLIDE PDF so you can take notes if you want.

Did You Know:

Dr Shiller is responding to the chaos and overwhelm of the corona pandemic by offering regular free stress-busting mind-body training sessions on zoom. You can get the schedule and register at www.mindbodygroove.com
Dr Shiller is available for telemedicine consultation worldwide regarding chronic pain, fibromyalgia, autoimmune disease, fatigue, and stress-related illness. Contact the office or schedule a consultation at www.drshiller.com
Inner Healing Essentials is an intensive six-week course taught by Dr Shiller, which teaches you the Six Steps To Inner Healing. It empowers you to transform stress into vitality, and begin to take back your life from chronic pain and illness. A new class begins quarterly. To get more info and be notified of the next start date: https://andrew-david-shiller.mykajabi.com/inner-healing-essentials-waitlist.

https://youtu.be/rCPvoRim_mw Stillness In Nature Mirrors The Stillness Within You
https://youtu.be/PGzBt2szass Stress Response Basics
https://www.drshiller.com/4-keys-to-a-mindset-that-can-transform-your-fibromyalgia/
https://www.drshiller.com/heal-pain-mindbody-wholeness/
https://www.drshiller.com/heal-fibromyalgia-pain-inflammation-fatigue-mindbody-healing/

Full Transcript:

Welcome back my friends, it is Dr. Shiller. This is part B of a long video that is talking about the complexity of chronic pain and chronic illness and really discussing an overview of the three-part healing process of addressing your mind-body system, your metabolic biochemical systems as well as your movement and structural system as three essential aspects of really taking a big picture of holistic view and that is where the therapeutic leverage is in the integrated approach, because by and large conventional medicine is looking at all these different problems as separate things as opposed to understanding the big picture and realizing that the various symptoms are flowing out of similar underlying physiologic abnormalities or imbalances and then you can address those imbalances, and so this is really, these two parts are the first part of how to really heal, and in part A of this one, we talked about kind of the scientific underpinnings of mind-body medicine and why it is so important, not only why your mind-body connection is so important in the development of chronic pain and chronic illness, and why it is so important in actually transforming and healing chronic pain and chronic illness, and what we are going to do in this video right now is get kind of an overview of the landscape of mind-body healing and understand some of the different elements and understand the rationale about why you do it, and to get a bit of insight on some of the things that people miss when they are first learning meditation or visual imagery or other sort of mind-body approaches and how to really take a big picture of view so that you not only enhance your comfort but you transform the illness process in your body, in your mind, and in the integration of mind and body. So, I hope it is informative and inspiring and interesting. –Next Slide– I want to take this question of relaxation, mindfulness, imagery, and therapy, and how it impacts your mind-body state, your state of consciousness and just review for a second the ways that it can impact your health and have a huge impact on how you are feeling, and we have talked about this about how pain pathways are altered, how brain function can be altered, how the immune function can be changed for better. We did not talk so much about this yet, but energy production by yourselves, your state of consciousness is what determines how you do in life with the people you care about, with the person at the bank, with the police officer who reports you are speeding, with all the things that we need to deal within the world in our roles and in our functioning. If I am going to place a calm and clarity where I am present to my own self, I am present to other people, then all of that stuff goes better, and I can tell you that from my own experience. I was like an anxious, weird, introverted kid when I was a kid, who did not know how to pay attention to myself or other people, and I was kind of a dork, like it just what it was. I was not a smooth person. A lot of people did not like me. I had a lot of challenges interpersonally. Not a lot of challenges in various aspects of what I was doing in life, and when I learned to get quiet and calm and actually start to live from a deeper place in my own being and start to live with more empathy for myself and more for other people, my life changed profoundly, and guess what, my relationships are not as stressful. Our relationships tend to be harmonious and positive, and I am not saying that to say I am so great. I am saying that to say that anyone can do this, and so many of the people that I have trained than other people who have trained, people who have learnt to actually find a state to calm themselves, learn how to navigate through the world to flow with the challenges when the wave comes, to ride it like a skilled surfer or dive underneath it, because of awareness, because of skill and self-management. Motivation and self-care. It starts with you, it starts in your hearts, it starts in your soul. Are you eating stuff that is actually good for you or you are eating stuff that feels good in the moment, because you have got a lot of stress and emotional anx and you are eating sugar and bakers and saturated fats which tastes so good. There is a reason they call it comfort food, but the fact is, it destroys your body, it feeds into and poisons so many of your systems, and the same thing about alcohol and other substances, and on the flip side, exercise and self-care, whether it is going for a walk, doing something pleasant that feels good, doing exercise that feels good. These are the things that actually shift your physiology for the better, and they can actually have a huge impact on your health, and that starts with where you are at, what your state of relationship with yourself in the world, and we have talked a bit about gut barriers and motility. So, all of this obviously connected, you are one unity. –Next Slide– I want to step back and think a bit more about the science again, and you basically have three functional areas of your brain, right? You have got neocortex, that is the thinking part of your brain, you have got your limbic brain is your emotional brain, your arousal brain, your stress response happens here. All of your emotions and all of your sensory step is processed here and go to your reptilian brain. Core biological functions, like blood pressure, heart rate, influences on immune function, gastrointestinal motility and function, and so when these things were first started to be evaluated, they used to think, “Oh yeah, these were strictly anatomically distinct areas and that turns out to not be true, that there is processing that goes on at these three levels, and they are different aspects of how you process reality, but their functions, they are not anatomically distant, and if you look up the triune brain, we will see this like progression of the science over the past, I think 40 or 50 years, how initially they thought it was anatomic and evolutionary and like embryonic, but the fact is there is so much interconnection. It is all one brain, but you do have these different kinds of functions and to the extent that you are aware that you got an intellectual, rational processing brain as well as an emotional, reactive brain, as well a biological and body physiological brain. You can better understand how your mind-body connection influences your health, because it influences all three levels. So, let us unpack that a little bit, because this is one of the places where people frequently fall down. I do a lot of training for people in mind-body therapies and healing. A lot of people come to me, “Dr. Schiller, I have been doing all this meditation, it is great. I go to this deep relaxed state and I feel so good. I do not have pain when I am there, but then I come back and my pain comes back or whatever the symptoms,” and you know my sense of what is going on is they are getting some degree of limbic quieting there, and they are getting some mental emotional quieting there, but they are not really getting that quiet into their body and [07:26] healing, what their body is holding on to in terms of self-protective responses, and a lot of times that person who is doing those meditations where they go up and out, they go into some sort of expanded God’s space or some sort of spiritual, energetic, expansive space, but then when they come back into their body, they are the same old person, and so they have their pain, they have their interpersonal conflicts, they get really angry with their kids or with their spouse sort of, they cannot function on their job because they hate their boss. It is because they are soft of disassociating in a certain way, and it is great to achieve that level of calm, but it is really important to bring that calm into the body and allow to start to change you and shift your instinctive, instinctual reactive patterns that come out of your heart and you are in body consciousness and memory. The way I understand it after practicing for 20 years and studying all the science is that a fundamental question that your whole body is asking all the time, whether it is your cortical or mental thinking, your emotional processing or even your physiology is are you safe or are you in danger? And that is a huge thing, because on a physiologic level, let me just unpack this, but like here are things that make us feel not safe, things that make us feel like we might be in danger or we are at risk of something bad happening, things like life stress, pain, trauma. Pain goes into every aspect of your mental, emotional, physiologic functioning; immune dysfunction and inflammation does as well. Toxins and drugs influence everything. Acute illness, surgery, or being in the midst of a pandemic influences every aspect and creates a danger signal. Your entire being is a danger detector. If our human being is not aware of danger, then you have a risk of actually getting hurt or killed. Think about primordial human who is out there in a jungle looking for mangoes, and he is looking for mangoes and he is so into mangoes, he is not even thinking about the tigers that he knows lives in the jungle, because he sees the mangoes, really there is a tiger hanging out there. If he does not see the tiger, he is going to get eaten. If he is focused on the tiger and he misses the mangoes, he can go looking for mangoes tomorrow, but he will not get eaten hopefully if he knows how to defend himself from the tiger, but the point is that we naturally have a bias towards danger and negativity, because it is protective, and we have protective responses that are built into our neuromuscular system, right? You touch a hot stove, you have a reflex that withdraws your hand, you do not have to think about it. You have reflexes throughout your body at every level of your spine in terms of your neuromuscular system, and you have got protective responses in yourselves, in your immune system. Your immune system in general is a protective response. If they would stand at the gate and say ‘friend or foe’ and to keep the bad guys out and let the good guys in, and so the danger detector is in the level of our consciousness, which I will start right correctly later, it is in our immune system, it is our structural system, and it is our biochemical system, and we have cellular protective responses. This is kind of a new thing that is showing up in biology and metabolomics, which is kind of the study of broader cells in the context of all cells, which is systems biology approach, and more and more we are seeing that they are these protective responses on a cellular level, that cell seemed to be able to shut down in response to danger, and they shut down their energy production, they can shut down communication with other cells, they can create a state of hypervigilance and immune activation, they have reduced their actual production of DNA and cellular reproduction,. So, on an actual cellular level, your body can start to shut down when you have persistent danger that it is exposed to, whether it is through your consciousness and your understanding and something dangerous in the world, whether it is immune activation, whether it is structural trauma or something that is happening physically to you, or whether it is biochemical trauma or biochemical changes that are dangerous to your body. You know, we are starting to see that the immune system has these sort of cellular and protein patterns that are called basically danger detectors or damage associative patterns. I do not want to go too much in that detail, because it will fit people out, but the point is on a cellular immune level we are wide for danger, and that protective response becomes part of what is dangerous to us, and the protective mode that develops is probably part of what maintains chronic illness, whether it is psychological protection or limbic emotional protection or physiologic cellular detection, just going to that brain diagram or there is like the stuff you are conscious of and thinking about. Then, there is a stuff that emotional you, just reacting to, whether you are aware of it or not aware of it. Then, there is stuff that your biology is reacting to, and most of us are just not aware of that at all, and so healing depends on bringing this whole system a sense of safety and a sense of calm and a sense of “Hey, it’s okay to be me,” right? –Next Slide– The protective mode is the problem, and what I encourage my patients to do and what I encourage you to do is learn to bathe your body and your mind in the biochemistry of healing, and there is a number of steps to that, and the typical mind-body interventions of relaxation and mindfulness and visual imagery and therapy are part of it, but it is a deeper more compressive thing that we have learned how to measure, but it is an experience that many people can have, and when you have it, you know it. You know what is like to be bathed in a sense of, it is okay to be mean right now. You feel it in your body, you feel it in your bones, you feel it in your heart and you know it in your mind, and the question is and the incentive is and the imperative is to learn how to cultivate that state of being and to learn how to get back into it whenever you need to, and to learn to make it part of your lifestyle if you have a chronic illness or chronic pain, so that your bathing your body in the biochemistry of healing that you are giving a signal to the protective responses in your intellect, your emotions, and your physiology to say, “It’s okay, it’s okay, we can get back to life” and that is how we get back to life, calm, safety, connection. Connection is huge, right? Connection is huge. Connections, what it is about? Positive emotion, turning off the danger response. –Next Slide– So, I have come up with what I call six steps of mind-body healing. I am not going into the details of this right now, but I want to give the overview of that, and I will talk about it again at another time if people are interested, but the six steps are relaxation, mindfulness, body awareness, and then inner insight, as well as developing heart and soul power and transformation. It is all about turning off the danger response. Let me just unpack these a little bit for a second. Relaxation is relaxation, that is the physiology that we have measured. Herbert Benson in the 70’s started measuring the relaxation response, and all this stuff is being built on his research, and it is amazing what he did. He is a cardiologist at Harvard Medical School. The relaxation response is a physiologic, low metabolic state that enables your body to start healing. Mindfulness is a state of mind. Mindfulness is a way of paying attention on purpose in a particular way to your present moment experience, to your thoughts, your emotions, your bodily sensations, and if your are inclined that way to your spiritual sense, and it is a way of learning to see what is really going on in your life. Learning to see how your own mind-body connection is operating, so you can make better choices of it. Body awareness is actually just what it says, being aware of your body. Most of us are walking around like more connected, you know, disconnected from our neck up or busy going, going, doing, doing, we think about our body when it starts to scream it is with some sort of symptoms, but body awareness by bringing your attention to your entire body and feeling it and bringing it a calm state of mind is profoundly healing and that can be done by sitting or lying down meditation. It can be done by simple movement arts like tai chi or yoga, Feldenkreis. Pilates has a lot of body awareness. There is various other approaches that can be done with tremendous body awareness and are tremendously healing. It is about inhabiting the body. It is about bringing your mind and your soul into your body with consciousness. Insight, inner map. Insight is part of what comes out of mindfulness and it comes out of body awareness. An insight comes from relating to your own being with awareness and compassion, and most of us are so full of judgment and self-doubt and self-hatred, and it happens because we get those messages at an early stage in life. It can happen because you are sick and because your body is not working like it should, your mind is not working like it should, and it is very easy to say, “I hate myself. I hate what I become. I hate the fact that I cannot do: ABCDEFG,” and what is the “I” and what is “the self”? What I want to suggest from a Torah and Kabbalistic point of view is that you have an eye, which is your higher soul. It is a deep intelligence that is not limited to your body, and when you start to reframe I hate myself and to connecting with your deeper I, your deeper self-awareness, the place of deep self-acceptance, or you actually see what is causing things and you have compassion on yourself, and it is something you develop overtime and you see the aspects of what is not right in your life, and from that place, you are so much more empowered, they actually make positive changes. Because if you are relating to all the challenging things with self-hatred and self-doubt and self-blame, then you are creating and feeding into that stress access, you are feeding into that anxiety, depression, and misery access, and when you connect to a deeper level of yourself, that is insightful and aware. What we start to do is actually see where you can intervene in an intelligent and compassionate way in your own reality to make positive choices. The next one here is heart and soul power. It is about [18:36], and that means waking up love. It means waking up compassion. It means waking up higher insight. These are really hard things to measure, but they are not hard things to feel if you feel it. Part of what we do in the meditation training I do is we awaken heart energy, and awakening heart energy is something it has been done in every spiritual tradition through all human history until ours. It is starting to happen in ours through apps and, you know, things people do in hospitals, but the point is that you can develop the energy of love in your heart, and your heart is not just a pump, your heart is a system of nerves and endocrine function as well as this is a pump that pumps your blood, but it is profoundly integrated with your brain, and your heart influences your brain and it influences your entire nervous system, and I can guarantee you that as you generate the heart energy of loving kindness and compassion, you will begin to shift your physiology, shift your emotions, and shift your thinking process about yourself and your world and for the better, and the last thing is transformation, and transformation happens when we take our body physiologic responses and our emotional reactivity, and we start to draw our higher faculties of heart and soul into those places, and that is profoundly transformative and beautiful. So, obviously all this needs to be unpacked. A lot of it is experiential and talking about it does not give it to you, but talking about it can give you a sense that it exits, and what I hope that talking about it will do is encourage you and empower you to start looking, start looking for how you can develop relaxation and mindfulness and how you can develop body awareness and compassion and insight and develop the powers of your heart and soul to heal yourself and to transform the pain and the suffering that you are living in. –Next Slide– So, I want to close with just sort of an observation that kind of sums a lot of this up. Somebody I know recently said, he was like, it is great that science has finally seen all the connections between these different things, we were talking about integrative medicine. Yeah, the connections between your heart and your mind and your gut and your immune system, science has started to see the connections, and I agree within its core. Science has seen the connections, but my sense is that reality is different than what science understands. Science is powerful. I am a scientist. I studied scientific method, I really believe in science, but we have to know that science is limited. Science is like a light that we shine on reality and we learn specific things about reality based on the scientific tools that we have for measurement and for analyzing the doubt that we get, and it does not enable us to understand all of reality, and for sure it does not enable us to understand the complexity integration of a human being, and especially human beings in relation to other human beings, the society. It is just too big and too complex and science is not there yet, and I would take this I do that science is finally finding all the connections and turned upside down and saying that science is starting to discover the fallacy of the idea that there is disconnection, because if I am starting to see connections, what I suggest to me that you know what? My heart and my gut are different things, and my heart and my immune system and my brain and my immune system are different things, and on a certain level they are, but you start as one drop of water, and you can become two, you become 4 and 8, 16 and 32, 3 trillion cells, and the fact is the amount of connectivity starts when your one cell, where everything is connected to everything else, and as you develop, everything stays connected. It is not like it is disconnected. You know, for sure, your heart has a different function than your digestive tract, but those functions are so profoundly interconnected, and one of what I suggest and invite people to move towards as there are starting to dive into and learn and practice mind-body self-healing is to experience their integration, experience their connection, experience that life has a unity to it, that you have a unity to it. If this is abstract, then it seems kind of weird too, that is okay. You do not have to believe it. My suggestion is just start, start to develop relaxation and calm, start to develop mindfulness, start to develop body awareness and compassionate awareness and insight, start to develop the power of your heart to transform your body and start to live. So, there are lots of ways to learn these things. I am going to keep talking about these things in other videos. Please feel free to share this with other people and thanks a lot for watching.

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Don’t Miss These 3 Things That Can Prevent Healing from IBS, Fatigue, and Chronic Pain: Part 3a

Posted on December 22, 2020March 3, 2024 by Andrew David Shiller, MD

Click HERE to watch part 3b.

Summary:

Your Mind-Body connection drives the ongoing process of IBS, chronic pain, fatigue, or chronic illness. It can also be your greatest strength in helping heal these and other difficult chronic problems. Despite what many people say, there is hope for healing Irritable bowel syndrome, fatigue, chronic pain, and other chronic illnesses so that you can live a satisfying and meaningful life. One of the keys to healing, is to understand the complexity of these syndromes, and the underlying biological imbalances that give rise to the symptoms. The first two posts in this series talked about the systems-biology model of chronic illness. They show you how these syndromes of chronic pain and illness arise from the integration of your body-wide-brain, digestive system, immune system, hormonal system, and so-on. These are the principles that have helped me to help many people who were thought to be helpless. A word of caution: if you learn this stuff, you might know more than your regular doctor about it, so be careful. This post is going to help you understand why and how you can mobilize your mind-body connection to help yourself heal. One of the most common mistakes that I see people make, is to do all the dietary, nutritional, and exercise stuff, while they don’t adequately take charge of the power of their mind-body connection. This lesson answers crucial questions that you should understand, if you want to heal:

How does the Brain-Immune-Gut-Hormonal integration create and perpetuate chronic illness and chronic pain?
What is the influence of the vagus nerve on all this?
How can you stimulate the vagus nerve to start reversing the disease process?
Why should you care that your brain and stress-response has cognitive, emotional, and physiologic aspects to it’s function?
What is the cell danger response, and why is it important in your healing process?
What are the six steps of mind-body healing?

In the near future, we will talk about the healing power of movement. Even if you feel too tired, weak, or have too much pain to move, there are things you can do to build your freedom and capacity for movement. And movement is one of the best medicines we know! Please comment or reply and share your thoughts, questions, and comments. I look forward to hearing from you. Scroll down for full transcript SLIDE PDF so you can take notes if you want.

Did You Know:

Dr Shiller is responding to the chaos and overwhelm of the corona pandemic by offering regular free stress-busting mind-body training sessions on zoom. You can get the schedule and register at www.mindbodygroove.com
Dr Shiller is available for telemedicine consultation worldwide regarding chronic pain, fibromyalgia, autoimmune disease, fatigue, and stress-related illness. Contact the office or schedule a consultation at www.drshiller.com
Inner Healing Essentials is an intensive six-week course taught by Dr Shiller, which teaches you the Six Steps To Inner Healing. It empowers you to transform stress into vitality, and begin to take back your life from chronic pain and illness. A new class begins quarterly. To get more info and be notified of the next start date: https://andrew-david-shiller.mykajabi.com/inner-healing-essentials-waitlist.

https://youtu.be/rCPvoRim_mw Stillness In Nature Mirrors, The Stillness Within You
https://youtu.be/PGzBt2szass Stress Response Basics
https://www.drshiller.com/4-keys-to-a-mindset-that-can-transform-your-fibromyalgia/
https://www.drshiller.com/heal-pain-mindbody-wholeness/
https://www.drshiller.com/heal-fibromyalgia-pain-inflammation-fatigue-mindbody-healing/

Full Transcript:

Hey, my friends, welcome back. We are talking today and then continuing to talk about three things that you should not miss in healing, fatigue, irritable bowel, chronic pain, and allow the symptoms that go along with or can be associated with those things. Today, we are going to get into the nuts and bolts of like, okay, how is the person actually healed? What do you need to do and what do not you want to miss? So, listen up to this. We are going to focus today talking about your mind-body system and how foundational it is to your healing process. So, a little background, the first couple of videos really talk about the complexity of your health and the complexity of disease and the different underlying physiologic imbalances that give rise to it, and we talked about a particular case. We talked about a guy who I saw. His name is Robert. He is in his 40s. He is a great guy, intelligence, sweet, motivated, really wants to do good things with his life, but he has completely stuck and cannot function. He has got so much abdominal pain and digestive symptoms that he cannot leave the house in the morning, he is fatigued, he can barely do stuff until the afternoon. He has got increasing anxiety. Lately, he has been sleeping so well at night, and he really feels like life is getting away from him, and he is not accomplishing what he wants to accomplish in life. –Next Slide– Okay, so here is Robert’s case, like I just shared about what was going on with him, and to give an overview of what I developed in those first two videos, which I really encourage you to watch, they go into a lot of depth and it really might illuminate a lot to see those first two videos about how to understand all these things [01:36] you, but as an overview, okay. Your mind is more or less the main place that you perceive stress, danger or challenging circumstances as a profound impact on your body, and why? One of the main things is that connection of your brain and your gut. There is something called the gut-brain axis that we have known about for centuries and centuries, a lot of the early philosophers talked about, all disease starts in the gut, and science is starting to finally figure that out and pretty much every professional journal, every professional specialty is talking about gut-brain axis as it relates to diseases in rheumatology and psychiatry and orthopedics in everything, and one of the main ways is that we have got this gut-brain axis. When a person has stressful, dramatic, difficult experiences, some of the changes that we see are dysbiosis which is a change in the actual biome of what is living in your gut, something called increase intestinal permeability as well as the tendency towards more inflammation, both locally in the gut and systemically. It gets more complex than this, right? Because those changes affect the immune system and you can get dysregulation of the immune system, that can show up in a lot of different ways, and again whether it is allergy, autoimmune disease, chronic illnesses that have an immune component, chronic pain which is related to immune disturbance or a variety of other clinical issues, immune dysregulation is part of that, and we are more and more seeing that the gut is part of which drives that and that an immune dysregulation feeds back into the gut. Oxidative stress is the shift in fundamental metabolic processes or biochemical process that happen all of yourselves that is related to immune dysregulation and again it is a two-way street where they affect each other and immune dysregulation feeds back in your brain. When a person gets a virus and feels sick and tired, it is because immune chemicals are circulating from the immune system, fighting that virus or infection and they go to your brain and they make you like lie down and sleep so you can heal, but what happens when the immune system is chronically dysregulated as you get this chronic impact on the brain, which can affect things like brain fog, energy, cognitive status, and brain inflammation, which can do a lot to make you sick, and then what is going on in your brain feeds directly into your immune system. One of the biggest stimulators of your immune function is acute stress and that actually empowers immune function, and one of the biggest things that impairs your immune function is chronic stress. So, again a two-way street of relationship, and then immune dysregulation has an impact on pain transmission, and we learned about how pain is not just like an electrical wire, it is an electrochemical flow of inflammation from the place that hurts to the part of your brain where you experience it, and your volume can be turned up, and then pain in itself could actually affect immune dysregulation, and that is intimately connected, what is going on in your brain and stimulating your stress response and feeding into all of this, and your cellular function, the core level of yourselves, your cellular energy production, metabolism, and DNA synthesis is influenced by immune dysregulation, influenced by stress and mind-body issues and influenced by what is going in your pain transmission system, and so this is a web of relationships. It is a cycle of relationships that evolve to protective you but frequently is what keeps you sick, and so that is what we are going to start about, talk about unpacking. So, let us like get some more layers here so that you can understand what I am talking about. –Next Slide– So, we talked a bit about the way we think about things in functional medicine as compared to conventional medicine. We think about antecedents, these were like early life stuff that set the stage. Triggers, transient events that happen in life that can shift the system, and then mediators, persistent changes in your biology, your biochemistry, your immunity, your gut function, stuff that like perpetuate and keeps you sick. So, antecedents like genetics and early life stress or trauma; triggers like stressors, infection, drug or chemical exposure; mediators, stuff like dysregulation of hormones, not sleeping well, stress and anxiety that persists, immune dysregulation, the fundamental things that go on in irritable bowel, like pain, dysbiosis, malabsorption, inflammation. These feed into your whole system in social circumstances, and all of these changes become like a process that flows downstream overtime. Disease does not just happen. It develops over the course of months and years, and frequently there is a trigger that takes your underlying situation and shifts it, and so it starts to shift the process that perpetuates, and that is why so many people seem to have a kind of a chronic thing that develops after they have some sort of injury, illness, toxic exposure, stress or whatever it is, and then they just keep getting worse, and they go to various doctors who were treating things individually, like, oh, you got this symptom, that symptom, that symptom, but they are not looking at the underlying issues. So, we are talking about treating as much as we can going upstream, getting at the underlying issues, unwinding the cycles that make people sick and that keep you sick. –Next Slide– Okay, so like we are talking in the case of this gentleman who saw me, who has got irritable bowel, who has got chronic abdominal pain, who is not sleeping, who is got anxiety, and who is got probably some degree of chronic inflammatory stuff going on, because it is irritable bowel or association with it, and he also has hormonal dysregulation, where his normal production of cortisol is not like it should be and it is low in the morning. These are what is going on in him, but the issue that I want you to see in this slide is that those can be underlying so many different kinds of problems. So, if you have got chronic pain or fibromyalgia, abdominal pain, fatigue, depression, anxiety, migraine headaches and neurodegenerative diseases like dementia, Parkinson’s, multiple sclerosis, neuropathy where your nerves get sick, autoimmune diseases, chronic fatigue. These share common underlying physiologic imbalances, some of which we have talked about in this case. –Next Slide– So, what you are going to do about it? You probably heard me talk about the three Ms, right? And this is just what I have come up with over 20 years of practice as three handles or windows through which you can come or look at your system and you need to address off three of these, and if you miss one or two of these, you frequently are not getting at the complexity of what is going on when you have a chronic illness or chronic pain. So, obviously mind is your mind-body connection. Movement, your movement system, metabolism is all of your biochemistry, your immune system, your hormones, all of that, and these all interact with each other, that is why these circles are intersecting, and what is really happening is right in the core of it, where everything comes together, and to my perceptive, you have also got spirit, you got an aspect of your being that is beyond measure, that is beyond what science can put a finger on, and pretty much almost everybody in the world senses that in some way, and that is part of what influences everything too, because it might be part of what integrates everything. –Next Slide– So, let us go further and talk about this. I am not going to try to talk about all three Ms today. I am going to kind of run through the metabolic biochemical stuff and run through the movement, mechanical structural stuff and spend more time on the mind-body axis, and then we will talk about those other two in more depth and we will drill down into those in the later videos. So, metabolic/biochemical, what is relevant for Robert who has got the condition we talked about or first of all diet, food sensitives, nutrients that can actually reduce irritability of the gut and low antigen diet that is full of antioxidants that actually tends to irritate the gut less and can help reduce inflammation and few radicals which produce oxidative stress. We are giving some adrenal supports and botanical substances that have actually been shown in research to support mood, energy, and to have an influence on that hypothyroid pituitary adrenal axis, which is involved in our chronic stress response. There was a substance called LDN or low-dose naltrexone that I use with a lot of people with chronic illness. It is worth reading about and understanding. It an off-label use, but very common drug called naltrexone, and it gets used a lot in irritable bowel, inflammation, pain, autoimmune diseases. It seems to be pretty safe. The research that we have shows that a lot of people get benefit who have not gotten benefit from anything. So, it is very well in my experience for irritable bowel, for inflammation, and frequently for mood. In terms of dealing with stress, we talked a bit about adrenal support but there are nutrients that can help your body deal with stress, stuff like B-complex and magnesium, other substances that can be either depleted or support your system in dealing with stress, addressing dysbiosis which is that alteration in the biome that is living in the bowel, which is mainly about probiotics and prebiotics. Sometimes, we get more aggressive and actually treat it with antibacterial stuff, whether it is botanical or pharmaceutical depending on the circumstances, and then addressing leaky gut. Basically, your immune cells which get broken down from various sources, whether it is dysbiosis, toxic drugs, toxic exposure, stress. When you feed them what they need, they frequently heal, and if you do not feed them what they need, they often doubt, and again this is supported by various levels of research that certain things like L-glutamine and zinc and vitamin A and E and vitamin D and omega fatty acids help the gut heal. –Next Slide– So, let us talk about the movement/mechanical system. Movement is medicine. Your body was made to move. When you get regular exercise, and regular exercise could be aerobic, stretching strength training, or some kind of mindful movement like yoga or tai chi and various other movement arts, dance, lots of different kinds of exercise, walking. It actually stimulates hormones, reduces inflammation. It can enhance sleep, reduce pain, enhance neurotransmitter function and make you feel good, and there is a lot of depth to understand what is appropriate for you given your circumstances. Depending on your level of health, depending on how much pain you have or what kind of condition your musculoskeletal system is in. So, there is subtlety to this, and I will drill down into this some more in a later video. –Next Slide– So, let us talk about mind-body healing. When most people think of mind-body healing if you are looking up on the internet [13:05] a biomedical web search like PubMed or something, you might see things about relaxation exercises, mindfulness, visual imagery, psychotherapy, CBT, various things like that, and these are all techniques that have been used and studied to see the effect they have on the overall stress axis, to see the effect they have on various symptoms and disease complexes, and there is a lot of research over the course of 20, 30 years that show that, you know what, these things make sense. They tend to be very low risk. Once you learn it, it tends to be very low or zero cost, and the potential benefits can be very great, especially depending on how much stress, trauma, difficult stuff was going on and how overactive your stress response is, and certainly my own clinical experience of using these techniques for over 20 years in my own life and with lots of patients is seeing profound impact, and this is one of those things that people miss, because I see a lot of people who come in and they are doing all this nutritional stuff and may be they are exercising, they might have chronic pain or fibro, IBS, or chronic fatigue, or autoimmune disease or whatever, but they are not really getting at their mind-body axis, and it is complex and it is subtle. So, lot of reasons why not. Some people just are not into it. For some people, there is a stigma, like whenever they have gone to a doctor over the course of years, and I have seen this with so many people like, who will sit down and go through all the science about why mind-body medicines are really important? Why it is a therapeutic tool? Why it is not that you are crazy? It is not to do something wrong with your mind, it is just that you know what, this is a therapeutic tool that can help you, and after like, so you means it is all in my head doc? And the unfortunate thing is lot of people have been stigmatized in that way. They have had problems that their doctors could not understand because they were never perceptive and then the doctor who cannot figure it out blames the patient, and so [14:58] nuts. It is all in their head, they need to take an antidepressant. Whenever it is complex, antidepressant actually have physiological effect that are not just about dealing with anxiety and depressant, but that is part of what this all talk is about that there was so much integration of the neurotransmitters that are involved in depression and anxiety as well as lot of other brain chemistry that are involved and actually generating and perpetuating symptoms and helping symptoms develop overtime, like that wave that flows downstream. Back to our topic, these things are techniques that get used a lot and they have been researched and let us talk more about why, just unpack this so you can see a little bit. Again, I talked about some of this in the previous talks, but I want you to see it here, because I really want to see how important this is, how real it is, how scientifically validated are these connections between your mind-body system and the rest of your systems as they relate to your level of health or illness. –Next Slide– So, these are some slides from the journal. The journal of basic and applied sciences that talk about normal stress response, chronic stress pathology, and chronic stress and cortisol resistance. So, this is the pathology and of things, right? Where person is healthy. There is a connection in physical, mental, oxidative, biochemical stress go into the brain and a signal goes out to what call the HPA or hypothalamic pituitary adrenal axis, stimulates not only epinephrine/norepinephrine with cortisol release, epinephrine/norepinephrine activate your immune system. Cortisol kind of like slows down inflammation and turns off that stress-related inflammatory response, so that you do not get sick, right? Because if you can imagine if you are out in the forest and you fall down and break your leg and you got an open wound or you get injured or something like that, your immune system needs to come in for defense and repair. So, it is a good thing that your immune system revs up with acute stress, but then when the stress is over, you want to quiet down. In some circumstances, we talked a lot about this in the previous two talks that stress does not turn down and that can happen because you got ongoing stressors, you got ongoing illness pain, injury, an environment in your life that is stressful, dangerous, whatever it is, or it could be that you got early life adverse childhood events that turned your stress response on overdrive, so that you get triggered by an illness or injury, your stress response just gets kicked for an armful and it keeps going, and you are like, hmmm, and you start to not even notice it after a while, but meanwhile, your stress response is going, going, and what happens there is you get kind of disconnect in this feedback loop and the adrenal glands are putting out cortisol, cortisol in response to this chronic stress and then that holds thing with your immune system being reactive is feeding into your brain and creating more biochemical stress from the immune overreaction, that is one of those vicious cycles, and the other thing that we have discovered over the years, because all the research you are now looking at, well, okay, chronic stress that affects health or maybe it is because of the cortisol, but wait a second, people with chronic stress do not always have the elevated cortisol, right?, that was the finding, but what they discovered is that in many cases, there was actually a loss of sensitivity to cortisol. So, it is not just that the cortisol goes high, high, high. Sometimes what happens overtime is that cortisol stops being elevated and the cells are like resistant to cortisol, the receptors downregulate. So, basically a person cannot even mount an immune response to a stressor, and that is when people start to really burnout and get that chronic fatigue, and we said this, it is probably why people start to burnout and get that chronic fatigue, immune weakness. The guy who says, “gosh, I get sick every year, anything, anybody has I get it.” I see a lot of people like that, and it is probably related to this chronic dysregulation of the HPA axis along with resistance to cortisol, so they cannot even mount a proper immune response to stress, it is of the more complicated than that, but this is part of it. –Next Slide– So, let us move forward. Let us talk about pain, whether its abdominal pain or peripheral pain in this whole feedback loop. Stress feeds this loop. We just talked about the HPA axis, and then it feeds into what we call sensitization of spinal pathways and central pathways in the brain, and central sensitization means your brain is turned up and it is like your pain processing is turned up, and peripheral sensitization means the actual nerves in your gut or your back or your knees if you have arthritis or your nerves if you have peripheral neuropathy, they become sensitized by various biochemical changes, which were all influenced by the stress response, and so this chronic stress response with all of the changes turns up sensitization in the periphery, meaning the rest of your body as well as the sensitization which is your brain and spinal cord. So, that is part of how pain gets worse. So, okay that is all the bad news. Let us talk about the good news. The good news is you have a system inside of your body that is actually there to help you cope in deal and it is probably of how mind-body therapies can help you and it is related to the something called the vagus nerve. The vagus nerve, here is a diagram that is coming from Frontiers in neuroscience and its talking about, this is not where this is coming from, forgive me. That is from another slide. Cut that. In any event, this is just a diagram that is an anatomic slide. Here is your brain, here is your spinal cord. You have got your vagus nerve pumping out here and it is connecting to all of your internal organs. Here, it says vagus right, and that is giving input to your heart, your lungs, all of your digestive organs, and then you have these other parasympathetic, which is the same branch, it is the, you know, just to review again, you have got your stress response and your relaxation response. Your relaxation response neurologically is mediated by your vagus nerve and some of the nerves in your brain as well as your pelvic splanchnic nerves that go to your pelvic organs and sexual organs and the end of your bowel, and this is all parasympathetic relaxation response. So, you can send relaxation signals to your gut and those seemed to have an impact on people with leaky gut and irritable bowel syndrome and also people with pain. –Next Slide– So, let us unpack this some more. Maybe we will see Dr. Bonas as you slide here in a moment. –Next Slide– Okay. So, vagus nerve to the rescue. What are we talking about? This looks complicated and technical and geeky and it kind of is, right? But that is the way scientists think and communicate with each other and I am part scientist, so I can hear them. Hematoencephalic barrier, that means your blood-brain barrier, right? It means your brain is protected from your nervous system, I mean from your immune system and from your blood and what it is it more or less, but the point is like this, that you have got vagus nerve fibers that are going out that actually have an influence on intestinal permeability and have an influence on inflammation in your gut. Vagal outflow has an influence actually on the bacteria in your gut. The population of bacteria in your biome that are part of what gives arise to this gut inflammation and systematic inflammation, and so vagal outflow, when the vagus nerves starts to act and gets strengthened and have increased output, it shifts a lot of the changes that give rise to complex chronic disease. This is such an important thing that, you know, most of the articles when you look in the medical literature, you look at vagus nerve and chronic illness, and you have got companies that are investing huge amounts of money in developing vagal nerve stimulators. A lot of them are invasive things where they actually like put something in your neck that stimulates your vagus nerve as it comes out, gives it like an electrical charge, and then noninvasive once they do it through the skin, and that is how really great and cool, and there is early research that shows unbelievable things, like, okay, these people have rheumatoid arthritis with really bad inflammation and deformation of joints, and they did valgus nerve stimulation and it stopped. People with chronic pain, vagus nerve stimulation, ooh, volume turns down. People with various kinds of chronic, really difficult problems, the conventional medicines often fails to deal with, and they use this invasive or noninvasive vagus nerves stimulation and you get some degree of effect. I am not here to push high tech, very expensive invasive tools that are there to stimulate your vagus nerve. I am here to push you to consider that in between your ears, with your free choice, with your mind-body connection, and your intelligence, you have the capacity to actually stimulate your vagus nerve. You have the capacity to stimulate neuro-parasympathetic nervous system and get benefits that come from vagal nerve stimulation, which seems to do a lot to turn down the volume on chronic pain, chronic illness, chronic inflammation and so on. –Next Slide– Let’s unpack this some more. Right, from Curious Immunology, Dr. Bonas has again. He loves this. He loves this. I think he is developing actual stimulation devices, but he is even talking about hypnosis and meditation and acupuncture as ways to stimulate different aspects of what we call now the vagal or cholinergic anti-inflammatory pathway that is stimulating the parasympathetic nervous system, which is the relaxation response, stimulates the anti-inflammatory pathway, and there is a bunch of biochemistry to it, right. The vago-parasympathetic reflux vagus nerve stimulates fibers that go in and elicit various kinds of neurotransmitters like acetylcholine and nicotine agonist and etc, etc. We do not want to go too much into the overwhelming detail. The point is that those things block things like tumor necrosis factor alpha. That is a cytokine, that is an inflammatory chemical that is involved in almost all of these chronic destructive illnesses like rheumatoid arthritis and chronic pain and fibromyalgia, TNF alpha, and other inflammatory cytokines like interleukin 6 are showing up as major determinates and drivers that are involved in things like diabetes and heart disease, Alzheimer’s disease, dementia, degenerative illnesses inflammatory, and vagal nerve stimulation is anti-inflammatory, and that is huge as potential game changer from other medicine. What I would predict is that in 20 or 30 years when various technologies, whether they are high-tech invasive stuff versus just knowing how to teach people to evoke the relaxation response and to get in all the aspects inside the heart and soul of a person that interrupts that relaxation response and stimulates the sympathetic or a stress response. When we really learn how to do that, we have a powerful set of tools for actually changing the course of chronic illness, and that is why we are here talking about this. –Next Slide– So, let us talk a little more. We are talking a lot about how stimulating relaxation pathways affect biochemistry, affect the way to gut, processes stuff, and the dysfunction in the gut that can be proinflammatory and create all sorts of brain toxic stuff and how we can turn that down. We looked at various ways that parasympathetic stimulation relaxation response stimulation can actually reduce inflammation systematically, but here is another aspect which is a direct effect on the pain pathways, and the fact that pain is really complex and this could be, you know, several hours long conference in itself to talk about the complexity of pain and chronic pain, but the point that I want you know is perceived pain is profoundly integrated with emotional distress and maladapted belief systems, and these are things that most of us do not really get taught how to deal with. My own experience over 20 years is teaching people how to deal with these things and seeing profound influences on not just perceived pain but the amount of distress and interruption and dysfunction in life a person has because of pain as it has processed through emotional distress and adaptive beliefs, and this is a vicious cycle, and every skilled pain management clinician, whether they are pain management, anesthesiologist or physiatrist or neurologist or the behavioral medicine people that work through the mind-body connection. This is really clear. It is really well understood. If you go to a well-equipped pain center almost anywhere in the world, they are going to be working with you on your mind-body healing. –Next Slide– Okay, so that has been kind of an overview about how chronic pain and chronic illness are really a multisystem, multifactorial problems, and how they develop overtime, and the important thing to know is that, that is part of why these things are workable and why probably you and many other people can actually have significant yield even though you have done the best of conventional medicine, but you probably have not looked at it in kind of a holistic an integrated way, and that is where the therapeutic leverage is, is addressing the different aspects that are all working together, and I talked a bit about the three-part model that I used that looks at three Ms, which are your movement or mechanical system in your body, your metabolic or biochemical system in your body, and your mind-body system, and we went into a little bit of detail about some of the scientific underpinnings of why your mind-body system is so powerfully integrated in the development of chronic pain and chronic illness, and why it is so crucial to address that in the healing process. Because you or some of the people watching this might have kind of decreased energy or attention span, because that is part of what chronic illness and chronic pain do. So, I am going to stop now and break this video into two parts. The next part is going to get more into kind of an overview really of what you should be thinking about when you are addressing mind-body healing and the different aspects of it, kind of a landscape and the overview of what mind-body healing is and some other places where people sort of fall down the pitfalls, the things that you can miss if you are not paying attention to it. So that is the second next part of this, go ahead and watch it now if you want to or you can come back to it later when you have more energy and you want to spend another, I think it is about 20 minutes or so. So, as always, feel free to share this video or this blog post wherever you are seeing it, and I am going to continue to produce information that hopefully is going to be inspiring, empowering, and transformative for you around healing from chronic pain and chronic illness. So, if you have not signed up for the newsletter, do so, and you will actually get notified when and new blog posts come out, and we will be in touch that way. On my email community, I shared various aspects and different things that inspire people. So, looking forward to seeing you next time. Thanks a lot.

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Unlearning Negative Mind Body Patterns That Create Pain and Illness: Part 2

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Unlearning Negative Mind Body Patterns That Create Pain and Illness: Part 1

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Don’t Miss These 3 Things That Can Prevent Healing from IBS, Fatigue, and Chronic Pain: Part 3b

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Don’t Miss These 3 Things That Can Prevent Healing from IBS, Fatigue, and Chronic Pain: Part 3a

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