How You Can Heal From Chronic Dizziness with Dr. Yonit Arthur

[00:00:00] Hello, everyone, and welcome back to the Heal with Grace podcast.
[00:00:03] I have a wonderful guest today who's going to really help break down
[00:00:07] and explain to you why you might be having chronic dizziness symptoms
[00:00:11] and that it's actually a good thing because it's a nervous system issue,
[00:00:15] which you can definitely recover and heal from like we talk about on this podcast.
[00:00:19] We have Dr.
[00:00:20] Yonit Arthur, who is the steady coach on YouTube and social media.
[00:00:25] And she is just such a beautiful example of how to get this information across.
[00:00:30] Dr.
[00:00:31] Yonit received her doctorate in audiology from Purdue University and as a licensed audiologist and coach.
[00:00:37] She is board certified through the American Board of Audiology
[00:00:40] and holds vestibular rehabilitation, advanced vestibular rehabilitation
[00:00:45] and concussion certifications through the American Institute of Balance.
[00:00:48] She has undergone extensive training and counseling,
[00:00:51] including internal family systems, level three, inferenced based cognitive behavioral therapy,
[00:00:57] exposure and response prevention, emotional expressive and awareness therapy
[00:01:02] and mindfulness based techniques.
[00:01:04] She is also a certified strength coach.
[00:01:07] Dr.
[00:01:07] Yoh also has a YouTube channel, the steady coach and has built a completely free comprehensive
[00:01:12] course for people dealing with chronic dizziness.
[00:01:16] If you have dealt with anything that includes vestibular migraines,
[00:01:20] EPPD, DGS, Canitis, even elements of POTS, which we get into anything along those lines.
[00:01:26] You 100% want to listen to this episode.
[00:01:29] Without further ado, let's go ahead and jump in.
[00:01:33] Hey there and welcome to Heal with Grace.
[00:01:35] I'm your host Grace Secker and I'm a holistic licensed therapist
[00:01:39] and nervous system coach who believes that the chronic and often unseen symptoms
[00:01:43] you're living with are a sign of something deeper going on.
[00:01:46] A sign that your nervous system needs attention.
[00:01:49] In each episode, I'll share the science behind the most common chronic health disorders
[00:01:53] plus holistic health tips using mental, physical and spiritual practices.
[00:01:58] You'll hear what I've learned in my journey and the true stories from our trusted
[00:02:01] guests so you can feel less alone in your experience and give yourself grace
[00:02:06] no matter what you're going through.
[00:02:08] So without further ado, settle in and get cozy.
[00:02:10] It's time to heal with grace.
[00:02:14] Hello, Dr.
[00:02:15] Yoni.
[00:02:16] Thank you so much for showing up here and having you on Heal with Grace podcast
[00:02:20] is an honor because you are huge in this community and I'm really excited
[00:02:23] for people to understand the nuances of chronic dizziness and the whole
[00:02:27] umbrella that it covers.
[00:02:29] So thank you for being here.
[00:02:31] Thank you so much for inviting me.
[00:02:33] It's such an honor to be here and thank you also for the amazing
[00:02:36] work you're doing in the space.
[00:02:37] Yeah, for sure.
[00:02:38] So for people that don't know you, why don't you go ahead and give
[00:02:41] us an idea of how you got here, how you got to specialize in this
[00:02:45] and a little bit of your story.
[00:02:46] Yeah, sure.
[00:02:47] So I think the headline of the story is that I burned out being a regular
[00:02:53] audiologist or what I like to call a real audiologist because what most
[00:02:57] audiologists do is definitely not what I do now.
[00:03:01] So I trained as an audiologist, got my doctoral degree, worked as
[00:03:05] an audiologist for a while, saw people with all sorts of chronic
[00:03:08] problems as we all do, just didn't have, shall we say, the avenue
[00:03:12] to actually help them in the way that I hoped to help them.
[00:03:16] So of course this is skipping all the details, but essentially
[00:03:19] I burned out and ended up with chronic back pain along with chronic
[00:03:23] migraines and, you know, symptoms because, you know, stress
[00:03:26] and symptoms are related, who would have thought, but I didn't
[00:03:30] necessarily put two and two together just yet.
[00:03:32] I actually went back to do some more learning and my mom developed
[00:03:37] chronic dizziness and then through all sorts of interesting
[00:03:41] life events started to realize, hey, I actually can help people.
[00:03:45] I just am going to need to do it outside the framework of typical
[00:03:49] audiology job.
[00:03:49] So I started working as a contractor and when I saw these
[00:03:54] people, they needed me to repeat myself a lot and I was
[00:03:58] learning a lot with them.
[00:04:00] So I started making videos for them and for me so that I
[00:04:04] didn't have to constantly repeat myself and so I could gather
[00:04:06] my thoughts and other people started watching them.
[00:04:09] So that's why I ended up with a YouTube channel.
[00:04:10] It was totally an accident, to be honest.
[00:04:13] I never thought anyone would watch those videos and the
[00:04:15] evidence is clear.
[00:04:16] If you look at my early videos, they were not intended to be
[00:04:19] seen by a wide audience.
[00:04:20] They're like crooked and the lighting is all messed up,
[00:04:22] but it turned out that chronic dizziness is very poorly
[00:04:27] understood and very poorly treated in practice despite
[00:04:31] having mountains of evidence pointing us to the kinds of
[00:04:35] treatments that actually will help chronic dizziness.
[00:04:38] So there was just an area of great need and it's been an
[00:04:42] enormous pleasure and privilege to be able to help meet that
[00:04:46] need and I'm so happy to tell you this.
[00:04:48] I'm going to start the podcast by just bragging about this
[00:04:51] for a second, not about me specifically, but just we're
[00:04:54] making a change.
[00:04:55] There's momentum now in the vestibular world.
[00:04:58] The actual clinical practice is changing and I'm starting
[00:05:01] to see people being referred to my channel by prestigious
[00:05:04] medical clinics and I'm starting to hear from patients.
[00:05:07] Hey, my doctor told me this could be stress related and
[00:05:10] they pointed me to you.
[00:05:11] I know, I know.
[00:05:13] I know.
[00:05:14] Yeah.
[00:05:14] Yeah, yeah.
[00:05:15] So it's changed a lot.
[00:05:16] That's what we want.
[00:05:18] That's what we want.
[00:05:18] Yeah, it's incredible.
[00:05:20] So I've been obviously heavily involved in that and it's
[00:05:22] just the most gratifying thing ever.
[00:05:24] Amazing.
[00:05:25] Yes, there's a lot of momentum in this field right
[00:05:28] now and it feels really great, especially I've talked
[00:05:31] about it on here, like being at the conference and
[00:05:32] being in that energy, right?
[00:05:33] And there's a lot of push and at the same time there
[00:05:35] are these different sectors, right?
[00:05:37] Of symptoms and yours is very much so one that I don't
[00:05:41] think many people would ever think about stress related,
[00:05:44] right?
[00:05:45] We think of a headache, okay, sure stress related.
[00:05:47] Obviously still people go down the route with migraines
[00:05:49] and things, but still there's not as much.
[00:05:51] So let's get into that.
[00:05:52] What kind of conditions actually fall under what you
[00:05:55] term chronic dizziness?
[00:05:56] Okay, so let me give you some of the diagnostic labels
[00:05:59] first that people end up with, but then I'll say
[00:06:01] something about that.
[00:06:02] So persistent postural perceptual dizziness
[00:06:05] or PPPD is very commonly diagnosed now, vestibular
[00:06:09] migraine or migraine associated vertigo, MDDS,
[00:06:13] Malded-DeBarchmont syndrome.
[00:06:15] Those are the biggest ones.
[00:06:16] I also see people whose symptoms are being blamed
[00:06:19] on post-concussion syndrome or cervicogenic dizziness,
[00:06:22] which is neck related dizziness.
[00:06:24] And sort of to my point, the point I was trying
[00:06:26] to make a few seconds ago when I said I have
[00:06:28] something to say about these diagnoses.
[00:06:30] All of these diagnoses are defined by a list,
[00:06:33] like basically a checklist of symptoms.
[00:06:35] So we see you have episodes of dizziness that
[00:06:39] lasts a certain amount of time.
[00:06:40] You've had some headaches before in your life.
[00:06:42] And yeah, that's pretty much the definition
[00:06:45] of vestibular migraine.
[00:06:46] So not to say that these definitions don't have value
[00:06:50] because they do give people names for what they're
[00:06:52] experiencing and help them find avenues of treatment
[00:06:56] that help them.
[00:06:57] But essentially all the things I mentioned
[00:06:59] and then there are many other descriptors are
[00:07:00] really just descriptions of the symptoms themselves.
[00:07:03] They all basically mean chronic dizziness that
[00:07:06] we don't have a good medical explanation for.
[00:07:09] Like you're dizzy, but we don't really know
[00:07:11] why you're still dizzy.
[00:07:12] You shouldn't be, essentially.
[00:07:14] What might they be told about what causes dizziness
[00:07:19] that maybe they would grab on to from a physical standpoint?
[00:07:22] Yeah.
[00:07:23] Yeah.
[00:07:23] Goodness gracious.
[00:07:24] So, okay.
[00:07:25] And I have to say that this has been improving
[00:07:29] because that's think one of the things again,
[00:07:31] this is just in my orbit.
[00:07:33] So I maybe this is not happening as universally
[00:07:36] as I think it is, but it seems to me that people
[00:07:39] are showing up more educated now.
[00:07:40] So I'm hoping that we, meaning me, but also all
[00:07:44] the people that have listened to what I am saying
[00:07:47] and who've listened to other people in the
[00:07:49] mind body world are now having an influence
[00:07:50] on what people are being told.
[00:07:52] So what they are typically told though is
[00:07:54] something to the effect of you.
[00:07:57] They're kind of two subtypes.
[00:07:59] You have this damage.
[00:08:01] So for some people it's an ear damage problem
[00:08:03] or maybe some kind of cervical issue, neck related issue
[00:08:07] or you've had a head injury, you had whiplash,
[00:08:10] whatever it is, you have this tissue damage
[00:08:12] and this has basically just changed the amount
[00:08:17] and quality of information that your brain gets.
[00:08:19] And so the dizziness that you have is the
[00:08:22] result of this tissue damage issue.
[00:08:24] So very similar to pain in that regard.
[00:08:27] Totally wrong because we see many instances of people
[00:08:30] with those exact issues who have no symptoms
[00:08:33] and we actually expect most people to no longer
[00:08:37] have chronic symptoms after having one of those issues,
[00:08:39] but this is still what people are sometimes told.
[00:08:41] So that's category one.
[00:08:42] When we do find something wrong, right?
[00:08:44] But for many people with dizziness,
[00:08:46] we find nothing wrong.
[00:08:48] There's nothing to be found with migraine.
[00:08:50] They're basically told this is a genetic brain disease.
[00:08:54] It's an illness.
[00:08:55] It's a disease and so they stop short of saying
[00:08:58] this is permanent damage.
[00:08:59] They don't use the word damage,
[00:09:00] but they use the word disease or illness
[00:09:02] and they immediately jump into and you're going to have
[00:09:04] to manage this for the rest of your life.
[00:09:06] This is now chronic and there's nothing that can be done.
[00:09:10] You are now condemned to having this forever,
[00:09:12] but we can maybe help you by controlling diet
[00:09:16] and giving you these medications.
[00:09:18] For people with non migraine diagnoses,
[00:09:21] sometimes they're told there's nothing that can be done.
[00:09:23] You need to learn to live with this.
[00:09:25] Very obviously extremely helpful to people.
[00:09:27] And sometimes they're told again,
[00:09:29] sort of along the same lines,
[00:09:31] we know that this has something to do with how your brain
[00:09:34] is processing orientation related information.
[00:09:36] So that part is correct.
[00:09:38] And so therefore this is a chronic problem
[00:09:40] that you will have for the rest of your life
[00:09:42] and here's what we can do to manage it.
[00:09:44] So they're given, you know, like,
[00:09:45] we have to change how you're thinking about it.
[00:09:48] We need to help you learn to live with a chronic disease
[00:09:51] and maybe here are some SSRIs
[00:09:53] or some vestibular therapy
[00:09:54] that can help with the symptoms a bit.
[00:09:56] Again, I want to be fair.
[00:09:57] Not everyone's being told these things,
[00:09:58] but that's been the general talk track over many years.
[00:10:02] That's scary when it's the rest of your life.
[00:10:04] We can't do anything.
[00:10:05] This is management, disease, illness.
[00:10:08] We'll talk about how fear plays a role in a little bit
[00:10:10] and that obviously is going to induce so much fear.
[00:10:13] Yes.
[00:10:14] Which I can only imagine as we know increases symptoms.
[00:10:17] Right.
[00:10:17] Right.
[00:10:18] I feel for anyone who has any kind of mind, body symptoms
[00:10:21] and to be clear, I see people as often happens.
[00:10:23] People sometimes have more than one, shall we say, right?
[00:10:26] So they don't just have dizziness.
[00:10:27] They may also have pain.
[00:10:28] They may also have, gosh, name anything,
[00:10:30] pull anything out of the hat.
[00:10:31] People have them.
[00:10:32] But the reason to me that I feel so passionate
[00:10:35] about making a change in the dizziness world
[00:10:38] is because dizziness is just a particularly frightening
[00:10:42] and terrible experience.
[00:10:44] It disconnects you from reality in a way
[00:10:47] that other symptoms don't.
[00:10:48] It's not something that people understand.
[00:10:51] Everyone has normal dizziness at times,
[00:10:53] but while everyone has had some kind of pain
[00:10:56] that's persisted longer than a day,
[00:10:58] we've all lived that, right?
[00:11:00] Very few people have had dizziness that persists
[00:11:02] for hours, days, weeks, months, years at a time.
[00:11:05] It's not an experience that people understand.
[00:11:07] And the problem here is that it's not just torturous.
[00:11:12] It makes the process of recovery that much harder
[00:11:14] because you're given these just fear-mongering messages,
[00:11:17] of course, sometimes by medical professionals.
[00:11:19] And then you're living in fear of reality
[00:11:22] because you can't connect to reality
[00:11:24] and you don't have words to describe this experience
[00:11:26] to other people.
[00:11:27] You actually question your sanity.
[00:11:29] So dizziness for so many reasons that these
[00:11:31] and others is just a particularly awful experience.
[00:11:34] Yeah.
[00:11:35] I remember you talking at the conference about this
[00:11:37] of completely pulls you out of your reality.
[00:11:40] And so actually there's nuances
[00:11:41] in how we work with it, right?
[00:11:43] Someone who's working with tracking their symptoms
[00:11:45] and their back pain is going to be different
[00:11:47] than tracking dizziness, right?
[00:11:49] And helping that, for example.
[00:11:51] So I'm like the textbook neuroplastic person
[00:11:53] who's had all different kinds of symptoms.
[00:11:55] I've had a few different bouts of vertigo.
[00:11:57] It did not last in a chronic state,
[00:11:59] but it was explained to me that I have the makeup
[00:12:02] of someone with POTS.
[00:12:04] And that was that type of thing.
[00:12:06] Okay.
[00:12:07] So where do you fit POTS?
[00:12:09] How do you explain it with dizziness?
[00:12:10] Because I do have a lot of people in my community
[00:12:12] with POTS with chronic fatigue
[00:12:13] that those seem to go together.
[00:12:15] They do.
[00:12:15] And POTS is a little tricky
[00:12:17] because it has so many systemic,
[00:12:19] like direct systemic effects.
[00:12:21] So with dizziness,
[00:12:22] we'll often see changes in heart rate
[00:12:24] and respiration and all that,
[00:12:26] but it's related to the anxiety
[00:12:28] and the disorientation from dizziness.
[00:12:30] It's not its own thing, its own symptom.
[00:12:32] Yeah.
[00:12:33] But in general,
[00:12:34] I think of POTS very much the same way
[00:12:37] that I think of the other symptoms
[00:12:38] that I mentioned.
[00:12:39] It just affects the autonomic nervous system.
[00:12:42] So basically our automatic nervous system functions,
[00:12:46] which dizziness does too,
[00:12:48] but less directly.
[00:12:49] So with dizziness,
[00:12:50] I'm typically talking about changes
[00:12:51] in how we understand orientation information
[00:12:55] and our sense of balance.
[00:12:56] Whereas with POTS,
[00:12:57] we're talking about how your body understands
[00:13:00] interfacing with itself and with outside information.
[00:13:04] But from the answer to your question
[00:13:06] of how I think about it,
[00:13:07] I don't think about it differently.
[00:13:10] I do think that people with POTS
[00:13:12] probably will relate more to my work
[00:13:14] than they might with just someone's work about pain
[00:13:17] because I address some of these
[00:13:20] you feel disconnected from your body nuances
[00:13:22] that you might not get
[00:13:24] when you're just talking about
[00:13:25] musculoskeletal pain, for example.
[00:13:27] Yeah, I would agree.
[00:13:28] I've had a few clients who
[00:13:30] they definitely have a combination of both
[00:13:32] and the stimuli like lights and noise
[00:13:36] and really increases that dizziness.
[00:13:38] And anyway, I've sent them sometimes to your videos
[00:13:39] because I was like,
[00:13:40] she just talks about it in a different way.
[00:13:42] A specific way, right?
[00:13:43] It's really helpful.
[00:13:44] I'm glad it's been helpful to them.
[00:13:45] Yeah, yeah.
[00:13:47] So in that,
[00:13:47] I actually was watching a couple of videos
[00:13:50] of yours just kind of going through
[00:13:51] and you mentioned one recently around
[00:13:53] once you recognize that you're grasping
[00:13:56] this is a nervous system issue, right?
[00:13:57] And you can actually help yourself
[00:13:59] and you can heal and recover from this.
[00:14:02] You mentioned two goals
[00:14:03] that need to happen for people when we're covering.
[00:14:05] What would those be?
[00:14:06] That sounds great.
[00:14:07] Gosh, I'm so organized.
[00:14:09] I'm like, what video is that?
[00:14:10] I'm wondering if you would know what this is,
[00:14:12] but I just in general, right?
[00:14:13] Like kind of categorizing, okay,
[00:14:15] there's so much information out there.
[00:14:17] There's so much to grab onto.
[00:14:19] Like where would someone start?
[00:14:21] Yes, yes, yes.
[00:14:22] And again, I've probably divided those categories
[00:14:25] up somewhat differently depending on
[00:14:27] when I've spoken about it.
[00:14:28] But broadly,
[00:14:29] it's how you're relating to the symptoms themselves
[00:14:32] and then how you're relating to stress
[00:14:35] slash yourself slash other things in your life.
[00:14:39] Those are the two broad categories.
[00:14:41] And I think that in the mind, body, world,
[00:14:45] everyone knows we're supposed to relate differently to symptoms.
[00:14:48] Like I feel like that's broadcast across the internet now.
[00:14:52] But that second piece seems really essential
[00:14:55] for people with dizziness in a way that I've noticed
[00:14:58] it doesn't always seem as important to people
[00:15:01] who have other kinds of symptoms.
[00:15:03] Not to say when I hear any recovery story
[00:15:05] with any symptom, of course,
[00:15:06] there's some component of I lost my fear of the symptoms
[00:15:08] and there's some component of personal growth.
[00:15:10] But it seems to me at least from my experience
[00:15:12] that this other piece,
[00:15:14] how I'm relating to myself, my stress, other people,
[00:15:17] my life really does need to be addressed
[00:15:19] for people who have dizziness to get better.
[00:15:22] Yeah.
[00:15:22] Can you maybe give some examples
[00:15:24] of what that looks like for people?
[00:15:26] Yeah.
[00:15:26] Yeah, yeah.
[00:15:27] Okay.
[00:15:27] So obviously,
[00:15:28] I'm going to leave the symptom response piece aside.
[00:15:31] I'm sure your audience has heard a lot
[00:15:33] about how to respond more neutrally
[00:15:35] or more positively to symptoms.
[00:15:36] That's what we'll leave that aside.
[00:15:37] So I'm trying to think of some good examples
[00:15:39] because it would be so nice to be able to illustrate this.
[00:15:41] So I think the simplest example would be something like,
[00:15:46] this is kind of a classic mind-body example,
[00:15:48] someone who's a big perfectionist, right?
[00:15:50] So let's just say you've mastered the art
[00:15:53] of responding to your symptoms neutrally,
[00:15:55] but you also attack life in a very perfectionistic way.
[00:16:00] What that means is that any bit of stress
[00:16:03] that comes anywhere near you gets amplified.
[00:16:05] It gets blown out of proportion.
[00:16:07] Because say you have a work stressor,
[00:16:10] say you have a project assigned to you,
[00:16:11] you're feeling well enough, you're off medical leave,
[00:16:13] you go back to work, you get a project assigned to you,
[00:16:16] and the perfectionist kicks in and you're like,
[00:16:18] oh my gosh, this project.
[00:16:19] And you're like, I've got to make sure all the T's
[00:16:21] are crossed and the eyes are dotted.
[00:16:23] So you have this outside stress that's legitimately,
[00:16:26] I mean, you have a work deadline.
[00:16:27] Maybe you still have symptoms.
[00:16:28] You have to deal with that.
[00:16:29] But now you're also adding more stress on top of that.
[00:16:33] So you're not just dealing with outside stress.
[00:16:37] You're also dealing with stress that's coming from the inside
[00:16:39] based on how you're relating to the outside stress.
[00:16:42] And what I've noticed is that some people can recognize this
[00:16:47] and say, I'm just gonna stop doing that.
[00:16:49] And then they just start doing,
[00:16:51] they start practicing self-compassion
[00:16:53] and they practice better self-talk
[00:16:55] and they just pull out of it.
[00:16:56] They change their habits.
[00:16:58] But in my world,
[00:16:59] and I can't tell you exactly why this is
[00:17:01] if it's because dizziness itself just interferes
[00:17:04] with so much that habit change can be so challenging.
[00:17:07] Or if it's because just the people that I end up working with
[00:17:11] are the people who tried the habit change
[00:17:12] and it didn't work for them.
[00:17:14] But what I notice at least with the people that I work with
[00:17:16] is they know what they need to do.
[00:17:18] They just can't do it.
[00:17:19] They're like, I know I'm being a perfectionist.
[00:17:22] I know I'm resentful of people around me
[00:17:24] and I shouldn't be.
[00:17:25] I know that I create a bunch of my own stress
[00:17:28] but I cannot stop.
[00:17:29] I just can't stop.
[00:17:31] And that's where the real work comes in.
[00:17:32] And I can certainly go into more detail on that
[00:17:34] if you want to.
[00:17:35] So yeah, that would be really helpful.
[00:17:36] So what would that look like?
[00:17:37] Because I agree.
[00:17:37] There's plenty of people I work with too
[00:17:39] that are like, okay, get it.
[00:17:40] I get it.
[00:17:41] I get it.
[00:17:41] I understand.
[00:17:42] I've watched all the videos.
[00:17:43] I've read the books.
[00:17:44] I listen to your podcast every single week.
[00:17:47] I've done your program, you know?
[00:17:49] Yep, yep.
[00:17:49] And also I don't know how to do this.
[00:17:52] Yeah, yeah.
[00:17:53] So I always tell people and this is just my approach.
[00:17:56] So I totally understand
[00:17:58] there are so many different ways to do this.
[00:18:00] So I'm just sharing what has worked for me
[00:18:02] or how I tend to look at my clients.
[00:18:04] But I like to start with what's here right now.
[00:18:07] What's happening in daily life right now?
[00:18:09] Like give me a sense of what's going on Sunday through Friday.
[00:18:12] Like who are you interacting with?
[00:18:13] What are the things for dizziness?
[00:18:15] You won't necessarily notice changes in symptoms.
[00:18:18] So this is another thing that makes dizziness tricky with pain.
[00:18:21] Often we'll tell people, okay, you can start to identify
[00:18:24] what some of your important stressors are by noticing
[00:18:26] when your symptoms fluctuate for dizziness.
[00:18:28] Often they just don't.
[00:18:30] You will just have them all the time, 24, 7, severe.
[00:18:33] And then they'll randomly go up and down depending on
[00:18:35] what you're doing with your eyes.
[00:18:37] And they're like, does that mean that every time I look
[00:18:39] at my computer, I'm stressed out?
[00:18:40] Or is that just dizziness side effect?
[00:18:42] So we can't rely as clearly on that.
[00:18:44] So I have to get a bigger picture perspective
[00:18:47] on what's actually going on in someone's life initially.
[00:18:50] And the places where these things show up the,
[00:18:52] I guess they're not the red flags, but the trailheads.
[00:18:55] So the flags that say, oh, this is the stuff
[00:18:57] that I might need to work on.
[00:18:58] They tend to show up in how you relate to yourself
[00:19:01] and how you relate to other people.
[00:19:03] I mean, that's really where it tends to show up the most.
[00:19:05] So when I have to do something, what happens to me inside?
[00:19:08] Like what do I do?
[00:19:09] What's the talk track?
[00:19:10] What's the automatic response?
[00:19:12] And thinking of anyone in my life with whom I have a,
[00:19:15] with whom I not entirely harmonious relationship,
[00:19:17] which I assume would mean everyone.
[00:19:20] I don't know anyone who has a completely
[00:19:21] harmonious relationship with anyone.
[00:19:23] What are the things that I've noticed to tend
[00:19:25] to cause the most friction?
[00:19:27] And what's the talk track that plays in my mind
[00:19:29] when that happens?
[00:19:30] So that's where I start looking.
[00:19:32] So we might start with an umbrella like,
[00:19:35] oh, Yonita, I know I'm such a perfectionist,
[00:19:37] but I need to know how that actually shows up in your life
[00:19:40] and what that's leading to, what kind of effects
[00:19:43] that's having and what that process looks like.
[00:19:45] I'll ask people to play it out for me like a movie.
[00:19:47] Like, okay, so you had to interact with Bob,
[00:19:49] who you find annoying.
[00:19:51] So here you are, Bob shows up, play the movie for me.
[00:19:54] Tell me exactly what's happening throughout this conversation
[00:19:56] and what's going on in you.
[00:19:57] Give me like a narration of what's going on in you.
[00:20:00] So the point of doing that is to realize
[00:20:03] that regardless of what kind of change work
[00:20:05] you end up deciding to use,
[00:20:06] whether that's habit change
[00:20:08] or emotional awareness type practices
[00:20:10] or self-compassion or parts work,
[00:20:11] whatever it is that you're using,
[00:20:13] you want to get specific
[00:20:14] about where the actual triggers are happening
[00:20:16] and where the change actually needs to happen.
[00:20:19] The big issue I see is that
[00:20:21] when people say, I can't change this,
[00:20:23] they're trying to change like this big conceptual thing
[00:20:25] that I'm a perfectionist, I'm just going to stop.
[00:20:27] But they don't actually know
[00:20:29] where these changes need to happen
[00:20:30] and what they can use to see
[00:20:32] that they're making progress toward that goal.
[00:20:34] They bite off just a giant chunk
[00:20:36] and they need to break it down essentially.
[00:20:38] But then we have lots of options.
[00:20:40] They maybe have it change.
[00:20:41] It may be, I noticed that I automatically do this
[00:20:44] every time I have to talk to Bob.
[00:20:45] Here's some small thing that I can change
[00:20:47] when I have to talk to Bob.
[00:20:49] So it could be just very cut and dry
[00:20:50] or it might be something much more experiential.
[00:20:53] Like I noticed there's this huge flare of resentment
[00:20:56] and anger that I feel toward Bob
[00:20:57] before I have this interaction with him.
[00:20:59] Let me stay with that
[00:21:01] and see if I can see what my mind and body
[00:21:03] are actually perceiving in Bob
[00:21:05] that's causing me to feel this way.
[00:21:07] And then we start breaking down the beliefs.
[00:21:08] So did that explain a little bit more?
[00:21:10] Okay.
[00:21:11] Yeah.
[00:21:11] And essentially a lot of what you're describing right
[00:21:13] is becoming aware of these
[00:21:14] not only tendencies, what affects us
[00:21:17] but then learning how to work with them,
[00:21:19] be with them, whatever that looks like, right?
[00:21:21] So like the first thing I usually do
[00:21:22] with someone because we talk a lot
[00:21:23] about the nervous system is understand,
[00:21:25] well, what are your different nervous system cues, right?
[00:21:27] When are you highly stressed?
[00:21:29] When do you shut down?
[00:21:30] When do you actually feel grounded
[00:21:32] or content or neutral?
[00:21:34] So first that and then we can help shift, right?
[00:21:36] Right, right, right, right.
[00:21:38] And here's the thing.
[00:21:39] I love what you just said.
[00:21:40] I think what people tend to see things
[00:21:43] as having like one-way arrows like,
[00:21:45] okay, I'm going to change this behavior
[00:21:47] or I'm going to change the thought
[00:21:48] and then that's going to change this.
[00:21:49] All of these things affect each other.
[00:21:51] So our feelings affect our thoughts,
[00:21:52] affect our feelings, which affect our thoughts,
[00:21:54] our beliefs affect our state, whatever.
[00:21:56] The good news is that means you can interrupt
[00:21:58] the cycle in many different places
[00:21:59] but the bad news is that if you've got only one trick
[00:22:03] which is like for example, thinking differently
[00:22:05] and you're not addressing other parts of the cycle
[00:22:07] and if they're very strong
[00:22:09] they're going to keep driving the cycle of behavior.
[00:22:12] So we keep coming back
[00:22:13] or I keep coming back to this example of a perfectionist
[00:22:16] but if you're trying something like habit change
[00:22:18] which I said it is really a very valuable way
[00:22:20] of doing things but you're not addressing the feeling
[00:22:23] that comes up toward this hypothetical Bob person
[00:22:25] that ends up resulting in you being a perfectionist
[00:22:28] then the thoughts are going to keep feeding off of the feeling
[00:22:32] until you address that too.
[00:22:33] Yes, exactly.
[00:22:34] That is actually I just did a post kind of in the same arena
[00:22:37] of some people talk about just retraining the brain, right?
[00:22:40] I'm really like training the brain out of danger mode.
[00:22:43] Some people talk about the emotional work
[00:22:45] and the trauma work and sometimes not all the time
[00:22:47] but there can be these two different camps, right?
[00:22:49] But actually, I mean, and kind of what you're saying
[00:22:51] we do need both.
[00:22:52] We can't just focus on changing the habit and the thought.
[00:22:54] There's also the emotion underneath it.
[00:22:56] Yes.
[00:22:57] And which I can as I say this out loud
[00:22:59] I totally get to be a lot and a little confusing at first.
[00:23:01] So people get overwhelmed at first, totally understandable
[00:23:05] risking a lot of you to understand these dynamics
[00:23:08] and it takes time.
[00:23:09] It does.
[00:23:09] It does.
[00:23:10] I'm a process thinker.
[00:23:12] I like thinking like breaking down
[00:23:14] how I think about things in like multiple steps
[00:23:16] which is why I have a YouTube channel
[00:23:17] I get to make all sorts of steps.
[00:23:19] But that's one of my first pieces of advice to people.
[00:23:22] All of these things are connected
[00:23:24] which makes make it seem overwhelming
[00:23:26] but actually it's good news because it means
[00:23:28] that you can work on one thing
[00:23:30] and you can start with that one thing
[00:23:31] and you are going to make an impact on your stress bucket
[00:23:35] or on your whole system
[00:23:36] even by working on just one thing in one way first
[00:23:39] and coming back to this example of how I ask, you know
[00:23:42] how I will often ask clients
[00:23:44] to really break down an experience for me.
[00:23:46] You can do the same thing for yourself
[00:23:47] and start to identify
[00:23:48] what are these smaller pieces that I actually need to work on
[00:23:51] and can I experiment with changing the thought
[00:23:54] or looking at the feeling
[00:23:55] or asking myself what the belief is
[00:23:57] and start to look for small shifts
[00:24:00] and just that one thing first
[00:24:01] and know that will have ripple effects later
[00:24:04] on all these other areas of your life.
[00:24:05] Oh, definitely.
[00:24:06] Definitely.
[00:24:07] Yeah.
[00:24:07] Okay.
[00:24:08] I want to talk about somatic tracking for a second.
[00:24:11] Sure.
[00:24:12] People know what somatic tracking is most likely
[00:24:14] and if you're new
[00:24:15] the idea of paying attention to our symptoms
[00:24:17] and shifting our relationship to it
[00:24:19] and essentially is what you mentioned earlier
[00:24:21] but with dizziness
[00:24:22] that looks different than a neck pain
[00:24:25] or a stomach issue or something like that.
[00:24:28] So how does that look different?
[00:24:29] How do you talk about somatic tracking with dizziness?
[00:24:31] Yeah.
[00:24:32] Great question.
[00:24:32] So there are a few different ways to approach this
[00:24:35] and of course tracking somatically means
[00:24:38] you're noticing something in your body
[00:24:39] and you're just staying with it.
[00:24:41] You're tracking it.
[00:24:42] So for some people
[00:24:43] who have certain kinds of dizziness symptoms
[00:24:46] for example someone who has constant rocking bobbing
[00:24:49] or swaying as will often show up with MDDS
[00:24:52] they can do sort of a more classic somatic tracking.
[00:24:55] So they'll be able to hone in on a particular sensation
[00:24:58] for most people they sort of localized
[00:25:01] like I notice rocking bobbing and swaying
[00:25:03] and it feels like it's affecting my whole body
[00:25:05] but when I focus on it actually
[00:25:07] it feels like it's coming from here in my head
[00:25:09] and then when they find that location
[00:25:11] or a location from which it seems to be emanating
[00:25:14] they can track that spot.
[00:25:15] So that's kind of the classic way
[00:25:17] but as you alluded to a lot of dizziness symptoms
[00:25:20] don't neatly localized
[00:25:23] and sometimes they're very abstract and difficult to track
[00:25:26] like how do you track derealization?
[00:25:28] Like it feels like the world's not real
[00:25:30] how do I track that right?
[00:25:31] So my go-to for those kinds of symptoms
[00:25:34] is to have people track their reactions to those symptoms
[00:25:37] and for most people those reactions
[00:25:39] are either fear or frustration
[00:25:41] among others but those are the big ones obviously.
[00:25:43] So fear is definitely an embodied experience
[00:25:46] as is frustration.
[00:25:47] People can typically locate fear and frustration in their bodies
[00:25:51] so I will invite people to notice the sensation
[00:25:53] and then notice their reaction to the sensation
[00:25:56] and then stay with the reaction and track that.
[00:25:59] That's similar to how I talk about fatigue.
[00:26:01] Yeah, that makes sense.
[00:26:02] Teague isn't all over body right
[00:26:05] and I get that question all the time.
[00:26:07] What do I do with fatigue?
[00:26:08] How do I track that?
[00:26:09] Right.
[00:26:10] Often there's resistance there.
[00:26:11] There's fear, frustration
[00:26:13] overwhelm, anger, blissness.
[00:26:15] Right, exactly.
[00:26:17] There's so much.
[00:26:17] I would say though there's a third category for dizziness
[00:26:20] and that's stuff like vertigo.
[00:26:22] So the thing with those that they're intermittent
[00:26:25] some of them are provoked
[00:26:27] so they're triggered by certain movements.
[00:26:29] So for example people with PPPD
[00:26:31] will often have movement specific triggers
[00:26:33] like if I turn I get this whoa
[00:26:35] or like this whoosh or this dropping feeling right.
[00:26:38] How do you track that when it only happens
[00:26:40] when it's triggered?
[00:26:41] And that those are obviously the most fearsome symptoms too
[00:26:44] sometimes because they take you by surprise
[00:26:46] or catch you off guard.
[00:26:47] So one thing that I always like to tell people
[00:26:50] and I hope people who are listening
[00:26:51] can really take this to heart.
[00:26:53] You are not trying to play battleship with symptoms.
[00:26:56] So we're not trying to eliminate a symptom
[00:26:58] by smashing it with a somatic tracking hammer.
[00:27:00] Okay, so you don't need to track
[00:27:03] each individual symptom to make it go away.
[00:27:05] So you may have some like the ones I just mentioned
[00:27:08] that you really just can't track
[00:27:09] although I have some suggestions on how you actually can
[00:27:12] but you may just say you know what
[00:27:13] I'm just not gonna track that thing
[00:27:15] and I'm gonna track these other symptoms that scare me
[00:27:17] and in doing so you are still creating a shift
[00:27:21] in how your brain understands symptoms in general
[00:27:23] and hopefully you've also heeded our advice from earlier
[00:27:26] and are not just working on your fear of symptoms
[00:27:28] you're also working on all these other things
[00:27:30] in your life the stressors the ways you relate to yourself
[00:27:33] and other people and stressful events in your life
[00:27:35] and when you do that you also bring down
[00:27:38] the levels of danger in your system as well
[00:27:40] and what you'll often find when you sort of say fine
[00:27:43] you know what I don't care if you're there anymore
[00:27:45] I'm not even gonna track you you know what so be it
[00:27:47] when you get to that point a lot of the time
[00:27:49] that's sort of like a bring it on
[00:27:51] I mean that's sort of like a you know what
[00:27:53] I'll just have to handle if it happens
[00:27:55] that kind of attitude actually is the whole point
[00:27:58] it's what we're trying to actually use somatic tracking
[00:28:00] to get to that kind of attitude
[00:28:02] so you're accomplishing often the same thing
[00:28:05] by not somatic tracking specifically a symptom
[00:28:08] that you can't somatic track
[00:28:09] but that said you still can you still can
[00:28:11] it's just not it's just not as easy
[00:28:14] so one thing I will use of course is imagery
[00:28:17] so I'll have people imagine the symptom happening
[00:28:19] and what will often happen is
[00:28:21] they will notice fear reaction
[00:28:23] so even if they're not actually experiencing the vertigo
[00:28:27] or the drop or the gravitational pull
[00:28:29] in the moment they can imagine it well enough
[00:28:32] to actually have a fear response
[00:28:33] and then I'll have them track that
[00:28:35] so I'll have them stay you know
[00:28:37] oh there's the sensation
[00:28:38] I want you to imagine the sensation
[00:28:39] and when you notice that feeling in your gut
[00:28:41] that feeling of fear right after that's what I want you to hold on to
[00:28:44] and track for a few seconds here
[00:28:45] another way to do this is to
[00:28:48] I have had some people do this
[00:28:50] actually provoke symptoms on purpose
[00:28:52] believe it or not
[00:28:53] these are brave souls but you know
[00:28:55] all of us used to spin around as kids
[00:28:57] to make ourselves dizzy
[00:28:58] because we thought it was funny
[00:29:00] okay so I have had people
[00:29:02] I'm not saying anyone actually needs to do this
[00:29:04] I think this is kind of hardcore
[00:29:05] but you can actually spin yourself around
[00:29:08] or do something specifically to provoke
[00:29:11] so that you can somatic track
[00:29:13] for a few moments after it happens
[00:29:15] makes sense
[00:29:16] I mean getting to the root of the point of somatic tracking
[00:29:19] is working with the fear in the first place
[00:29:20] or what we're trying to get to like you mentioned
[00:29:22] and that's that's huge
[00:29:24] because we're not then bypassing
[00:29:26] and just trying to get rid of it by somatically tracking
[00:29:28] which happens all the time right
[00:29:29] and actually expanding our capacity
[00:29:31] to be with what's underneath
[00:29:33] and causing more symptoms in the first place
[00:29:35] yes so that's right
[00:29:36] that's right
[00:29:37] and I really want to emphasize that too
[00:29:39] it's good to I'm so glad we're talking about somatic tracking
[00:29:41] it's a great tool
[00:29:42] and also I see it misused a lot
[00:29:45] because people are understandably
[00:29:47] like get this thing out of me
[00:29:49] like get this out of my body now
[00:29:51] but ultimately
[00:29:53] I personally have spent a lot more time
[00:29:56] with my clients
[00:29:57] working on that other stuff usually
[00:29:59] the symptom response piece needs to be there
[00:30:02] but if we're not really addressing any of these stressors
[00:30:06] then we're not really cutting the fuel lines
[00:30:10] so to speak to the symptoms
[00:30:11] exactly
[00:30:12] that's where so much of the work is
[00:30:14] it's almost like this is kind of this entry point
[00:30:16] to understanding how to attune to be with our symptoms
[00:30:19] without as so much fear
[00:30:21] yes right
[00:30:21] so yeah definitely
[00:30:23] okay what about for some people
[00:30:26] because I work also with people with
[00:30:28] I see OAB like bladder type symptoms
[00:30:30] and a lot of times for that
[00:30:31] I've noticed with some different symptoms
[00:30:33] there can definitely be an increase in the symptom
[00:30:36] when we start to pay attention to it right
[00:30:37] and yes we can talk about
[00:30:39] how fear is increasing that and reducing the fear
[00:30:42] and also I just validate people as a reality to
[00:30:45] okay yeah you are focusing on it more
[00:30:47] and symptoms are increasing
[00:30:48] so how do you talk about that with people with dizziness
[00:30:51] that's a great question
[00:30:52] obviously the first thing I'm going to check in with
[00:30:54] is dizzy intention and the attitude
[00:30:56] so are we going in there to try to eliminate symptoms
[00:30:59] are we trying to get rid of it
[00:31:01] are we still terrified of symptoms
[00:31:03] are we thinking somatic tracking is the magical tool
[00:31:06] that's going to solve everything
[00:31:07] all those things are going to just make it not work
[00:31:09] and increase symptoms
[00:31:10] but yes attentional focus on symptoms
[00:31:12] does increase your brain's attention on symptoms
[00:31:15] meaning it's going to increase the volume dial
[00:31:17] it's going to
[00:31:18] here's the way I think about it
[00:31:19] it's the spirit of somatic tracking
[00:31:21] that we're trying to learn
[00:31:23] it's the skill of responding in a certain way
[00:31:26] it is not actually designed to be a 15 minute meditation
[00:31:30] we do not need to spend 15 minutes lying down
[00:31:33] and thinking about something that we don't want to pay attention to
[00:31:36] if that's not actually the assignment
[00:31:39] some people love doing that
[00:31:41] and I encourage them
[00:31:42] if you enjoy doing it as a meditation
[00:31:44] if you enjoy doing it for a prolonged period of time
[00:31:46] then do it
[00:31:47] but actually what we're trying to learn is
[00:31:49] how to glance at the symptom
[00:31:51] respond in a neutral slash attuned slash curious
[00:31:56] slash kinder way
[00:31:57] and then to go back to doing something else
[00:31:59] that's actually the skill we're trying to build from my perspective
[00:32:01] we can just skip all the let's focus on the symptoms part
[00:32:04] and just practice that slight touch point like acknowledge
[00:32:07] there it is
[00:32:08] respond to myself with compassion
[00:32:09] maybe a breath and on we go
[00:32:11] we can just go back to doing what we were doing
[00:32:13] yeah
[00:32:14] I love that
[00:32:14] and there's so much permission
[00:32:16] in it
[00:32:17] and in flexibility
[00:32:18] it doesn't have to be like a lot of us will take on this
[00:32:21] all or nothing
[00:32:22] rigidly
[00:32:22] healing type based right
[00:32:24] and we just want to do it the way that it's supposed to be done
[00:32:26] yes
[00:32:27] and also even across different symptoms in the same person
[00:32:31] you'll find some symptoms are trackable and some are not
[00:32:34] personally
[00:32:35] I have not had actual migraines for a very long time
[00:32:38] because obviously
[00:32:39] I've done a lot of this stuff for them for myself
[00:32:42] and in response my body said no more migraines
[00:32:44] but when I've had
[00:32:46] I mean maybe in the last five years I've had maybe two
[00:32:49] okay
[00:32:50] when I have attempted to do somatic tracking
[00:32:53] when I have a migraine
[00:32:54] I simply cannot be with the sensation without getting upset
[00:32:58] with it
[00:32:59] migraines are not just head paint
[00:33:01] they are
[00:33:01] it's a whole body nausea thing
[00:33:03] it's bad
[00:33:04] I can't respond to my sensations in any way that's useful
[00:33:08] or neutral in that moment
[00:33:09] so for me
[00:33:10] it would look more like what I described like acknowledge
[00:33:13] and then
[00:33:14] I move to something else
[00:33:15] maybe acknowledge
[00:33:16] and then I move to something else
[00:33:18] and I'm still accomplishing the same thing
[00:33:20] but without the sustained focus
[00:33:22] yeah
[00:33:22] that's high trading moments
[00:33:25] yes is
[00:33:25] exactly
[00:33:26] exactly
[00:33:27] I love that
[00:33:27] thank you
[00:33:27] okay
[00:33:28] one more little segue
[00:33:29] or not segue
[00:33:30] but topic
[00:33:31] I guess
[00:33:31] with any symptoms
[00:33:32] we can start to become afraid of the outside world
[00:33:34] obviously
[00:33:35] certain situations
[00:33:36] going out of the house
[00:33:37] doing things
[00:33:38] travel
[00:33:39] social
[00:33:39] whatever
[00:33:40] right
[00:33:40] and so
[00:33:41] especially
[00:33:42] with dizziness
[00:33:43] there is this
[00:33:43] derealization
[00:33:44] and like fear of
[00:33:46] what
[00:33:46] this happens in public
[00:33:47] and what am I going to do
[00:33:48] so
[00:33:49] how do you think of exposures
[00:33:51] without
[00:33:52] this
[00:33:52] maybe more extreme
[00:33:53] like
[00:33:53] well
[00:33:54] I know it's my body
[00:33:54] so I can just do it
[00:33:55] I'm going to force myself
[00:33:56] and do all the things
[00:33:57] versus
[00:33:57] no
[00:33:58] I can't do anything
[00:33:59] and I have to be completely safe
[00:34:00] before I try
[00:34:01] anything
[00:34:02] yeah
[00:34:02] this is so tricky
[00:34:03] and what
[00:34:04] it came to mind
[00:34:05] when you
[00:34:05] when you said that was driving
[00:34:07] in particular
[00:34:08] yeah
[00:34:09] because
[00:34:10] I could make the case
[00:34:11] for why you should still go to Costco
[00:34:13] even if it feels terrible
[00:34:14] Costco by the way
[00:34:15] for people who've never had
[00:34:16] sustained dizziness symptoms
[00:34:18] Costco is like
[00:34:19] the final frontier
[00:34:20] it is like
[00:34:20] it's like a dizziness funhouse
[00:34:22] I mean it's just bad
[00:34:23] it's so visually stimulating
[00:34:25] the big open space
[00:34:26] makes you feel very disoriented
[00:34:27] I call it vestibular therapy max
[00:34:29] like it's really intense
[00:34:30] but
[00:34:31] I could still make the argument
[00:34:32] listen
[00:34:33] I know it's going to be rough
[00:34:34] but ultimately
[00:34:35] you're safe
[00:34:36] like you go to Costco
[00:34:37] and if you feel dizzy
[00:34:39] then you
[00:34:39] it worse comes worse
[00:34:40] you're
[00:34:40] you'll sit down
[00:34:41] right
[00:34:42] but then
[00:34:42] in some cases
[00:34:43] like
[00:34:44] driving
[00:34:44] there's actually a potential safety issue
[00:34:46] or
[00:34:47] I have people
[00:34:47] who
[00:34:48] have actually
[00:34:49] typically
[00:34:50] this is a little tricky
[00:34:51] sometimes people have had falls
[00:34:53] and then they're like
[00:34:54] okay but going to Costco
[00:34:55] actually isn't safe
[00:34:56] I could fall
[00:34:57] and actually hurt myself
[00:34:58] yeah
[00:34:58] so
[00:34:59] generally speaking
[00:35:01] I will
[00:35:02] start with having people
[00:35:03] to hydrate these exposures
[00:35:05] in ways that
[00:35:06] are truly less
[00:35:08] risky
[00:35:08] so
[00:35:09] for falls
[00:35:10] I have no shame about this
[00:35:11] and people
[00:35:12] may not like to hear this
[00:35:13] but I will tell people to use a cane
[00:35:16] I will tell people to use a walker
[00:35:17] and I know in
[00:35:18] the mind-body world
[00:35:19] oh my gosh
[00:35:20] there's nothing wrong with you
[00:35:21] you shouldn't be using any stuff
[00:35:22] you need to actually
[00:35:24] meet yourself
[00:35:24] where you are first
[00:35:25] that's my big message
[00:35:26] I think
[00:35:27] everything I'm about to say
[00:35:28] will fall under this headline
[00:35:29] when it comes to these actual
[00:35:30] or perceived safety issues
[00:35:32] you have to meet yourself
[00:35:33] where you are
[00:35:34] first
[00:35:35] and then you can think about
[00:35:36] how to progress
[00:35:37] I think
[00:35:37] so much of the fear
[00:35:38] comes from thinking
[00:35:40] that
[00:35:40] it's all or nothing
[00:35:41] you have to do this thing
[00:35:42] and it has to be in this way
[00:35:44] otherwise it doesn't count
[00:35:45] and that's just not true
[00:35:46] this is why
[00:35:47] I'm just constantly
[00:35:48] talking about process
[00:35:49] oriented goals
[00:35:50] you have to focus on the process
[00:35:52] and not just in the
[00:35:53] platitude way
[00:35:54] really
[00:35:54] again
[00:35:54] I'm a data person
[00:35:55] I like processes
[00:35:57] you should have very clear
[00:35:58] goals for yourself
[00:35:59] like
[00:35:59] what does an improvement mean
[00:36:01] that's not symptom related
[00:36:03] and then
[00:36:04] when you start to do that
[00:36:05] your courage will grow
[00:36:07] your fear will drop
[00:36:08] likely symptoms will drop too
[00:36:10] and then you'll be able to
[00:36:11] increase the intensity
[00:36:12] of these exposures
[00:36:14] so
[00:36:14] for some people
[00:36:15] with dizziness
[00:36:16] that truly may mean
[00:36:17] you get into the car
[00:36:18] and you go nowhere
[00:36:19] that may be what you're doing
[00:36:20] to start off with
[00:36:21] it may be you're driving
[00:36:22] around the neighborhood
[00:36:23] and it may be that
[00:36:25] you have to have another person
[00:36:26] in the car with you for a while
[00:36:28] and here's the tricky part
[00:36:29] right
[00:36:30] because some people will come to me
[00:36:31] saying
[00:36:32] I've already done that
[00:36:33] and now I'm stuck with this person
[00:36:35] I'm stuck at this lower level
[00:36:37] of exposure
[00:36:37] and I don't know how to take it
[00:36:38] to the next level
[00:36:39] but I need this person
[00:36:40] with me to feel safe
[00:36:41] the issue here is
[00:36:42] the framing
[00:36:43] under which you're doing all this
[00:36:44] changes once you understand
[00:36:46] it's a neural circuit issue
[00:36:47] so if you've just been powering
[00:36:49] through trying to
[00:36:50] expose yourself to driving
[00:36:51] like I'm just going to get rid of this
[00:36:52] and all I need to do is just
[00:36:54] you know just push through
[00:36:55] and it'll work out
[00:36:55] if that is not
[00:36:57] the same attitude that you have now
[00:36:58] that you understand
[00:36:59] this is a neural circuit issue
[00:37:01] you understand it truly
[00:37:02] is a brain prediction issue
[00:37:04] and that your brain needs you to feel
[00:37:06] safer
[00:37:07] not safe
[00:37:07] but safer
[00:37:08] in order to rewire
[00:37:09] and that it's
[00:37:10] totally possible to recover
[00:37:12] and for the symptoms to go away
[00:37:14] now that you know that
[00:37:15] and you have a totally different framing on it
[00:37:17] you have to meet yourself
[00:37:18] where you are right now
[00:37:19] without shaming yourself
[00:37:20] and only then
[00:37:21] will you be able to make progress
[00:37:22] from where you are
[00:37:23] and then you could be creative
[00:37:25] about how exactly
[00:37:26] you progress from there
[00:37:27] the biggest barrier
[00:37:29] I see
[00:37:29] it's not that people can't
[00:37:31] progress their exposures
[00:37:33] it's that they're stuck
[00:37:34] in kind of this black
[00:37:34] and white thinking about
[00:37:35] what they should be doing right now
[00:37:37] what they
[00:37:37] I say they should
[00:37:38] they should themselves
[00:37:39] stop shooting yourself
[00:37:40] so if you can stop
[00:37:41] shooting yourself and say
[00:37:42] okay
[00:37:43] this is where I'm at right now
[00:37:44] but I do understand
[00:37:45] that I can get better from here
[00:37:47] how can I creatively
[00:37:48] increase the intensity
[00:37:49] here in a way that
[00:37:50] straddles the line
[00:37:52] where I don't
[00:37:52] maybe necessarily
[00:37:53] feel a hundred percent safe
[00:37:55] but I also am not
[00:37:56] completely flipping out
[00:37:57] you can always find a way
[00:37:59] to advance what you're doing
[00:38:00] yes
[00:38:01] thank you
[00:38:01] thank you for saying that
[00:38:02] especially with
[00:38:03] like we
[00:38:04] probably share this information similarly
[00:38:05] I always talk about
[00:38:06] supports
[00:38:07] you could have your supports
[00:38:08] it's okay
[00:38:09] it is not a crutch
[00:38:10] you are not
[00:38:10] telling your brain
[00:38:11] that it's only physical
[00:38:12] just yes
[00:38:13] a few of these things
[00:38:14] right
[00:38:15] as long as you have this understanding
[00:38:16] and like you said
[00:38:17] you are working
[00:38:18] towards this
[00:38:19] drastic
[00:38:20] helpful
[00:38:20] supportive
[00:38:21] yeah
[00:38:21] like you wouldn't
[00:38:22] I love my
[00:38:23] my metaphors
[00:38:24] and I tell people
[00:38:25] would you go put
[00:38:26] 300 pounds on a squat rack
[00:38:28] with having never trained
[00:38:29] of course you wouldn't
[00:38:30] you'd probably be starting with body weight
[00:38:32] and then you'd maybe
[00:38:33] you know
[00:38:34] grab a couple dumbbells
[00:38:35] I mean you'd be working your way up
[00:38:36] to something like that
[00:38:37] right
[00:38:38] so why wouldn't you expect
[00:38:39] to need to do that now
[00:38:40] and to follow that metaphor
[00:38:42] similarly
[00:38:43] let's just say
[00:38:44] you were trying to work up
[00:38:46] to this squat
[00:38:47] and you found out your technique
[00:38:48] had been totally off
[00:38:49] the whole time
[00:38:50] you'd probably need to start back
[00:38:51] from the beginning
[00:38:52] or close to the beginning
[00:38:53] and work your way back up
[00:38:54] that's exactly
[00:38:55] what you're doing now
[00:38:56] with these exposures
[00:38:57] if you were powering through
[00:38:58] like I'm just going to force myself
[00:38:59] through this
[00:39:00] and everything's really dangerous
[00:39:01] and I may never get to recover
[00:39:03] that's technique
[00:39:04] that was
[00:39:04] maybe not optimal
[00:39:05] so now you're going to do it differently
[00:39:07] with better technique
[00:39:08] but you're going to need
[00:39:08] to meet yourself
[00:39:09] where you are
[00:39:10] to be able to advance
[00:39:11] exactly
[00:39:11] exactly
[00:39:12] we can't
[00:39:13] expect ourselves
[00:39:14] also
[00:39:17] right
[00:39:17] I'm sure there's ebbs and flows
[00:39:18] and you expand yourself
[00:39:19] a little bit
[00:39:20] and maybe
[00:39:21] you get a little more
[00:39:22] little more dizzy
[00:39:23] but it's not all lost
[00:39:24] that's of course
[00:39:25] a huge thing
[00:39:26] and I know that happens everywhere
[00:39:27] in the mind-body world
[00:39:29] with all symptoms
[00:39:30] but because dizziness
[00:39:31] also just
[00:39:32] sort of naturally
[00:39:32] affects mood
[00:39:33] and causes anxiety
[00:39:35] in and of itself
[00:39:36] even without any kind of psychological
[00:39:38] like oh
[00:39:38] I'm catastrophizing
[00:39:39] dizziness itself
[00:39:40] is accompanied by anxiety
[00:39:42] when people have these
[00:39:43] we call them dips
[00:39:44] like when you have a dip
[00:39:45] when your symptoms increase
[00:39:46] when people have these dips
[00:39:48] they're often taken off guard
[00:39:50] by how much worse
[00:39:51] they feel psychologically
[00:39:52] and that's not driven entirely
[00:39:54] by thinking about it
[00:39:56] poorly
[00:39:57] or not having the right attitude
[00:39:58] it's physiologic
[00:40:00] and this is just important
[00:40:01] for people to know
[00:40:02] also
[00:40:03] I know I interjected there
[00:40:04] without a whole lot of context
[00:40:05] but it's important
[00:40:06] for people to know
[00:40:07] when they're doing
[00:40:08] these kinds of
[00:40:08] titrated exposures
[00:40:10] that you're going to have
[00:40:10] ups and downs
[00:40:11] and the way
[00:40:12] that you feel about it
[00:40:13] is also going
[00:40:14] to be accompanied
[00:40:15] by a lot of ups and downs
[00:40:16] and not all of that
[00:40:17] is being driven
[00:40:18] at all
[00:40:18] by something you're doing
[00:40:20] wrong at all
[00:40:20] it's just part of what happens
[00:40:22] to your body
[00:40:22] when you feel disoriented
[00:40:24] which is again
[00:40:24] why those process
[00:40:26] goals are so important
[00:40:27] because then
[00:40:27] you'll have numbers
[00:40:28] for yourself
[00:40:29] last week
[00:40:29] I was a jerk to myself
[00:40:31] five times
[00:40:31] during the drive
[00:40:32] and this week
[00:40:32] I was a jerk to myself
[00:40:33] only three times
[00:40:34] during the drive
[00:40:35] I'm making progress
[00:40:36] like I may feel bad
[00:40:37] right now
[00:40:38] but I have data showing
[00:40:39] that I'm actually improving
[00:40:40] that link
[00:40:41] to the psychological process
[00:40:42] the mood shift
[00:40:44] I think that was really important
[00:40:45] to be said
[00:40:45] so thank you
[00:40:46] because
[00:40:46] yes it happens
[00:40:47] with all symptoms
[00:40:48] for sure
[00:40:49] and also
[00:40:50] yeah
[00:40:50] I can only imagine
[00:40:51] the amount that it can happen here
[00:40:53] and like the link
[00:40:53] that
[00:40:53] that's there
[00:40:54] yes
[00:40:55] this is something I just
[00:40:56] I want to
[00:40:57] preach about
[00:40:58] to the mind-body world
[00:40:58] all the time
[00:40:59] I'm like
[00:40:59] just let me talk to you
[00:41:00] about this
[00:41:01] because
[00:41:02] there's an assumption
[00:41:03] often that anxiety
[00:41:04] depressive feelings
[00:41:05] are psychological in nature
[00:41:07] and of course
[00:41:08] we always
[00:41:08] want to look
[00:41:09] at that
[00:41:10] possibility
[00:41:10] of course
[00:41:11] there's some contribution
[00:41:12] there's also a
[00:41:13] just kind of a natural
[00:41:14] physiological response
[00:41:16] when you feel disoriented
[00:41:17] your body is like
[00:41:18] okay
[00:41:18] you need to sit down
[00:41:19] and get in bed now
[00:41:20] like
[00:41:20] you're actually in danger
[00:41:22] you don't know
[00:41:23] where you are in space
[00:41:24] it's the most important sense
[00:41:25] we have
[00:41:25] I will also die on that hill
[00:41:27] we need to know
[00:41:28] where we're oriented
[00:41:29] in space
[00:41:29] far more than we need to be able
[00:41:30] to see
[00:41:31] where we're going
[00:41:32] or taste our food
[00:41:33] just orientation
[00:41:34] if you think back
[00:41:34] to the most primitive
[00:41:36] organisms
[00:41:37] the number one
[00:41:37] most important sense
[00:41:38] is knowing
[00:41:39] where they are in space
[00:41:40] doesn't matter
[00:41:40] if you can find food
[00:41:41] if you don't actually know
[00:41:42] where you are in relation
[00:41:43] to the food
[00:41:44] right
[00:41:44] so
[00:41:45] there's a reason
[00:41:46] why
[00:41:47] it makes you feel so bad
[00:41:48] when you're disoriented
[00:41:49] and
[00:41:50] as soon as you can call
[00:41:51] it's bluff
[00:41:51] and say
[00:41:52] this is just my brain
[00:41:53] chemistry
[00:41:53] like actually
[00:41:54] just fooling me
[00:41:55] like trying to mess
[00:41:56] with me
[00:41:56] it feels so much better
[00:41:58] you can separate from it
[00:41:59] yeah
[00:42:00] for sure
[00:42:01] okay
[00:42:01] so and on that note
[00:42:02] is there anything else
[00:42:03] that we have not talked
[00:42:04] about that you feel
[00:42:05] like is really important
[00:42:06] people to know
[00:42:07] because this is great
[00:42:08] we need people to understand this
[00:42:09] yeah
[00:42:10] the only other thing
[00:42:11] that I
[00:42:11] I think that we haven't
[00:42:12] mentioned so far
[00:42:13] directly is
[00:42:14] is just the anxiety piece
[00:42:15] so
[00:42:16] if I can say a word
[00:42:17] about that
[00:42:18] so
[00:42:18] obviously one of the
[00:42:19] greatest risk factors
[00:42:21] for someone to develop
[00:42:22] chronic dizziness
[00:42:23] after having
[00:42:23] an episode of dizziness
[00:42:25] is pre-existing
[00:42:26] anxiety
[00:42:27] now
[00:42:27] that's true
[00:42:28] however
[00:42:29] however
[00:42:29] as we were just talking about
[00:42:31] disorientation
[00:42:32] has a way of messing
[00:42:33] with your physiology
[00:42:34] most people
[00:42:35] over 90% of people
[00:42:36] with dizziness
[00:42:37] and up with anxiety
[00:42:38] even if they've never
[00:42:39] had anxiety before
[00:42:41] and this
[00:42:42] messes with people
[00:42:43] so
[00:42:43] hard
[00:42:44] because I
[00:42:45] work with people every day
[00:42:46] who've never had an intrusive
[00:42:48] thought in their entire lives
[00:42:49] and then suddenly
[00:42:50] it's like their brain turns
[00:42:51] on OCD mode
[00:42:52] and I'm not
[00:42:53] making
[00:42:54] light of OCD
[00:42:55] I'm saying they
[00:42:55] actually develop
[00:42:57] sort of obsessive
[00:42:58] compulsive disorder type
[00:42:59] thought patterns
[00:43:00] that they've never ever
[00:43:01] experienced before
[00:43:03] so
[00:43:03] I just think this is such
[00:43:04] an important thing
[00:43:05] for people to understand
[00:43:06] because
[00:43:06] when they're experiencing
[00:43:07] dizziness
[00:43:08] it's not just
[00:43:09] physiologic terror
[00:43:10] it's not just
[00:43:11] I don't know where I'm
[00:43:11] oriented in space
[00:43:12] it has these downstream
[00:43:13] effects
[00:43:14] that
[00:43:15] end up
[00:43:15] producing
[00:43:16] thought patterns
[00:43:17] distressing
[00:43:18] and disturbing
[00:43:18] thought patterns
[00:43:19] that again
[00:43:20] are just
[00:43:20] natural brain stuff
[00:43:22] that's just happening
[00:43:22] because your
[00:43:23] brain is disoriented
[00:43:24] and trying to figure out
[00:43:25] what it means
[00:43:26] and it's not actually
[00:43:27] you
[00:43:27] it's not
[00:43:28] that you have
[00:43:28] a psychological problem
[00:43:29] now
[00:43:30] and now you have OCD
[00:43:31] it's an effect
[00:43:32] of the
[00:43:32] of the disorientation
[00:43:33] however
[00:43:34] it does mean
[00:43:35] that to recover
[00:43:36] from dizziness
[00:43:37] if you're also
[00:43:37] experiencing
[00:43:38] fear and anxiety
[00:43:39] and obsessive
[00:43:40] compulsive
[00:43:40] thought patterns
[00:43:41] et cetera
[00:43:41] you're gonna need
[00:43:42] to address those
[00:43:43] I don't like using
[00:43:44] black and white language
[00:43:45] but
[00:43:46] in my experience
[00:43:47] can't recover
[00:43:48] unless you know
[00:43:49] how to address those things
[00:43:50] you have to
[00:43:51] know
[00:43:51] how to work
[00:43:52] with that fear
[00:43:52] and anxiety
[00:43:53] that is
[00:43:54] in my opinion
[00:43:55] probably the biggest
[00:43:56] obstacle
[00:43:56] for the majority
[00:43:57] of people
[00:43:58] who are dealing
[00:43:58] with dizziness
[00:43:59] it's not
[00:44:00] exactly
[00:44:01] response to symptoms
[00:44:01] it's not
[00:44:02] exactly stress
[00:44:03] it's
[00:44:03] I'm being attacked
[00:44:04] by my own mind
[00:44:05] as a result
[00:44:06] of the disorientation
[00:44:07] and
[00:44:08] I believe it
[00:44:09] I believe the thoughts
[00:44:09] that are happening
[00:44:10] and I'm basically engaging
[00:44:11] in compulsive
[00:44:13] behavior
[00:44:13] or compulsive
[00:44:14] thinking to try to
[00:44:15] stop it
[00:44:15] and now
[00:44:16] it's become
[00:44:16] its own
[00:44:16] cycle
[00:44:17] so I
[00:44:18] strongly encourage
[00:44:19] people
[00:44:19] who have dizziness
[00:44:20] to
[00:44:21] take just
[00:44:22] a slight detour
[00:44:23] from the
[00:44:23] mind-body
[00:44:23] world
[00:44:24] and
[00:44:24] look up
[00:44:25] some
[00:44:26] good
[00:44:26] anxiety
[00:44:27] specific
[00:44:28] resources
[00:44:28] you're
[00:44:29] probably going
[00:44:30] to need them
[00:44:30] and I can give them
[00:44:31] I can list some
[00:44:32] if
[00:44:32] if that's okay
[00:44:33] yeah for sure
[00:44:33] yeah
[00:44:34] dare
[00:44:35] so
[00:44:35] DA
[00:44:36] RE
[00:44:37] they're great
[00:44:38] they're great resource
[00:44:39] disordered
[00:44:40] or
[00:44:40] drooling
[00:44:40] salata
[00:44:41] he's a great podcast
[00:44:42] on
[00:44:43] on anxiety
[00:44:43] the anxiety guy
[00:44:44] just
[00:44:45] some resources
[00:44:45] to get you started
[00:44:46] anxiety
[00:44:46] rx
[00:44:47] by rust
[00:44:47] kennedy
[00:44:48] everyone
[00:44:48] with dizziness
[00:44:49] almost everyone
[00:44:50] with dizziness
[00:44:50] is going to need
[00:44:51] those kinds of tools
[00:44:52] as part of
[00:44:52] the recovery
[00:44:53] toolkit
[00:44:53] thank you
[00:44:54] so much
[00:44:55] also
[00:44:55] I want to highlight
[00:44:56] for all the
[00:44:56] therapists
[00:44:57] and coaches
[00:44:57] that are
[00:44:57] listening to this
[00:44:58] because we have
[00:44:58] a few here
[00:44:59] quite a few
[00:45:00] I mean
[00:45:00] I think that's
[00:45:01] so important
[00:45:01] as a therapist
[00:45:02] myself
[00:45:02] to
[00:45:03] recognize
[00:45:03] that
[00:45:04] to
[00:45:04] understand
[00:45:05] that link
[00:45:06] and
[00:45:06] part of
[00:45:07] what I'd like to
[00:45:07] get out in the world
[00:45:08] is to help
[00:45:10] don't know this work
[00:45:10] who's never been
[00:45:11] trained in
[00:45:11] purity
[00:45:12] right
[00:45:12] he's
[00:45:13] understand it
[00:45:13] right
[00:45:14] yes
[00:45:14] yes
[00:45:14] so glad you're
[00:45:15] doing that
[00:45:15] there's
[00:45:16] such a gap
[00:45:16] there's
[00:45:16] such a gap
[00:45:17] in the
[00:45:17] therapist
[00:45:17] community
[00:45:18] and so my
[00:45:18] point being
[00:45:19] yes
[00:45:20] just
[00:45:20] please
[00:45:21] understand this
[00:45:21] too
[00:45:21] for your clients
[00:45:23] do not assume
[00:45:23] the way that
[00:45:24] we would work
[00:45:24] yes
[00:45:25] yes
[00:45:25] especially
[00:45:26] since so
[00:45:26] many of you
[00:45:27] listening
[00:45:27] right
[00:45:28] are probably
[00:45:28] very trauma
[00:45:29] informed
[00:45:30] and are
[00:45:30] really
[00:45:31] ready to
[00:45:32] dig in
[00:45:32] deep to
[00:45:32] that
[00:45:33] stress
[00:45:33] bucket
[00:45:33] like
[00:45:34] oh my
[00:45:34] gosh
[00:45:34] what
[00:45:35] you know
[00:45:35] what
[00:45:35] what's
[00:45:36] all the stress
[00:45:37] the
[00:45:40] place do
[00:45:40] not assume
[00:45:41] that the obsessive
[00:45:42] compulsive
[00:45:42] stuff
[00:45:43] or the anxiety
[00:45:44] or the health
[00:45:44] anxiety
[00:45:45] or the fear
[00:45:45] that
[00:45:46] that's coming
[00:45:46] from that
[00:45:47] it may
[00:45:47] actually
[00:45:48] just be
[00:45:49] a side
[00:45:49] effect
[00:45:50] of the dizziness
[00:45:51] symptoms
[00:45:51] themselves
[00:45:52] and you
[00:45:52] treat them
[00:45:53] as symptoms
[00:45:53] true
[00:45:54] but
[00:45:54] there are certain
[00:45:55] ways of treating
[00:45:56] them as symptoms
[00:45:57] that
[00:45:57] are different
[00:45:58] from how
[00:45:59] you would
[00:45:59] treat
[00:45:59] a physical
[00:46:00] symptom
[00:46:01] for example
[00:46:02] messages of
[00:46:02] safety
[00:46:03] and reassurance
[00:46:04] not the
[00:46:04] right move
[00:46:05] for
[00:46:06] for
[00:46:06] intrusive
[00:46:06] thoughts
[00:46:10] really tricky
[00:46:10] because you kind of
[00:46:11] have to both
[00:46:11] give reassurance
[00:46:12] about symptoms
[00:46:13] but not
[00:46:13] reassurance
[00:46:14] about the
[00:46:14] fear
[00:46:14] at the same
[00:46:15] time
[00:46:15] it's an
[00:46:16] interesting
[00:46:16] needle to
[00:46:17] thread
[00:46:17] but
[00:46:17] this is why
[00:46:18] I'll often
[00:46:18] work in
[00:46:19] stages
[00:46:19] if someone's
[00:46:20] dealing with
[00:46:20] a lot of
[00:46:21] the fear
[00:46:21] and anxiety
[00:46:21] we work
[00:46:22] there first
[00:46:22] and then
[00:46:23] we'll
[00:46:23] move on to
[00:46:23] stress
[00:46:24] related stuff
[00:46:25] okay
[00:46:25] that makes
[00:46:25] so much
[00:46:26] sense also
[00:46:26] I
[00:46:27] hear another episode
[00:46:28] coming into play
[00:46:29] regarding
[00:46:29] treatment
[00:46:30] oh my goodness
[00:46:31] hey
[00:46:31] thank you
[00:46:32] so much
[00:46:32] for all of this
[00:46:33] I know
[00:46:33] it was incredibly
[00:46:34] helpful
[00:46:35] thank you
[00:46:35] is there
[00:46:36] anything else
[00:46:36] do you
[00:46:36] feel like
[00:46:37] is important to know
[00:46:38] as we look up
[00:46:39] most important
[00:46:39] thing is
[00:46:40] I don't care
[00:46:41] how long
[00:46:41] you've had
[00:46:42] symptoms
[00:46:42] you
[00:46:43] are not
[00:46:43] the exception
[00:46:44] and
[00:46:45] day one
[00:46:45] of your recovery
[00:46:46] is the
[00:46:46] day that
[00:46:47] you realize
[00:46:47] that you
[00:46:48] can recover
[00:46:49] so
[00:46:49] if you've had it
[00:46:50] for 30
[00:46:50] years
[00:46:51] or three
[00:46:51] months
[00:46:51] or however
[00:46:52] long
[00:46:53] does not matter
[00:46:54] day one
[00:46:54] of your recovery
[00:46:55] is
[00:46:56] the day
[00:46:56] that you realize
[00:46:57] you can
[00:46:58] and you can
[00:46:58] amazing
[00:46:59] highly
[00:46:59] highly
[00:47:00] back that
[00:47:01] as well
[00:47:01] okay
[00:47:01] we will of course
[00:47:02] link everything
[00:47:03] your youtube
[00:47:04] channel
[00:47:07] and
[00:47:08] just really appreciate
[00:47:08] coming on
[00:47:09] thank you so much
[00:47:10] thank you
[00:47:10] thank you
[00:47:10] for having me
[00:47:11] you're welcome
[00:47:12] all right
[00:47:12] and we will
[00:47:13] talk to you
[00:47:14] all
[00:47:14] next week
[00:47:16] if this
[00:47:16] podcast
[00:47:17] means something
[00:47:17] to you
[00:47:18] it would mean
[00:47:18] so much to me
[00:47:19] if you could
[00:47:19] do these
[00:47:20] couple
[00:47:20] things
[00:47:21] one
[00:47:21] go to the
[00:47:22] hill
[00:47:22] with grace
[00:47:23] show page
[00:47:23] wherever
[00:47:24] you listen
[00:47:24] and tap the plus sign
[00:47:26] or click
[00:47:26] on the follow
[00:47:26] button
[00:47:27] so you
[00:47:27] don't
[00:47:27] miss an episode
[00:47:29] it helps
[00:47:29] both of us
[00:47:29] out
[00:47:30] while you're there
[00:47:31] if you could
[00:47:31] give a five
[00:47:32] star
[00:47:32] review
[00:47:33] so that
[00:47:33] this podcast
[00:47:34] can reach more
[00:47:35] people
[00:47:38] so I can continue
[00:47:38] sharing
[00:47:39] episodes
[00:47:39] that help
[00:47:40] you
[00:47:40] as well
[00:47:40] as others
[00:47:42] thanks for listening
[00:47:43] and I hope
[00:47:43] this brings
[00:47:43] you hope
[00:47:44] on your
[00:47:44] journey