The Science Behind Emotions, Pain & the Nervous System with Mark Lumley, PhD

[00:00:00] Hello, hello, and welcome back to the Heel with Grace podcast.
[00:00:05] I have a really cool guest today, and I'm actually really excited for you to listen to this episode
[00:00:12] because as we were talking in the beginning, you'll hear me say, oh, sorry, we'll edit
[00:00:18] this out because I forgot to ask how he wanted me to introduce him, his name, whether doctor
[00:00:24] or just name. And there's a little tidbit learning opportunity there.
[00:00:29] So you'll get to see or listen to how we go about that first and foremost.
[00:00:35] We have Dr. Mark Lumley, who is a clinical psychologist and distinguished
[00:00:39] professor of psychology at Wayne State University, where he has spent over three
[00:00:44] decades researching the powerful role of emotions and how they play in our
[00:00:49] health. He is best known for developing and testing emotional awareness and
[00:00:53] expressive therapy, E-A-E-T, which is something that we've talked about on here
[00:00:58] as well, which is an evidence based approach shown to people shown to help
[00:01:01] people with chronic pain by addressing unresolved emotions and stress.
[00:01:06] Dr. Lumley has published more than 200 peer reviewed articles with his work
[00:01:09] continuously funded by the National Institute of Health.
[00:01:13] He has also contributed to advancing pain reprocessing therapy and other
[00:01:17] mind body approaches, bridging cutting edge science with clinical practice.
[00:01:21] His mission is to help people understand and heal the emotional roots of chronic
[00:01:25] symptoms so they can reclaim their lives. So without further ado,
[00:01:29] I'll let you go ahead and listen and highly recommend Pro Tip to save this
[00:01:35] episode, save it so you can keep coming back to it and reminding yourself
[00:01:39] the power of emotional expression, the power of how emotions drive our
[00:01:44] nervous system into a state of stress response, which can create and
[00:01:47] drive chronic pain and illness. All right, here we go.
[00:01:51] Hey there and welcome to Heal with Grace. I'm your host, Grace Secker, and I'm a
[00:01:55] holistic licensed therapist and nervous system coach who believes that the
[00:01:59] chronic and often unseen symptoms you're living with are a sign of something
[00:02:03] deeper going on, a sign that your nervous system needs attention. In each
[00:02:07] episode, I'll share the science behind the most common chronic health
[00:02:11] disorders plus holistic health tips using mental, physical, and spiritual
[00:02:15] practices. You'll hear what I've learned in my journey and the true
[00:02:18] stories from our trusted guests so you can feel less alone in your
[00:02:22] experience and give yourself grace no matter what you're going through. So
[00:02:26] without further ado, settle in and get cozy. It's time to Heal with Grace.
[00:02:32] Okay, I also just realized I didn't ask, do you like to go by Dr.
[00:02:36] Lumley, Mark Lumley, Dr. Mark Lumley? What's, how do you prefer?
[00:02:40] And this is being recorded right now, right? That's actually-
[00:02:42] Yes, but I will, we will edit this out.
[00:02:44] But to be honest with you, when people ask me that question, when
[00:02:47] patients ask me that question, I say, what do you, are you most
[00:02:51] comfortable calling me? And then I'll ask them to call me the other
[00:02:54] thing, the least comfortable thing, which she gets at where we're going to
[00:02:59] go with this talk today.
[00:03:01] Well, you know what? Yeah, I'm so curious to know why you do that.
[00:03:06] What's your, or we're going to add this in. So let's just go ahead
[00:03:10] and go with it. Why do you ask people to do that?
[00:03:13] Yeah, partly because I like to be a little provocative. Maybe
[00:03:15] that's part of my personality.
[00:03:17] But there's a larger message here, which is growth usually
[00:03:20] happens when people do that, which is uncomfortable.
[00:03:23] And most of what happens with most of us in life is we try to do
[00:03:26] the predictable and comfortable thing, which usually means things
[00:03:29] don't change. It's when we start to go in directions that are
[00:03:32] hard for us or uncomfortable or that creates some anxiety,
[00:03:35] that's often where change happens. So if you're comfort zone,
[00:03:38] where to say, I really want to call you Dr. Lumley, and I
[00:03:40] would say, try Mark and how does it fit for you? Or the
[00:03:44] opposite way around too? I really like to be casual. I don't
[00:03:46] like to be too professional. I'd say, well, try Dr. Lumley and
[00:03:48] see how that fits Grace.
[00:03:51] Okay, well, you know, to be honest, I'm not sure which one,
[00:03:55] but I'm going to first go with Mark. Hi, Mark.
[00:03:58] Hi, great to see you, Grace.
[00:03:59] Welcome to the Heal with Grace podcast. I really appreciate
[00:04:02] you coming on.
[00:04:03] I got to tell you, when I got your invite, it was a
[00:04:05] really fortunate time. I will do a little digression for a
[00:04:09] brief moment. Okay, I'm in a part of a study group at
[00:04:12] my church, and we were reading this book. What's so
[00:04:14] amazing about Grace by Philip Nancy? We really were
[00:04:19] covering this book. It's about you having grace in our
[00:04:22] lives and grace for other people. And your email pops up
[00:04:24] and it's like, here's a grace asking me to participate. I
[00:04:27] said, this is just like a sign. I would love to
[00:04:29] participate. Nice to meet you, Grace. And I imagine you're
[00:04:32] amazing as well.
[00:04:34] Thank you. Thank you. I've really grown. I mean, I use
[00:04:37] my name obviously in the title, I've grown to really, really
[00:04:40] value it and understand how much it what it really means. I
[00:04:43] think as a kid, I didn't think much of it or didn't. Yeah, I
[00:04:47] don't know if I really liked it that much. But I, there's a
[00:04:50] lot of meaning behind it.
[00:04:51] Yeah, we could use a lot more of that in our lives in our
[00:04:53] world, our country. Yeah. Yeah. So first and foremost, for
[00:04:57] people that do not know, can you give us a little background
[00:04:59] about who you are, what you do and how you got into this
[00:05:02] work?
[00:05:03] Sounds good. I'm a clinical psychologist. And I've
[00:05:06] long been interested in medicine. I was once a pre
[00:05:09] med student who decided to not go to medicine, but to go
[00:05:11] to clinical psychology. But I've been interested in how the
[00:05:14] mind and body operate together for a long time, and started
[00:05:17] working in the I made a decision at some point early on in my
[00:05:20] life to, unlike most of my peers who went into practice, went
[00:05:24] into hospital systems or private practice, I went into the
[00:05:26] academic world. So I've been at Wayne State University in
[00:05:29] Detroit, major university for since 1991. And when I went
[00:05:34] there, I had no interest in chronic pain. As a matter of
[00:05:36] fact, I had a professor in graduate school who said, I
[00:05:39] will quote her. I hate chronic pain patients, they never
[00:05:42] get better. And I feel so useless. And I said, okay, I will
[00:05:46] not go in that direction. And I didn't until I got to become
[00:05:49] a professor and a bunch of my students said, we'd like to do
[00:05:52] our doctoral dissertations on people with rheumatoid
[00:05:55] arthritis or people with fibromyalgia or people with
[00:05:58] non cardiac chest pain or people with inflammatory
[00:06:01] bowel disease. And I had a whole bunch of these students
[00:06:03] interested in this topic. And I said, I guess I better
[00:06:05] start learning something about chronic pain. And that
[00:06:08] led to this career, which has really moved in the direction
[00:06:12] of understanding what's driving chronic pain. I've long been
[00:06:15] interested in emotions. And what happens when people don't are
[00:06:19] not aware of their emotions, and they don't express them very
[00:06:21] well, is that a problem? Looks like it is. And I've been
[00:06:25] interested in methods of things like expressive writing and
[00:06:28] done a lot of research on that over the years, with
[00:06:31] Jamie Pennebaker's work, a lot of research on what happens
[00:06:35] if you ask people to write about difficult emotional
[00:06:37] stressful experiences. And the past 15 years or so have
[00:06:40] moved into the direction with my colleagues of doing work in
[00:06:44] developing a therapy that would tackle those emotional
[00:06:47] processes, those, those discomforts. And if those
[00:06:52] things are indeed driving some people's chronic pain, then
[00:06:55] can we fix those emotional issues and reduce or eliminate
[00:06:58] their chronic pain? And that's where my work has been
[00:07:01] going.
[00:07:02] There's many of us who myself included who have heard their
[00:07:06] own history of chronic pain, chronic symptoms, right? Going
[00:07:09] into this work. I'm the same never, never in a million years
[00:07:12] that this would be my specialty being a therapist. Do you
[00:07:16] have any of that experience for yourself?
[00:07:18] Yeah, I didn't give you too much personal stuff in that
[00:07:20] little story, did I? It was mostly the sort of
[00:07:22] straightforward, professional stuff. Most vivid, vivid
[00:07:26] memory of a mind about a issue for me was fourth grade
[00:07:30] science, presentation in elementary school, the teacher
[00:07:33] was showing a movie of blood transfusion, or actually
[00:07:37] hemodialysis. And the blood was going out of some
[00:07:40] patient's arm to a machine and coming back again. And I
[00:07:43] remember watching this going, I don't feel so good. I'm not
[00:07:46] going to make it. And I walked out on the hallway and I
[00:07:48] barfed. And I sat there against the lockers embarrassed
[00:07:52] that I had barfed, but also sort of curious, like, how
[00:07:55] the heck did that happen? How the heck did something go
[00:07:57] in my eyeballs and change my body around and come out? So
[00:08:00] there's that over the years. I've actually was especially
[00:08:03] when I was younger, weekends, going a white way for like a
[00:08:06] scouting weekend or something, my intestines would shut off
[00:08:09] on Friday afternoon, and then return on Sunday afternoon
[00:08:13] when I'm pulling into my driveway back home. It's
[00:08:15] like the intestines said, we're in an uncomfortable place
[00:08:18] here, let's stop working. So chronic pain in the usual
[00:08:22] sense. No, I haven't had much the way I've had eggs or
[00:08:23] back or neck big, but I've had these other sort of
[00:08:25] things. And I've had they've been a curiosity to me
[00:08:27] and things I've worked on. By the way, I did my
[00:08:29] doctoral dissertation on overcoming blood phobia. Oh,
[00:08:33] really? Yeah, I guess we do research sometimes on our
[00:08:36] own issues. It became very interested in that phenomenon.
[00:08:40] Yeah. This is just going to be a side note, because it's
[00:08:42] not what the episode's about necessarily. But what did you
[00:08:45] find within that? I'm personally curious, is that
[00:08:48] something I've very much so dealt with? Yeah, yeah. So
[00:08:51] first thing is two, two things. When people that the
[00:08:55] people who tend to have the blood phobia, blood, you
[00:08:57] know, fainting experience, phasovagosyncope, tend to be
[00:09:01] people who can experience another's pain or body, almost
[00:09:04] personally, like high empathy, there's a high empathy piece. You
[00:09:08] see somebody else's broken body or blood coming out, you
[00:09:10] feel it within your own arm or leg or whatever. The other
[00:09:14] piece to it is that it happens when a person feels
[00:09:17] helpless. So there's a state of you have to sit here
[00:09:20] and take it, you can't you can't fight or flee, you
[00:09:23] know, the fight or flight response. If that fight or
[00:09:25] flight response that sympathetic drive gets turned off, it
[00:09:28] has to be terminated. All that's left is a response, a
[00:09:31] parasympathetic response that drops your blood pressure, and
[00:09:34] you start to faint. So if we could actually fight or run, we
[00:09:40] would actually keep our sympathetic fight or flight
[00:09:42] system activated and we keep our blood pressure up and we
[00:09:44] wouldn't faint. So you can take people who have to sit
[00:09:46] there and you know, give blood and actually have actually
[00:09:49] have a son. I think it's okay for me to say this
[00:09:51] publicly. Sure. He had a lot of blood work done when he
[00:09:54] was a kid and he had the same thing that dad had and he
[00:09:56] start to pass out. And what I actually had him do as his dad,
[00:09:59] I'd say, take your other hand and pound it and take your
[00:10:01] feet and pound it like you're fighting something while they
[00:10:03] have to keep taking blood, watch his blood pressure
[00:10:06] stay up. If you stop doing that, he starts to go down,
[00:10:09] like fight against son and even yell a little bit, Ah, stop
[00:10:13] would allow the activation of the sympathetic nervous
[00:10:15] system to keep his blood pressure up and get through
[00:10:17] the blood draw procedures.
[00:10:20] That's fascinating. I've never made that connection.
[00:10:23] That's something I've dealt with many, many times, passed out
[00:10:25] many times by giving getting blood taken and I've learned to
[00:10:29] work with it by soothing and calming up, put on a meditation
[00:10:33] or music or just kind of distract in a way.
[00:10:35] Distract.
[00:10:37] And but still, that's I've never tried.
[00:10:40] It's a fascinating phenomenon. So you have, there's a fear
[00:10:43] thing that kicks in, which one makes you fight or flee.
[00:10:45] There's also a response, a person that thing wants to
[00:10:48] shut your body down and protect you. And when you
[00:10:51] when your head says, I'm stuck and I can't yell, fight,
[00:10:54] scream or anything that gets turned off, it just leaves
[00:10:57] the decreasing blood pressure, parasympathic drive and
[00:11:00] then you feel it. So my recommendation is yell and
[00:11:04] scream and fight a little bit with while you're being
[00:11:06] exposed to one of those stimuli that normally would
[00:11:10] make you go.
[00:11:11] Okay. All right. Interesting.
[00:11:14] Yeah. And by the way, you might think, what's that
[00:11:16] got to do with what we're talking about today? Well,
[00:11:18] emotions are important. And the truncating of emotions,
[00:11:22] the blocking of them, this turning them off can be a
[00:11:25] problem. And the experiencing and expressing can be
[00:11:27] adaptive sometimes.
[00:11:29] Yeah. So I'm just going to introduce then EAET,
[00:11:33] Emotional Awareness and Expressive Therapy, which
[00:11:34] you've helped help develop. Can you explain a
[00:11:37] little bit about that and how that's helping people
[00:11:40] with pain and chronic symptoms?
[00:11:42] Yeah. So my colleague, Howard Schubiner, who is
[00:11:45] a physician, we've been working together nearly 20
[00:11:47] years now. And as we got into this world together,
[00:11:50] he came out it from John Sarno's perspective of
[00:11:54] it's something about the mind and the brain and
[00:11:55] it's not your, not your body that's diseased. I
[00:11:58] came in it from a perspective of psychological
[00:12:01] therapies that tackle emotional issues like
[00:12:04] exposure therapies for trauma or fears. We
[00:12:08] started working together and said, how are we
[00:12:09] going to put our minds together and help
[00:12:11] folks if, if there's trauma or conflict or
[00:12:16] interpersonal problems in people's background and
[00:12:19] that seems to be driving some of their pain. I'm
[00:12:21] being a little cautious with the language because
[00:12:23] it's not all people. It's not all types of pain,
[00:12:25] but there's a meaningful subset of folks who
[00:12:28] have backgrounds and what they've done with
[00:12:29] their emotions is usually not giving them some
[00:12:33] full adaptive expression, full experiencing.
[00:12:36] They've sort of worded them off or blocked
[00:12:38] them or something. So we started working
[00:12:40] together and initially with a group of
[00:12:43] patients with fibromyalgia and he was doing his
[00:12:46] thing and I was doing my thing. We got
[00:12:47] together and said, let's make a new thing and
[00:12:49] we called it something. We ended up, initially
[00:12:51] we called it something called emotional
[00:12:53] exposure therapy. We thought we would expose
[00:12:55] people to their emotions, but that turns out
[00:12:58] to be EET and it looks like eat and nobody
[00:13:01] wanted to say that sort of thing. And also
[00:13:03] too many people have three letter acronyms
[00:13:05] for their therapy names. So we, I basically
[00:13:08] said, let's come up with something that
[00:13:09] sounds more like what we're actually
[00:13:10] doing, which is awareness of emotion and
[00:13:13] expression of emotion therapy for chronic
[00:13:15] pain. I will confess, that's a lousy name,
[00:13:19] E-A-E-T, nobody can remember, too many
[00:13:20] vowels. Nobody, it's too long, people like
[00:13:23] three, not four. And if I were rebranding it,
[00:13:25] I'd come up with something better. But here
[00:13:27] we are. So we've been doing a series of
[00:13:29] studies, Howard and I and a number of
[00:13:30] all other colleagues. And it's a very
[00:13:34] different approach than cognitive
[00:13:35] behavioral therapy or acceptance of
[00:13:37] commitment therapy or mindfulness based
[00:13:39] therapies. It really does try to help
[00:13:42] people. We start with a model of what
[00:13:45] it is we think is going on with pain,
[00:13:46] which is current pain neuroscience model.
[00:13:49] It's the brain is the organ of pain and
[00:13:52] it's reading some signals from your body,
[00:13:54] some sensations, but it's integrating it
[00:13:56] with a lot of other stuff, your
[00:13:57] beliefs, your fears, models in the
[00:13:59] society, what's your background stuff
[00:14:03] you're preventing yourself experiencing
[00:14:04] sort of the threats that might be
[00:14:06] looming up from the back and it creates
[00:14:08] an alarm system called pain. And for
[00:14:10] some people, acute pain, it's a pretty
[00:14:12] good representation of what your body
[00:14:15] is going through. But chronic pain, it's
[00:14:16] usually a poor representation of what
[00:14:18] your body is experiencing. It's more
[00:14:19] about what your brain has learned or
[00:14:21] is expecting. And so we start with
[00:14:24] that educational piece. And then we
[00:14:26] start to get into a life history with
[00:14:28] people. Let me go through your whole
[00:14:30] life. And by the way, it's stunning
[00:14:32] how many patients have seen doc after
[00:14:34] doc after doc. And they don't know
[00:14:37] the professionals have never learned
[00:14:39] people's histories. Tell me your story
[00:14:41] Grace. Tell me take me back. The good
[00:14:44] stuff and the challenging stuff since
[00:14:45] you were, you know, age one. And and
[00:14:48] then as we hear that story, tell me
[00:14:50] about health issues, pain or other
[00:14:52] things that happened. You know, how
[00:14:54] your parents got divorced then? Oh,
[00:14:56] you had this bad experience in high
[00:14:57] school. What was what were you
[00:14:58] experiencing? Many patients will start
[00:15:00] to see these connections between what
[00:15:02] happened in their lives and the
[00:15:04] various health related challenges they've
[00:15:06] had. We'll look at the, you know, you
[00:15:09] have this back pain right now or neck
[00:15:10] pain or whatever. When did it start?
[00:15:12] Well, it really blew up when I was in
[00:15:14] college. What was going on? Well, I was
[00:15:16] struggling with my so and so. And you
[00:15:19] know, and many patients, the majority
[00:15:22] that we see have stories that start
[00:15:24] to make some sense that the pain
[00:15:25] doesn't just, you know, not this
[00:15:27] just injury boom pain, but there's a
[00:15:29] backstory to it. And then we start
[00:15:31] to take people to the next step,
[00:15:32] which is, let's look at your emotions
[00:15:34] that you have connected with some
[00:15:36] experience. Oh, so you had this
[00:15:38] really thinking of a recent patient.
[00:15:41] You got this new job and the boss was
[00:15:43] vicious, a tyrant, and you ended up
[00:15:45] having chronic pain about a month
[00:15:46] later. Let's go back and replay an
[00:15:49] episode with that boss here in the
[00:15:51] safety of our session. In this time,
[00:15:53] I'd like you to sort of get a hold
[00:15:54] of whatever it is that you're
[00:15:55] starting to the feelings that come
[00:15:57] up. And this is a really important
[00:15:59] point. The feelings are often
[00:16:01] there's like two classes of feelings.
[00:16:03] There's the feelings that people
[00:16:05] often bring into therapy. I'm feeling
[00:16:07] like crap. I hate myself. I'm feeling
[00:16:10] down. I'm feeling unanxious. I'm
[00:16:12] anxious. I'm on edge. I'm irritable.
[00:16:16] And that's what they bring in. That's
[00:16:17] what they say. But underneath that
[00:16:19] are usually some feelings that are
[00:16:21] healthy and adaptive that fit the
[00:16:23] situation. So your boss was a
[00:16:26] tyrant and, you know, humiliated
[00:16:28] you and whatnot undeservedly.
[00:16:31] What other feelings are in there?
[00:16:32] Maybe there's a part of me that's
[00:16:33] mad. Good. Let's activate that
[00:16:35] healthy part of you that's mad. And
[00:16:37] it would help them feel it in their
[00:16:39] body. We'd help them start to give
[00:16:42] it some words and even use their
[00:16:45] body to do something as opposed to
[00:16:46] their body sitting there doing
[00:16:48] nothing. Emotions want to have a
[00:16:50] body that's involved. Anger wants
[00:16:53] to do something with the hands and
[00:16:54] the face and the voice. And
[00:16:57] sadness wants to do something with
[00:16:58] the tears, you know, and love
[00:17:01] wants to do something that feels
[00:17:02] like I want to hold and grab on to.
[00:17:04] And the last one we're looking at
[00:17:05] is some sort of self compassion,
[00:17:07] which really needs to do something
[00:17:08] like this and something like this.
[00:17:11] And what I'm looking for is what
[00:17:12] emotions are hard for a person to
[00:17:14] experience and express. What are
[00:17:16] uncomfortable or anxiety provoking,
[00:17:19] hence the connection with what
[00:17:20] name makes you least comfortable
[00:17:22] calling me as we started this.
[00:17:24] But if we look at that issue,
[00:17:26] I'm looking for what emotions have
[00:17:28] been sort of blocked or buried
[00:17:29] in there, usually one of three
[00:17:31] types, the anger related
[00:17:32] emotions, the connecting
[00:17:34] feelings like sadness
[00:17:37] or love that bring you closer to
[00:17:39] a person and the positive self
[00:17:41] feelings like compassion and
[00:17:42] pride. And when I see that it's
[00:17:45] hard for a person to experience
[00:17:46] or express those things when
[00:17:48] they should be able to and like a
[00:17:49] certain situation, then that's
[00:17:51] the direction that we go to help
[00:17:52] them develop more comfort with
[00:17:54] those feelings. So that's sort of
[00:17:55] it in a nutshell.
[00:17:57] Yeah. What do you say, just
[00:17:59] piggybacking on that last part?
[00:18:00] What do you say when someone I get
[00:18:02] this a lot? Well, I'm just, I've
[00:18:04] never really been an angry person.
[00:18:05] I just don't, you know, I just
[00:18:07] don't have that. That's not me.
[00:18:09] Yeah, I start with, wow, you're
[00:18:11] the one. I thought you might be
[00:18:13] some human out there. I haven't
[00:18:14] met many before.
[00:18:16] What you mean is that you
[00:18:17] don't experience anger.
[00:18:20] Are you the fortunate one who's
[00:18:21] never been in a situation that
[00:18:23] were treated wrongly or put
[00:18:25] in a weird uncomfortable spot and
[00:18:26] answered, well, I suppose I was,
[00:18:28] but somewhere in there, there was
[00:18:30] anger, but it got blocked or
[00:18:32] something. And I actually will take
[00:18:34] a person, one of the things I
[00:18:35] like to do is say, what would it be
[00:18:36] like for you, Grace, who doesn't
[00:18:38] feel ever becoming angry, to
[00:18:41] right now raise your voice and
[00:18:42] say, you're wrong, Mark, stop
[00:18:45] that. I'd invite a person to do
[00:18:47] that. And it's amazing that
[00:18:50] even faking it, that little
[00:18:52] role play, many people will
[00:18:54] have a lot of anxiety even doing
[00:18:56] that. So that's, is it
[00:18:59] you don't ever feel angry or it's
[00:19:01] scared to experience it and give
[00:19:02] it some voice becomes the
[00:19:04] question.
[00:19:05] Yeah, yeah, it's uncomfortable
[00:19:07] when you've never been able to
[00:19:09] do so or allowed to do so or
[00:19:10] never learned how.
[00:19:12] Yeah, so those things, it's
[00:19:14] been blocked. I've been
[00:19:14] allowed to have had to suppress
[00:19:15] it. Then you'll see the anxiety
[00:19:17] bubble up when a person starts
[00:19:19] to and why invite them to
[00:19:21] try something that sounds or
[00:19:22] looks a little like anger.
[00:19:24] Yeah. Can you speak to the
[00:19:28] I also get this question a lot
[00:19:29] of, well, OK, I can understand
[00:19:31] maybe emotional expression is
[00:19:33] important, but I have a real
[00:19:34] physical, you know, disability
[00:19:37] or something going on in my
[00:19:38] body. It's real. I'm not just
[00:19:40] emotionally making it up. Like
[00:19:42] what do you how does that?
[00:19:44] How can you answer that?
[00:19:45] Yeah, well, we start with
[00:19:47] yep, what you're experiencing
[00:19:48] pain wise or whatever else is
[00:19:49] definitely real.
[00:19:52] So usually go back to your
[00:19:53] brain is the pain thing and
[00:19:56] your brain is creating pain
[00:19:57] from whatever it's reading in
[00:19:58] your body, whatever sort of
[00:20:00] tensions or inflammations or
[00:20:02] whatever nerve issues might be
[00:20:03] there. And it's probably adding
[00:20:05] a piece to it that might be
[00:20:07] coming from these emotional
[00:20:08] things that have been blocked.
[00:20:10] And let's I usually, you know,
[00:20:11] I'm not a physician and I
[00:20:12] don't know that I have magic
[00:20:13] answers to figure out how much
[00:20:14] of your pain is coming from
[00:20:16] what. So I'll invite the
[00:20:18] person to experiment with me
[00:20:20] and let's see what we learn.
[00:20:22] And by the way, Grace, if it
[00:20:23] turns out that I'm wrong and
[00:20:25] it's actually mostly driven by
[00:20:27] what's going on in your body
[00:20:28] and not much to deal with
[00:20:29] emotional stuff, then I can
[00:20:30] matter of fact, you can even
[00:20:31] tell me that I'm wrong.
[00:20:33] Could you practice that by
[00:20:34] the way Grace just saying
[00:20:35] Mark, you were wrong about
[00:20:36] me. Give it a try.
[00:20:38] Mark, you were wrong about
[00:20:39] me. How's that feel saying
[00:20:41] that? Okay, but a little
[00:20:43] uncomfortable. Good, good.
[00:20:45] You did it pretty easily.
[00:20:46] There's a set of people's
[00:20:47] like, I can't say that.
[00:20:48] No, I just their alarms go
[00:20:49] off about having a voice
[00:20:51] like that. So I actually
[00:20:52] do that little bit of weird
[00:20:53] stuff, inviting a person to
[00:20:54] try some new ways of expressing
[00:20:56] themselves.
[00:20:58] Yeah, I would imagine that
[00:21:01] would take probably time to
[00:21:03] right, especially for someone
[00:21:04] who's never been able to do
[00:21:05] that, or especially in front
[00:21:08] of someone that they're just
[00:21:09] getting to know and to me,
[00:21:11] that could be pretty
[00:21:12] vulnerable.
[00:21:14] Yeah, so I mean, a couple
[00:21:15] of parts there. Yeah, it
[00:21:16] does take some time. We
[00:21:17] can't do this in 15 minutes
[00:21:18] usually. But I'd say, are
[00:21:21] you feeling vulnerable right
[00:21:22] now? And you say, yeah, it
[00:21:23] feels really awkward. I don't
[00:21:24] know you, Mark. And I'd say,
[00:21:26] cool, what shall we do to
[00:21:27] make that easier for you? And
[00:21:30] I'd say, how about this one?
[00:21:33] Practicing this, Mark, accept
[00:21:34] me the way I am. And I don't
[00:21:36] really trust you. But I want,
[00:21:37] I want, I might try
[00:21:38] something like, I want to
[00:21:39] trust you, but I don't, Mark,
[00:21:40] I just want you to know
[00:21:41] that. And I invite the
[00:21:42] person to be honest with me
[00:21:43] along those lines, something
[00:21:44] like that. But a lot of
[00:21:46] these things, a lot of
[00:21:47] these issues can be worked
[00:21:49] on more quickly than many
[00:21:50] people have thought. In my
[00:21:52] field, clinical psychology,
[00:21:53] many people have thought it
[00:21:54] takes a long time to do this
[00:21:55] work. It takes months, years.
[00:21:58] A lot of things can be done
[00:21:59] much more quickly. You have
[00:22:02] to believe that people have
[00:22:02] the capacity, the person
[00:22:04] across from you has the
[00:22:05] capacity, even though
[00:22:06] they're scared and they're
[00:22:07] new, and they don't know
[00:22:09] you, they have capacity,
[00:22:11] they have abilities.
[00:22:15] I know from going through a
[00:22:17] EAET training, you're
[00:22:19] right, it is mouthful,
[00:22:21] that there's a lot of,
[00:22:25] there were a lot of
[00:22:25] practitioners that were even
[00:22:27] a little bit nervous about
[00:22:27] getting into this work
[00:22:28] themselves, being the
[00:22:29] therapist, being the coach,
[00:22:31] being, you know, someone
[00:22:32] that who leads this, which
[00:22:34] was interesting to me. I
[00:22:35] think it makes sense, but
[00:22:37] there's, I mean, yeah,
[00:22:39] there's both vulnerability
[00:22:40] on both sides, I'm sure.
[00:22:42] There really is. I do a lot
[00:22:44] of work on training
[00:22:45] psychologists that's part of
[00:22:46] my job at the university.
[00:22:47] And yeah, I often have to do
[00:22:50] the work of helping people
[00:22:51] go from, I want people to
[00:22:53] like me and I want people to
[00:22:55] be comfortable and calm and
[00:22:56] happy all the time, my
[00:22:57] clients, my patients, to, I
[00:23:00] need to be able to help take
[00:23:02] them to a difficult place,
[00:23:04] even though they're going
[00:23:05] to become anxious, even
[00:23:06] though they might show
[00:23:07] anger, you know, it's
[00:23:08] interesting, we recruit
[00:23:10] people into our field who
[00:23:11] are great at social skills
[00:23:14] and good at working with
[00:23:15] others and have great
[00:23:17] ability to make people feel
[00:23:18] comfortable. And then I ask
[00:23:20] them to try to do something
[00:23:20] that maybe doesn't work in
[00:23:21] that direction. That's hard.
[00:23:24] At this point, I think
[00:23:25] there's only, you know, some
[00:23:26] people can do it and other
[00:23:27] people are sort of really
[00:23:29] too uncomfortable to do this
[00:23:30] work. And I suggest they
[00:23:31] don't, they can do other
[00:23:31] things. Personally, I've had
[00:23:34] to do some of this work on
[00:23:35] my own therapy and my own
[00:23:37] life to try to develop more
[00:23:38] capacity to do that. But
[00:23:40] it really helps when a
[00:23:41] person comes to you and
[00:23:41] says, Mark, I'm in pain,
[00:23:43] I'm struggling, I'm
[00:23:43] suffering, help me. Then
[00:23:45] I'll invite them to do some
[00:23:46] work. And most people are
[00:23:47] like, Yeah, I need to do
[00:23:50] this. I'm scared. And I'll
[00:23:51] say, you can do this, let's
[00:23:52] do it together. And then we
[00:23:53] work together and move
[00:23:54] forward. It's really kind
[00:23:55] of beautiful.
[00:23:57] Yeah, yeah. I mean, it does
[00:23:59] take, I've learned that as
[00:24:01] well, it takes my own work
[00:24:03] to be able to do this to
[00:24:05] because, I mean, yeah, I
[00:24:06] come from a place where
[00:24:07] it's super vulnerable and
[00:24:09] not okay to express or
[00:24:10] feel or take up space or,
[00:24:12] you know, make not make
[00:24:14] but help someone else be
[00:24:15] uncomfortable too. Because
[00:24:17] to your point, being
[00:24:17] uncomfortable helps us change
[00:24:19] and how to ship that. Yeah.
[00:24:21] Yeah. Okay, can we go back
[00:24:23] to the when you mentioned
[00:24:24] journaling, when you've been
[00:24:25] doing some studies
[00:24:26] with a baker? Can you
[00:24:28] describe a little bit more
[00:24:29] of that work? I've talked
[00:24:30] a little bit about journaling
[00:24:31] on here, especially journal
[00:24:32] speak by Nicole Sachs and
[00:24:34] things like that. But I
[00:24:36] think that could be really
[00:24:37] helpful for our listeners
[00:24:38] to understand that piece
[00:24:39] of it, the journaling.
[00:24:40] Yeah, there's a bit of a
[00:24:41] disconnect between the
[00:24:43] research on it and the
[00:24:44] practice of it. And I came
[00:24:46] to the research
[00:24:47] perspective. Okay, Jamie
[00:24:49] Penn Baker developed this
[00:24:50] paradigm. He's a social
[00:24:52] psychologist who wanted to
[00:24:53] see if you could help people
[00:24:54] sort of give voice to
[00:24:55] whatever they hold inside
[00:24:56] will help their health. And he
[00:24:58] developed a simple
[00:24:58] experimental paradigm,
[00:25:00] randomly assigned some people
[00:25:01] to write for a few days
[00:25:03] about difficult experiences
[00:25:04] they've had in their deepest
[00:25:05] feelings. And other people
[00:25:07] that control condition of
[00:25:08] people randomized to write
[00:25:09] about neutral things, for
[00:25:09] example, and then follow
[00:25:12] them up both groups to see
[00:25:13] if the health improves of the
[00:25:14] first group relative to the
[00:25:15] second group. And he did that
[00:25:18] with a bunch of college
[00:25:18] students. We ended up doing
[00:25:20] this work in people with
[00:25:21] fibromyalgia and rheumatoid
[00:25:22] arthritis and asthma and a
[00:25:24] bunch of other conditions. We
[00:25:25] did probably 15 studies over
[00:25:26] the years, sometimes talking
[00:25:28] out loud, sometimes writing,
[00:25:30] sometimes typing, sometimes
[00:25:32] with a guide who's getting
[00:25:33] the feed some feedback to
[00:25:34] you, lots of different
[00:25:35] sometimes keeping it
[00:25:36] completely private and
[00:25:38] other times turning it into
[00:25:39] the research team. So
[00:25:40] somebody sees it. We tested
[00:25:41] lots of different ways. The
[00:25:43] bottom line was that several
[00:25:46] things. I was amazed that most
[00:25:48] people are sort of ready and
[00:25:50] open to share some stuff that
[00:25:52] they might not normally share
[00:25:54] when invited to. So, you know,
[00:25:56] Penn and Baker was stunned
[00:25:57] that people actually have
[00:25:58] been through some stuff and
[00:25:59] they're writing it out. And I
[00:26:00] too was often stunned by
[00:26:01] what people when invited,
[00:26:03] when instructed, please take
[00:26:05] a risk and do it would
[00:26:06] share. That was number one.
[00:26:08] Number two, the effects were
[00:26:10] not that big. They're actually
[00:26:12] pretty small in terms of the
[00:26:13] magnitude of the effect on
[00:26:15] health. And there's lots of
[00:26:17] reasons for that. I think
[00:26:18] partly it's you're comparing
[00:26:20] it to a control group that's
[00:26:21] doing some writing and you
[00:26:23] kind of look at the
[00:26:23] difference. Partly it's an
[00:26:24] experimental thing and you're
[00:26:25] randomly assigning people to
[00:26:26] do it. It's a little
[00:26:28] sterile in the research
[00:26:29] environment. But study after
[00:26:32] study showed the effects were
[00:26:33] pretty small. And so that's
[00:26:36] a little different than
[00:26:37] what happens clinically and we
[00:26:38] use it now clinically. And
[00:26:40] it's much more about the
[00:26:41] clinician working with the
[00:26:43] patient to say, let me see if
[00:26:45] I can use some guidance on
[00:26:45] what to write about. And maybe
[00:26:47] you want to bring that
[00:26:48] writing, you know, see what
[00:26:49] you do with it and what you
[00:26:50] learn from it. Maybe we can
[00:26:51] talk about it next session.
[00:26:52] Matter of fact, what would it
[00:26:54] be like? Personally, I like
[00:26:55] the unsent letter as well,
[00:26:56] which is not what we tested
[00:26:57] experimentally. The unsent
[00:26:58] letter is probably the most
[00:26:59] powerful one. What is it
[00:27:01] that you wish you could say
[00:27:02] to so and so but write it
[00:27:04] out as honestly as you can
[00:27:05] but don't send the darn
[00:27:06] thing. And we'll actually
[00:27:08] invite people to bring it
[00:27:09] back to session and even read
[00:27:11] it out loud or as if they're
[00:27:12] reading it to the person
[00:27:13] sitting in the empty chair
[00:27:15] there, you know. So I think
[00:27:17] clinically, that's what
[00:27:18] Nicole Sacks also finds
[00:27:19] clinically. It's a lot more
[00:27:20] powerful than perhaps
[00:27:22] done. And we, you know, when
[00:27:23] tested in these somewhat
[00:27:25] sterile randomized controlled
[00:27:27] trials, which is what we've
[00:27:27] done a lot of. So we use
[00:27:30] it as a homework exercise
[00:27:31] now. And and many people will
[00:27:33] say, actually, I heard a
[00:27:35] woman say just last week,
[00:27:36] she said, I didn't do it.
[00:27:38] Why not? It scares me to see
[00:27:41] it in print. I said, OK,
[00:27:43] let's maybe think of some
[00:27:45] other ways to move towards
[00:27:46] that goal so that it doesn't
[00:27:47] scare you as much. But it
[00:27:48] was a huge flag of this is
[00:27:49] needed, you know, needed
[00:27:51] difficult but needed and
[00:27:53] see if we can work some
[00:27:54] ways to get you there.
[00:27:55] In this study, I'm just
[00:27:57] curious, were there were
[00:27:59] the instructions about how
[00:28:02] to write about something
[00:28:03] difficult, meaning like you
[00:28:05] mentioned in the beginning
[00:28:06] instead of just writing about
[00:28:07] oh, I was frustrated or oh,
[00:28:08] that made me a little annoyed
[00:28:10] instead getting at the anger
[00:28:12] or the disappointment or the
[00:28:14] despair, the sadness.
[00:28:16] Was that part of it?
[00:28:18] Yeah, the original
[00:28:19] instructions that Pena Baker
[00:28:21] developed were very innocuous.
[00:28:23] They didn't have any direction
[00:28:24] for it other than be honest
[00:28:26] and don't worry about your
[00:28:27] grammar and your spelling
[00:28:28] and your sentence structure
[00:28:29] and stuff like that.
[00:28:31] But there was no more guidance
[00:28:32] than that. And the hope was
[00:28:33] people would be able to do
[00:28:34] something with it.
[00:28:35] My observation reading many
[00:28:37] of these writings over the
[00:28:38] years is that while people
[00:28:39] will talk about an experience
[00:28:41] they've had, they may share
[00:28:42] something, they don't know what
[00:28:44] to do with it emotionally
[00:28:45] in the writings.
[00:28:47] They often will kind of just
[00:28:48] ruminate about it, talk about
[00:28:49] their frustrations or their
[00:28:50] helplessness or the sort of
[00:28:52] emotions that I think are
[00:28:53] sort of secondary rather than
[00:28:55] the primary adaptive ones
[00:28:57] that I'm depressed and
[00:28:58] I'm anxious and feeling
[00:28:59] stupid and that sort of stuff.
[00:29:01] And they don't have to do
[00:29:02] with it. And so
[00:29:03] clinically, I think you have
[00:29:04] the opportunity to help a person
[00:29:07] direct their writing a little
[00:29:08] more.
[00:29:09] I mean, some patients blow my
[00:29:10] mind and they can do it, but a
[00:29:11] lot of people need the
[00:29:12] extra. That's one of the
[00:29:13] things that moved my research
[00:29:14] from expressive writing
[00:29:16] or emotional disclosure alone
[00:29:18] as a standalone technique to
[00:29:19] integrate it into this larger
[00:29:21] E-A-E-T thing we're doing
[00:29:23] as a homework, as a better
[00:29:25] of the homework.
[00:29:26] Let's expand on that a little
[00:29:27] bit more. What do you mean
[00:29:28] then by maybe people will
[00:29:31] write about something, but
[00:29:31] they don't know what to do
[00:29:32] with that emotionally?
[00:29:33] What's the disconnect there
[00:29:35] and what is it actually
[00:29:36] worth trying to get them to do?
[00:29:38] Yeah, I mean, most commonly,
[00:29:40] I don't know if I want to use
[00:29:41] the word unconscious or not,
[00:29:42] but people are minimally
[00:29:44] aware of certain emotional
[00:29:45] experiences.
[00:29:46] Classically, let's take a
[00:29:48] person, a woman who was
[00:29:49] sexually assaulted, far too
[00:29:51] common, and they might
[00:29:53] start to write about it.
[00:29:54] They rarely write about
[00:29:55] themselves becoming powerful
[00:29:56] and kicking that guy's
[00:29:58] butt or, you know, they
[00:30:00] write about their shame,
[00:30:02] they write about their disgust,
[00:30:03] they write about their numbness,
[00:30:04] they write about their dysfunction.
[00:30:06] They're revealing some things,
[00:30:08] but I don't consider most of
[00:30:09] that the right direction.
[00:30:10] What almost always is buried
[00:30:12] in there somewhere is anger or
[00:30:14] rage towards him, right?
[00:30:18] And that's the piece that's
[00:30:19] been smooshed down, suppressed,
[00:30:21] moved away, something.
[00:30:23] And that's the part that needs
[00:30:24] some help.
[00:30:25] And then the second big
[00:30:26] category is things in the
[00:30:27] family. The families are even
[00:30:28] more complicated because
[00:30:29] there's almost always two sets
[00:30:30] of feelings. There's the
[00:30:31] anger and the longing for
[00:30:33] love and closeness from somebody.
[00:30:36] And those things are in such
[00:30:38] conflict that the person often
[00:30:39] doesn't quite recognize either
[00:30:40] of them. They're just sort of
[00:30:41] feeling stuck and wanting to get
[00:30:44] out or something to survive.
[00:30:46] And so much of our work,
[00:30:48] whether it's an expressive
[00:30:49] writing, but especially in
[00:30:50] therapy, is trying to help
[00:30:52] people experience some of what
[00:30:53] those feelings are and build
[00:30:55] them a little bit inside them,
[00:30:56] recognize them and give them
[00:30:57] permission to be expressed.
[00:30:59] We sometimes have to guide
[00:31:00] people along a little bit in
[00:31:02] that process.
[00:31:04] Yeah, the family's one where
[00:31:07] I'll also, maybe it's around
[00:31:09] this, but add to it where
[00:31:11] there's also a protection
[00:31:12] factor, right? Where I've
[00:31:13] asked, you know, how would
[00:31:15] you feel about, how did you
[00:31:16] feel about that with your
[00:31:17] parents and how you weren't
[00:31:19] able to express or how did
[00:31:20] that make you feel? And they're
[00:31:21] hesitant to say it because
[00:31:22] they don't want to be mean
[00:31:24] or say anything bad or, you
[00:31:26] know, well, they were there,
[00:31:28] right? That kind of thing
[00:31:29] that almost dismissal.
[00:31:32] So there's that second layer
[00:31:34] of protection where it feels
[00:31:35] like if I express actually how
[00:31:37] I feel it's really bad or
[00:31:38] mean.
[00:31:39] Yeah, yeah. And I think I
[00:31:41] hear two parts happening
[00:31:42] there. One part is I've learned
[00:31:43] that I need to be nice in
[00:31:45] general. And so I'm not
[00:31:45] going to do it. But this
[00:31:47] other part, which is really
[00:31:48] important, is I long for
[00:31:50] something from that
[00:31:51] relationship, attachment,
[00:31:53] connection, love, and its
[00:31:56] anger threatens that.
[00:31:58] For me to voice
[00:31:59] disagreement, anger, assertion,
[00:32:01] push away, it risks pushing
[00:32:03] away and me losing them. So I
[00:32:04] need to hold on to them.
[00:32:05] So one of the exercises I love
[00:32:07] to do with folks, even an
[00:32:08] audience, I'll ask people to
[00:32:09] pair up and simply
[00:32:11] practice role play, fake it.
[00:32:14] Being assertive to the person
[00:32:15] next to you, like as a
[00:32:16] partner, you know, saying
[00:32:17] something strong and assertive
[00:32:18] and it's hilarious to see how
[00:32:20] people, even though it's
[00:32:22] been given an explicit
[00:32:22] permission, people will start
[00:32:24] to go and they'll giggle
[00:32:26] it away, they'll reach out
[00:32:27] and touch, they'll they'll
[00:32:28] reconnect in some way, they'll
[00:32:29] apologize. I don't really mean
[00:32:31] this, but I do a number of
[00:32:33] connecting behaviors. By the
[00:32:35] way, if I do the other side,
[00:32:37] I'd like you to become as
[00:32:38] vulnerable as you can with
[00:32:40] that person and tell them
[00:32:41] your deepest, darkest secret.
[00:32:42] Go ahead. People will go.
[00:32:46] And they'll actually put up
[00:32:47] a little bit of a wall, a
[00:32:48] protective wall, right? That's
[00:32:50] that's both of those are
[00:32:51] good. I mean, they need to
[00:32:52] protection of all and you
[00:32:53] need the connection. But it
[00:32:54] becomes a vivid example for
[00:32:56] many people of how they are
[00:32:58] uncomfortable being too
[00:32:59] assertive or too vulnerable.
[00:33:02] And they end up creating kind
[00:33:03] of a narrow band of comfort
[00:33:05] for themselves. And one way I
[00:33:07] like to think of growth is
[00:33:08] expanding the zone of comfort
[00:33:10] that we have from if I go too
[00:33:13] far to the assertion, it
[00:33:14] scares me if I go too far to
[00:33:15] the vulnerable connecting open
[00:33:16] vulnerable scares me. And
[00:33:18] what we need to do is help
[00:33:19] people expand that.
[00:33:21] I like that zone of
[00:33:21] discomfort or do you say
[00:33:23] discomfort or comfort?
[00:33:24] Probably the disc discomfort
[00:33:26] it's too narrow. The comfort
[00:33:28] zone is too narrow. We got to
[00:33:29] exactly. Yeah, I use a window
[00:33:31] of tolerance. But actually
[00:33:33] that kind of describes the
[00:33:34] feeling orientation of it.
[00:33:36] Yeah. Okay. I think this is
[00:33:38] going to be really, really,
[00:33:39] really helpful. We talk a
[00:33:40] lot about mind body
[00:33:41] connection and understanding
[00:33:43] what happens with chronic
[00:33:44] symptoms, but the emotional
[00:33:45] piece. I often find people
[00:33:47] get they skip over a little
[00:33:50] bit more because it's really
[00:33:52] scary. I think it's probably
[00:33:54] the scariest part of a lot
[00:33:55] of this is to go there. And
[00:33:57] it's also just not understood.
[00:33:59] It's hard to grasp when you've
[00:34:00] never actually helped it.
[00:34:02] Yeah. And, you know, what
[00:34:05] people will say, oh, it's
[00:34:06] just experiencing emotions.
[00:34:07] Actually, you have to do some
[00:34:08] assessment of which emotions
[00:34:09] need to be activated or
[00:34:10] experienced. And it's there's
[00:34:12] almost like two layers.
[00:34:13] There's the superficial layer
[00:34:14] that people bring in. And
[00:34:15] then there's the underlying
[00:34:16] layer that needs to be
[00:34:17] accessed. And that's not
[00:34:17] easy stuff.
[00:34:20] Yeah, yeah, for clinicians or
[00:34:22] clients. Yeah, exactly.
[00:34:24] There's plenty of other
[00:34:26] therapists that I know that
[00:34:27] don't do this work that have
[00:34:29] no idea. They don't maybe not
[00:34:30] no idea, but just don't
[00:34:31] really get it. They don't
[00:34:32] understand, right? I was never
[00:34:34] taught this in school. I've
[00:34:35] had to seek this out. But I
[00:34:36] do think it's really
[00:34:37] exciting for where it's
[00:34:38] going because it feels like
[00:34:39] there's a lot of momentum
[00:34:40] around awareness and helping
[00:34:42] people understand this
[00:34:43] work. Yeah, I'm excited
[00:34:44] about it, too. You know,
[00:34:46] I've also been involved with
[00:34:47] the pain reprocessing
[00:34:48] therapy world. So I'm doing
[00:34:49] research on that with my
[00:34:49] colleagues. And I am
[00:34:51] currently thinking is that's
[00:34:52] a great starting place doesn't
[00:34:54] do much with emotions. It
[00:34:55] focuses more on people's
[00:34:57] experience of their body and
[00:34:57] their fears about their body
[00:34:59] and movement and pain and what
[00:35:00] it means and how to reverse
[00:35:01] some of that. And our current
[00:35:03] clinical trial with people
[00:35:04] with back and neck pain, we
[00:35:05] start with some PRT stuff, and
[00:35:07] then we build on to all the
[00:35:08] emotional stuff. And there's
[00:35:10] a set of people who get
[00:35:11] better with the PRT pieces,
[00:35:14] the pain reprocessing
[00:35:14] pieces, give them a new
[00:35:16] model, new way of thinking
[00:35:17] about what their brain is
[00:35:18] doing. And, and it's like,
[00:35:19] whoa. And, and then
[00:35:21] there's a number of people
[00:35:22] who we need to do a lot
[00:35:23] more. Yeah, the patient who
[00:35:25] said to me not long ago, she
[00:35:26] said, you know, it's really
[00:35:28] strange, I have back pain when
[00:35:29] I bend over, but only when my
[00:35:31] husband's around, not when I'm
[00:35:32] alone. That is, well, there's
[00:35:34] issues with that husband. And
[00:35:35] we dug a little deeper, we've
[00:35:36] on the issues with the
[00:35:37] husband. And these things
[00:35:38] happen in many, many patients
[00:35:40] there's this sort of
[00:35:41] interpersonal piece that
[00:35:43] activates the emotions. I
[00:35:44] realized right now, I didn't
[00:35:46] say much about
[00:35:46] relationships. But EAT
[00:35:49] doesn't end with just doing
[00:35:50] emotional work, we
[00:35:51] encourage work on actual
[00:35:53] relationships. And that means
[00:35:55] often, as you learn what you
[00:35:57] actually feel and need,
[00:35:58] figuring out how to best
[00:35:59] communicate that in the real
[00:36:01] relationship. That's really
[00:36:02] scary. But when people can
[00:36:04] make that step, it's really
[00:36:05] healing as well, because
[00:36:07] they've learned either new
[00:36:08] boundaries, they've put up
[00:36:09] some new boundaries, if
[00:36:10] needed, they've connected in
[00:36:12] ways that they've not
[00:36:12] connected. And we help
[00:36:14] people, usually people are
[00:36:15] stuck in relationships, and
[00:36:17] they need some help.
[00:36:18] How to work those things in
[00:36:19] a new way. And the emotional
[00:36:21] work first really opens up the
[00:36:22] pathways to working on
[00:36:23] relationships. And when people
[00:36:24] make those changes, not only
[00:36:26] they say their pain is a lot
[00:36:27] better, but they say, I'm a
[00:36:29] different person. And that's
[00:36:30] really cool. You don't see
[00:36:31] that much with pain
[00:36:32] reprocessing therapy, they
[00:36:33] say, that's nice not to be
[00:36:34] in pain. With EAT, a lot of
[00:36:36] people say, I'm looking in
[00:36:38] the mirror and I'm looking at
[00:36:38] a different person than I
[00:36:39] was three, four months ago.
[00:36:41] I'm feeling different in my
[00:36:43] relationships, feeling more,
[00:36:44] more capacity to engage in
[00:36:46] life in ways that I
[00:36:47] interpersonal ways I've been
[00:36:48] avoiding, whatever it might
[00:36:49] be, more able to be
[00:36:50] community. One guy said, it's
[00:36:52] really strange. I used to be
[00:36:54] bothered with my letting my
[00:36:55] kids win in little
[00:36:56] competitions. He says, I
[00:36:59] actually am comfortable
[00:37:00] letting my kids win now.
[00:37:01] That's really strange. You
[00:37:02] know, he became comfortable
[00:37:04] within his own skin of who
[00:37:05] he is in his emotional life
[00:37:06] and it showed up in his
[00:37:07] relationships.
[00:37:09] That was going to be my
[00:37:09] next question is, okay, if
[00:37:11] we're working on the
[00:37:12] expressing emotions within
[00:37:13] ourselves. Does that also
[00:37:16] mean it's kind of the
[00:37:16] question people ask, do I
[00:37:18] also have to change things
[00:37:19] in my life or maybe there's
[00:37:21] something big that I'm
[00:37:22] realizing? Is it enough just
[00:37:23] to express it in my to my
[00:37:26] therapist or my journaling
[00:37:27] practice? Do I actually have
[00:37:29] to change something in order
[00:37:30] to get out of pain?
[00:37:31] Some people do and some
[00:37:32] people don't. I think is my
[00:37:33] best guess. There's some
[00:37:34] people who can do the do
[00:37:35] the work in here, in here
[00:37:37] and in here. And it actually
[00:37:39] takes away the pain or it
[00:37:40] reduces it greatly. You know,
[00:37:42] some of our fibromyalgia
[00:37:43] patients who've made the
[00:37:44] best success are people who
[00:37:46] have made major changes in
[00:37:47] their life. I'm thinking
[00:37:48] of one who got rid of the
[00:37:49] pain in her butt, called her
[00:37:50] husband, who was a bad
[00:37:51] husband. And she talked to me
[00:37:53] six months later says, I'm
[00:37:55] free from him and I'm free
[00:37:56] from fibromyalgia and I think
[00:37:57] they're connected to each
[00:37:58] other. Another woman said, I
[00:38:00] realized I've got an alcohol
[00:38:01] problem. And I needed to go
[00:38:02] to AA and I've been
[00:38:03] avoiding it for years. And
[00:38:05] that move, that move in
[00:38:07] my life is the huge thing
[00:38:09] that made a change in my
[00:38:10] body. You know, so and
[00:38:12] sometimes they're smaller. I
[00:38:14] finally talked to that
[00:38:14] roommate that I've been
[00:38:15] avoiding dealing with the
[00:38:16] issue in our room, you
[00:38:17] know, our shared space. A
[00:38:20] lot of things that happen
[00:38:21] like that. I think that's,
[00:38:22] it certainly adds to the
[00:38:23] benefit of some people
[00:38:25] might not do. But I think
[00:38:26] in general, you probably
[00:38:27] need, well, hopefully the
[00:38:28] emotional cognitive work
[00:38:29] that you're doing in
[00:38:30] therapy session will
[00:38:31] actually change behavior
[00:38:33] and mostly interpersonal
[00:38:34] behavior out there. Let's
[00:38:36] hope. I also wonder, I
[00:38:37] mean, I've noticed too
[00:38:38] that once you do enough
[00:38:40] work within yourself
[00:38:41] interpersonal, sometimes
[00:38:44] not all, but sometimes
[00:38:45] it's almost hard to
[00:38:45] continue with the same
[00:38:48] either type of relationship
[00:38:49] or job or whatever it is
[00:38:51] in your life. There's a
[00:38:53] disconnect there. Yeah. Yeah.
[00:38:55] As you discover what's
[00:38:56] more true for you, as
[00:38:57] you discover what your
[00:38:58] needs really are. Many
[00:39:00] people will say, I need
[00:39:02] to not take that anymore.
[00:39:03] You know, I'm going to
[00:39:04] finally speak up and
[00:39:05] that might be a big
[00:39:06] change. I'm going to
[00:39:07] change jobs. I remember
[00:39:09] one woman we worked
[00:39:10] with and she ended up
[00:39:11] saying I needed to make
[00:39:12] a stand with my boss
[00:39:14] who had promoted the
[00:39:15] guys above me, over me
[00:39:16] several times. And she said
[00:39:18] when I finally did, I
[00:39:20] felt this thing happen to
[00:39:21] my body was just huge, you
[00:39:23] know, that would help that
[00:39:24] the boss actually heard her
[00:39:25] and said, you're right,
[00:39:26] that helps. But her being
[00:39:28] able to find the courage
[00:39:29] the ability to say I'm
[00:39:30] important and this is not
[00:39:31] fair. She'd worked on
[00:39:33] that in therapy, imagining
[00:39:35] her boss and being able
[00:39:35] to have this conversation.
[00:39:37] And then she played it
[00:39:38] out in real life. So
[00:39:41] that's scary stuff. But
[00:39:43] can be really healing.
[00:39:45] And if there are a few
[00:39:46] therapists out there
[00:39:47] are really feeling gutsy.
[00:39:49] Would you ever bring in
[00:39:50] a person from the person's
[00:39:52] life into the session
[00:39:53] in order to have your
[00:39:54] patient client practice?
[00:39:56] Being honest, I'll share
[00:39:58] a real quick story.
[00:39:59] One of my favorite patients,
[00:40:00] Fibromyalgia, she had
[00:40:02] been for 30 years
[00:40:03] struggling with it and
[00:40:04] struggling with her very
[00:40:05] domineering feisty mom.
[00:40:07] And she was scared of her
[00:40:08] mom ever since she told
[00:40:09] her mother shut up
[00:40:10] 30 years ago and mom
[00:40:12] got angry with her and
[00:40:12] she's been sort of
[00:40:13] intimidated.
[00:40:14] I said, I got to meet your mom
[00:40:16] and she said, oh, no, no, no,
[00:40:17] no, you don't want me, my mom,
[00:40:18] she's good.
[00:40:20] And I'm scared.
[00:40:20] And I said, we had to do some
[00:40:21] work to help you at least
[00:40:22] be honest with your mom.
[00:40:23] And she ended up after a
[00:40:25] month of just talking about
[00:40:26] it, brought mom in.
[00:40:27] And mom was a 75 year old
[00:40:29] feisty lady.
[00:40:30] What are you doing here?
[00:40:31] Why am I doing here?
[00:40:32] And she ended up.
[00:40:34] I asked if the patient
[00:40:35] could tell her mother,
[00:40:37] shut up.
[00:40:39] I can't.
[00:40:40] Can you tell her what you
[00:40:41] want to tell her?
[00:40:42] Mom, I want to tell you, shut up.
[00:40:44] But I'm afraid to ever since
[00:40:45] 30 years ago.
[00:40:47] And mom looked at her and said,
[00:40:49] why are you such a scary cat?
[00:40:50] Why don't you speak your mind?
[00:40:51] Well, I don't think I'd like it
[00:40:52] if you told me shut up, but you
[00:40:54] should stop being a scary cat.
[00:40:55] That's what he said.
[00:40:56] 75 year old told the 50 year
[00:40:57] old mom, right, 50 year old
[00:40:59] patient.
[00:41:01] That was that was the
[00:41:02] extent of our session mostly.
[00:41:03] And I see the patient the next
[00:41:05] week.
[00:41:05] And I said, how are you doing?
[00:41:06] She goes, this is the weirdest
[00:41:07] thing that's happened to me.
[00:41:08] For the first time in 30 years,
[00:41:10] I went to my mom's house
[00:41:10] who just lives a few blocks away.
[00:41:12] And I didn't want to run out of
[00:41:13] the house in pain.
[00:41:15] I was able to be there
[00:41:16] comfortably for an hour.
[00:41:17] I said, did your mother change?
[00:41:18] Oh, no, she's still the same way
[00:41:20] she's always been.
[00:41:21] What happened to you?
[00:41:22] Something happened in my
[00:41:22] experience of myself and her
[00:41:24] that I didn't feel scared
[00:41:25] anymore.
[00:41:25] And it took I'd worked with
[00:41:27] this woman for a long time
[00:41:28] privately and it took her
[00:41:30] finding the courage to say
[00:41:31] something to her mom like, I
[00:41:32] want to say shut up to you,
[00:41:33] but I'm scared of you.
[00:41:35] And that was the piece that
[00:41:37] allowed her to grow in a way
[00:41:38] that she had never grown
[00:41:39] before.
[00:41:40] Wow.
[00:41:41] Yeah.
[00:41:41] Those moments, it's hard.
[00:41:43] I think sometimes to believe
[00:41:44] that they can be that powerful.
[00:41:47] Yeah, when people have been
[00:41:48] scared and avoidant for so long,
[00:41:50] being able to take a step
[00:41:51] towards what they've been scared
[00:41:52] of.
[00:41:54] I'm no longer that scaredy cat.
[00:41:55] I'm somebody who can have a voice.
[00:41:56] I can somebody can do something
[00:41:58] or I'm somebody who can hug
[00:41:59] and connect and trust and cry.
[00:42:01] Maybe cry if I've been avoiding
[00:42:03] that one.
[00:42:04] Yeah.
[00:42:06] You've published over,
[00:42:08] correct me if I'm wrong,
[00:42:08] but over like 200 papers
[00:42:10] and been funded by the NIH.
[00:42:13] NIH.
[00:42:15] What excites you about most
[00:42:17] where the mind, body, field
[00:42:18] of chronic pain and symptoms
[00:42:20] is going?
[00:42:21] Yeah.
[00:42:22] I'm seeing this movement
[00:42:24] in lots of places to say
[00:42:27] pain doesn't have to be something
[00:42:28] we just live with and manage
[00:42:31] and that the brain is really
[00:42:33] important and pain can be
[00:42:35] many people's pain, at least
[00:42:37] something called primary pain
[00:42:39] or the neuroplastic pain,
[00:42:40] if you like, can be really
[00:42:41] quite reversible for many,
[00:42:42] many people.
[00:42:43] And I'm pretty tightly tied
[00:42:46] to the academic community,
[00:42:47] you know, the scientists
[00:42:48] and the world of this stuff.
[00:42:49] And many of them have been
[00:42:50] skeptical, but they don't
[00:42:51] have to make out of me
[00:42:52] because I'm a mainstream
[00:42:53] research guy who also believes
[00:42:55] in this other model.
[00:42:56] And I've had lots of
[00:42:57] conversations with my colleagues
[00:42:58] who are starting to come around
[00:42:59] and say, maybe there's
[00:43:00] something there, you know.
[00:43:02] And so that's exciting to see
[00:43:04] the kind of old guard
[00:43:06] who've been kind of stuck
[00:43:07] in a certain model, loosen up
[00:43:09] and start to see new ways
[00:43:10] of operating.
[00:43:12] So that's really kind of cool.
[00:43:14] Now, if we can NIH to put
[00:43:16] forth more money to it, it'd
[00:43:17] be nice to.
[00:43:17] But that's a hard one.
[00:43:20] And is that mainly with
[00:43:21] other clinical psychologists
[00:43:23] or are you talking all
[00:43:24] different types of professionals?
[00:43:26] Yeah, when I go
[00:43:27] to the major pain meetings,
[00:43:28] you know, the pain
[00:43:29] meetings nationally and
[00:43:30] internationally, and I talk
[00:43:31] with colleagues, I'm just
[00:43:32] seeing more people across
[00:43:33] the spectrum who are more
[00:43:35] open to these models.
[00:43:36] And they used to be.
[00:43:37] Yeah.
[00:43:38] Good.
[00:43:39] Cool.
[00:43:40] Yeah.
[00:43:41] Thank you so much for all
[00:43:42] the work that you've done.
[00:43:43] It's really powerful.
[00:43:44] My pleasure.
[00:43:45] Thank you.
[00:43:46] Yeah.
[00:43:47] Yeah.
[00:43:48] Is there any words of wisdom
[00:43:50] that you could leave us with
[00:43:52] for someone who's feeling
[00:43:53] really stuck in their chronic
[00:43:55] health journey?
[00:43:55] And they're they're obviously
[00:43:57] listening to this.
[00:43:58] So they're maybe thinking,
[00:43:59] OK, something's maybe
[00:44:02] something is a little more
[00:44:03] than just the structural
[00:44:04] treatments I've been
[00:44:06] chasing for the past
[00:44:07] however many years.
[00:44:07] Like, what would I do now?
[00:44:09] Yeah.
[00:44:11] Open yourself up to the
[00:44:12] possibility that what goes on
[00:44:13] above the neck is actually
[00:44:15] really important.
[00:44:15] And the most important part
[00:44:17] of that is the things that
[00:44:18] are tied with your emotions,
[00:44:19] your fears, your emotional
[00:44:20] needs.
[00:44:21] Anger is often a piece
[00:44:23] of that buried somewhere.
[00:44:23] But for other people,
[00:44:24] it's especially it's the
[00:44:26] need to be able to cry
[00:44:27] or to connect or feel
[00:44:28] vulnerable.
[00:44:29] But for a lot of patients,
[00:44:30] it's the blocked anger,
[00:44:32] the blocked assertion
[00:44:33] that comes from that
[00:44:34] ability to speak their mind
[00:44:35] to say no to say stop
[00:44:37] to say this is what I need
[00:44:38] at one and to try to find
[00:44:40] the right in a safe place
[00:44:42] therapy or privately to find
[00:44:44] your voice in giving
[00:44:46] that some expression.
[00:44:47] I encourage people to be
[00:44:48] privately empty chair
[00:44:49] and put dad, mom, sibling,
[00:44:51] whomever, professor,
[00:44:53] whomever it might be
[00:44:54] in that chair that you need
[00:44:55] that needs to hear your voice
[00:44:57] and practice some expression
[00:44:58] and see what becomes of your
[00:44:59] body in the process of doing
[00:45:00] that, you know.
[00:45:02] And if your body starts to
[00:45:03] have a reaction to that,
[00:45:05] that's meaningful.
[00:45:06] Means that something is
[00:45:07] connected between that
[00:45:08] emotional experience
[00:45:09] and the bodily experience.
[00:45:11] And there's hope then to
[00:45:13] to move that bodily experience
[00:45:15] in the right direction.
[00:45:16] Yeah, I'll echo that and say
[00:45:17] that most of the times
[00:45:18] when I hear people
[00:45:20] feeling stuck in this work,
[00:45:22] it's usually because
[00:45:24] not everyone, but a lot.
[00:45:26] It's because they've done
[00:45:27] maybe some of the brain
[00:45:28] training or they've understood
[00:45:30] or read a book about
[00:45:31] the mind, body connection.
[00:45:33] And they're maybe finding
[00:45:34] a little bit of progress,
[00:45:36] but they're still feeling stuck
[00:45:37] is that they haven't gotten
[00:45:38] to the emotional piece yet.
[00:45:40] And it's the I find
[00:45:43] it's such the core
[00:45:44] so much of this of this work
[00:45:46] and the body sensations
[00:45:47] and all all the things
[00:45:49] happen in the body.
[00:45:50] So if you feel like
[00:45:51] you're stuck in that place,
[00:45:53] highly recommend navigating
[00:45:55] and searching more
[00:45:56] in terms of this emotional work
[00:45:57] when listening to this podcast again.
[00:45:59] Yeah, yeah.
[00:45:59] And I think there's
[00:46:01] a lot of therapists out there.
[00:46:02] You won't find many therapists
[00:46:03] who've been trained
[00:46:03] in what we're doing.
[00:46:04] It's still kind of new.
[00:46:06] But if you ask a therapist,
[00:46:07] please help me dig into my emotions
[00:46:09] and go there with me.
[00:46:11] I mean, you actually sound strange,
[00:46:12] but a patient or a client
[00:46:13] could actually ask a therapist
[00:46:15] to take them to a certain place.
[00:46:16] Many therapists will sort of do that.
[00:46:19] It's they're they're nervous
[00:46:20] unless the patient says,
[00:46:21] please help me go there.
[00:46:22] And then therapists have permission
[00:46:24] and they're more likely
[00:46:24] to help a person go there.
[00:46:26] Yeah, that's true.
[00:46:27] That's true.
[00:46:28] And hey, maybe send them
[00:46:29] this podcast and say this.
[00:46:30] I listened to this and
[00:46:32] I want you to help me go here.
[00:46:33] Yeah, that's good.
[00:46:36] All right, thank you so much again
[00:46:38] for showing up and coming on
[00:46:39] and sharing all your wisdom.
[00:46:40] Really appreciate it.
[00:46:41] My absolute pleasure.
[00:46:42] Thanks, Grace.
[00:46:43] You're amazing, by the way.
[00:46:44] Amazing grace.
[00:46:46] Thank you.
[00:46:47] We will see you next time.
[00:46:50] If this podcast means something to you,
[00:46:52] it would mean so much to me
[00:46:53] if you could do these couple things.
[00:46:55] One, go to the Heal with Grace
[00:46:56] show page wherever you listen
[00:46:58] and tap the plus sign
[00:46:59] or click on the follow button
[00:47:01] so you don't miss an episode.
[00:47:02] It helps both of us out.
[00:47:04] While you're there,
[00:47:05] if you could give a five star review
[00:47:07] so that this podcast can reach more people,
[00:47:10] it would mean so much to me
[00:47:11] so I can continue sharing episodes
[00:47:13] that help you as well as others.
[00:47:15] Thanks for listening
[00:47:16] and I hope this brings you
[00:47:17] hope on your journey.