Ending The Pain-Fear Cycle with Daniella Deutsch

Welcome to Shrink for the Shy Guy. This is the show for you. If you are sick and tired of being held back by fear, self doubt, social anxiety, shyness, anything that's stopping you from you being you. I'm going to share the most powerful tools and resources that I've been discovering over the last 15 years on my journey to eradicate social anxiety and instill confidence first in myself and then in every single person that I meet on my journey. You're going to learn these tools and how to apply them in your life now so that you can become the most free, powerful, bold, authentic version of you. Hey, welcome to today's episode of the show. I am so excited to be with you today and to share this with you because I did an interview recently with a a brilliant woman who works at the Pain Reprocessing center about physical pain, but way beyond that, about anxiety, about what creates physical pain, what creates anxiety and strategies and tools that you can use in your life now to completely neutralize that and find your way back to being healthy in your body, but way beyond that, healthy in your mind, in your emotion, in your soul, really. So I cannot wait to get into that interview. Her name is Daniela Deutsch and she is a social worker and she works at the Pain Psychology Center. And specifically her role is to train all the clinicians there in pain reprocessing therapy, which is a therapeutic approach developed by Alan Gordon and Howard Schubiner about how to change the way that you perceive what's happening in the sensations with pain to free yourself of that pain. And there's some really amazing material about that in a book called the Way out, which was written by Alan Gordon, in which they also talk about the back pain. The Boulder Back Pain Study, which is a recent, I think it was 2019, 2020, very recent study that where they contrasted pain reprocessing therapy with sort of treatment as usual. And there's a variety of treatments that people would have for chronic back pain and other types of pain. And pain reprocessing blew the other approaches out of the water because the goal is not to mitigate, minimize symptoms and just kind of get the person feeling okay enough to get back to life. It's like, how do we really end this? Because this pain doesn't have to be here. You could be free from it. So that's the game they're playing. That's why I love this conversation. And whether you have any sort of reoccurring physical pain or injuries that keep coming back or not, and you just experience anxiety and you want to feel more confident and less fear of the future, less catastrophizing, more solidity in yourself, more of a sense of peace and ease and safety. Either way, this interview is for you because you're going to find out that, well, really the path to both is one and the same. So let's dive right now into that interview with Daniela Deutsch. Welcome, Daniela. Thank you for joining us today.

Thank you for having me.

Okay, so pain, physical pain. Most people have physical pain and they think I've done something physically to damage myself. In fact, that's one of the first things we look for if maybe we wake up and our back hurts or foot hurts or something, head hurts, it's like, okay, how did I sleep? What did I do yesterday? Oh, I shouldn't have lifted that thing, you know, Ah. And we go, you know, physical pain equals physical cause. And you know, what I wanted to explore with you today is that, you know, maybe, and maybe there are other things that can create pain, especially when it comes to something like pain that is persisting that, you know, if you did injure yourself picking that thing up, your body would pretty rapidly heal. However, the pain that persists. And as we were just talking before the recording started, you know, a lot of people, clients of mine, and listeners of this show, have pain, physical pain that is intermittent or pretty persistent, that they might not realize is not just physical, structurally caused pain. So I'd love to start with that and then we can go deeper together. But maybe like a 30,000 foot view, if someone is new to that concept, how could my pain be caused by something other than of physical damage to my body?

Absolutely. I mean, recent studies kind of have shown that most chronic pain, which is back pain, neck pain, fibromyalgia, repetitive strain injury, headaches, I mean, I can go on and on, but that most forms of chronic pain are often not the result of physical damage, but actually of learned neural pathways in the brain. And at the Pain Psychology center, at the Pain Reprocessing Therapy center, we call it neuroplastic pain. But there's so many different terms for it. There's tms, there's ppd. But the idea is that all pain is a danger signal. Right. Like you were saying, we experience pain to warn us that there's some type of physical damage. So normally when we injure ourselves, the body will send signals to the brain informing us of tissue damage. Right. So if I put my hand on a hot stove, this is like the classic example I put My hands on a hot stove, I experience pain. It warns my brain, take off your hand from the stove. And so we remove it, and then we protect ourselves from causing further damage. But sometimes the brain can make a mistake. And so neuroplastic pain occurs when the brain makes a mistake, and then it sticks. Right. And so neuroplastic pain results from the brain misinterpreting safe messages from the body as if they were dangerous. Right. In other words, it's kind of like a false alarm. So.

Right, right. And so what's a distinction? There is. Let's say you kind of think about, like, conditioning in psychology. Right. Behavioral conditioning back to Skinner and in the olden days. And it would be like. Let's say you use the example of touching the stove. If I touch the stove, I get feedback on my finger that it's hot and it burn, and I naturally want to move my hand away. However, if someone turned the stove off and I'm across the room, I'm not even getting touched by the stove. And yet, I don't know, someone pokes me with a lighter or something, I can be like, oh, my gosh, you know, the stove came on and I got burned. Even over here.

It's all about the belief. It's kind of your. Your brain's perception of what is going on. And so if your brain believes that there's physical damage, you can experience pain. And even if there is no damage.

Yeah. And so the mechanism is really interesting. And maybe it's not essential to totally understand it, but I think it can help. It definitely helped me to learn this. So I want people listening. They really see if they can get it. It's. So how is my. If the brain is misinterpreting, those sensations coming from my body are neutral or normal. And then if you, you know, if you tell someone who's experiencing, like, searing pain that that's not coming from their body. So is what is happening there? Is the brain completely generating a new sensation, or is it that the sensation is normal, but the. There's so much fear there that it. That it's perceived differently. What's your sense of that?

Well, a lot of times I explained it as an amplified sensation. If I'm speaking to someone who has back pain, I'll say to them, okay, you're sitting there right now, and I'm sitting here, and you're feeling something in your back, but I'm also feeling something in my back. We're both sitting. We're both using back muscles. Of course, we're going to feel something. We have nerve fibers in our back that are sending messages to our brains. And these messages are safe, or like you said, they're neutral. And they're saying, you know, this is just a sensation, but your brain is misinterpreting these messages as if they're dangerous. Right? So it's like if I were to toss you a baseball and your brain thought it was a hand grenade, you'd respond as if it was dangerous, even though it's just baseball. So there are nerve fibers in my back that are sending messages to my brain, but my brain is interpreting them accurately. Right? It's just the light amount of pressure. It's just the sensation. There's no reason for alarm. There's nothing dangerous going on. But your brain is getting the same messages and interpreting those messages as dangerous. And as a result, it's kind of amplifying the sensation. Does that make sense?

Yes. And what's interesting though is if you tossed, I love that example of the baseball and a hand grenade. If you tossed me a hand grenade, my reaction, if I realized what it was, or if it was a baseball I thought was a hand grenade, regardless, my reaction would actually be fear. It would be anxiety, right? Oh my God. And I'm gonna die. Not necessarily that. When it touched my hand, it felt like it was stabbing me or something, maybe I would experience that. But so how come if we're, if we perceive a sensation as, or this neutral sensation, and now I'm, I'm, I'm having a false alarm reaction to it, how come it's experienced not just as like a sensation and then anxiety? How, why would the brain actually, you know, it's actually physical pain or is that the language of the nervous system in that sense?

I mean, that's a really good question. But I think that when one dangerous signal is activated, whether that's anxiety, whether that's there, we experience so many, we have many different danger signals. Whether that's anxiety, fatigue, hunger, those are all danger signals that help us evolutionarily. It helps warn us that we're tired or we're hungry, or that there's an external threat and pain is a danger signal for internal threats. But when one danger signal is activated, we feel unsafe. We have a general feeling of unsafety, and then we're more likely to interpret everything through a lens of danger. So if we're feeling anxious, I mean, think about before you are about to take a really big exam, right? Like you might have a headache or a stomachache and experience all those different symptoms because one danger signal is activated and therefore you're more likely to interpret physical sensations as louder than they actually are.

I love it. Yeah, very. I appreciate your ability to break it down. It's very clear. So, okay, I'm experiencing overactive responses to neutral sensations, lots of danger going on. I know that from my own experience with pain symptoms. It definitely, I'm aware that I'm afraid of the pain, which I think is again part of the problem. The fear of the pain perpetuates. Now I'm in more danger. Um, and of course the origin of it maybe is danger, sense of danger. And I've seen that it's not just I'm afraid of the pain sensations. Usually for the pain sensations to arise. I'm already in some state of hyper arousal and danger. Maybe that's anxiety in my life or a background fear or I know that in the book the Way Out, Alan talks about pressure on yourself, self criticism, these kinds of ways of being that can, that can create more threat or alarm. So I guess let's highlight some of those and then we can talk about the way out. How do we create more of a sense of safety? But what are some of the main. If someone. If not just fear of the pain, that one's kind of obvious. But what else might be creating a sense of danger or alarm? Have you guys seen in people's lives?

Right. So having kind of fear in general. So it's, it's interesting you bring that up because you are the shrink for the shy guy. But we'll have a lot of people with social anxiety, right. And their brains actually interpret social situations as dangerous. Right. Even though those social situations are not as dangerous as their brain is interpreting. And so that might be something that is making their danger signals activated and therefore making them interpret sensations as louder than they are as well. And so then the work will start diving into how do we start interpreting all situations correctly, including social situations, in order to turn down the hypervigilance, in order to turn down that overall sense of danger so that we can turn down the pain. It's really intimately connected.

Yes, that's a great segue into how do we do that, how to create. I think there's probably two questions at least here, but one is the, you know, short term, in the moment, how do we switch tracks from danger anxiety to safety neutral sensations? And then secondly would be like, how do we create more of a habit of that, that becomes more of a common way of being. So it's not just reoccurring recreating the same patterns again and again. So let's tackle that first one. What are some of the ways that you help clients there find safety in the moment?

So I mean, this is such a big topic. There are ways that we can talk about it more practically speaking of how can they go into their bodies and notice what's happening in their bodies when they interpret danger? For example, they're in a social situation, their brain is interpreting danger, they experience a spike in anxiety followed by usually an uncomfortable physical sensation. Like, I know for you, you said that you were actually a really shy guy growing up, right? So your brain interpreted social situations. Can you give me an example of like one social situation that you would interpret as dangerous? Kind of go from that.

Can I, Can I? Which one? Let me, let me take my. From my bouquet. Um, I would say a common one would be there be a group of people interacting that I don't know that well and I want to go interact with them and I need to sort of insert myself or jump in. And I interpret that as, you know, I'm going to get rejected. And occasional attempts in my life where I had done that did not go well. And then I imagined that was a failure and I was ostracized and that sort of thing. So that's a very common one.

You see, even then you're starting to go into the thoughts and the, you know what's going to happen and catastrophizing about it, and I'm going to be rejected and you know, what can I do instead of just kind of staying in the moment. So your brain is interpreting, this is dangerous, you get a spike of anxiety. And then I assume that there's some type of uncomfortable physical sensation happening in your body that you kind of don't even notice because you already escaped the thoughts of, I'm going to be rejected, I don't know what's going to happen. So are you aware of what happens in your. Or what used to happen in your body when you are in that type of social situation?

Sure, definitely used to. Because as a, as a perfected human, I don't feel any anxiety anymore ever. No. Yeah, and you're right. At that age I had no awareness physically. Obvious. I guess if I had like a pounding heart, I would notice that. But you know, for the most part, pretty, pretty disconnected from my awareness. So yeah, now if I feel any sort of anxiety arising or maybe then at the time was occurring too, I will feel squeezing in my chest around the heart area, maybe sometimes down the solar Plexus, maybe a hot sensation in my upper chest, around my collarbones. Wow.

I mean, that's really descriptive. So you're clearly very aware of your body at this point in your life.

But lots of practice, lots of somatic tracking.

Yes. And so that is kind of what I would do in this situation with a client is I would do somatic tracking for that uncomfortable physical sensation so that they can start creating a new association between something that they interpret as dangerous and kind of a felt feeling of safety instead of danger. But usually in the beginning, people just kind of go right over that uncomfortable physical sensation. And instead of taking care of themselves in the moment when their danger signals are activated, and instead of communicating messages of safety to themselves in that moment, they'll resort to familiar negative behavioral patterns like self criticism or problem solving or preoccupation or going on the Internet and googling their symptoms or, I don't know, whatever it is they'll go, they'll resort to a negative pattern which will only reinforce that whatever situation they're in that they're in is actually dangerous. And so the practical, from a, you know, practically speaking, what I want to do with clients is help them, you know, get in tune with what they're feeling at the moment and regulate themselves so that they're not reinforcing danger. Does that make sense?

Yeah, absolutely. And for people who are curious about. We just use the term somatic tracking. That, that is, I know a tool that you guys teach there. By the way, at the end of the interview, we'll have an opportunity for people to find out more about your clinic that you guys work in and how to access and learn. Of course, there's the book the way out, written by Alan Gordon is the creator of the pain reprocessing center. And. But that's a technique in there. And I think he has a podcast as well. Right. It might be just called the way out, or maybe it's called something else.

He's called tell me about your pain.

Tell me about your pain in which they teach the somatic tracking. So we're not going to go super in depth. We'll make sure there's resources@shrinkforthshyguy.com under this episode to links to all this stuff. So. But it's very, it's a, it's a very similar technique that I've used on this podcast to something that one of my mentors called the peace process. It's a sort of a mindfulness based technique to be able to be with the sensations rather than in your mind. So just to reference that for people who are maybe curious about learning more there. So you just said something that I definitely. Even after sort of finding the quote the way out, and for the most part being generally pain free, no medications and more active than I ever have been, there will be periods where I'll have, you know, relapses. And every single time, pretty much there's a pattern that. Where there is some sort of stressor situation in my life. Usually at this point it's not social anxiety. Cause I feel pretty confident in pretty much all that. That arena. But it's like bigger risk, bigger life changes. So I'm putting maybe more risk in sort of business when it comes to investing and marketing and, you know, sort of financial moves. We are going to be moving in a. Literally about three weeks right now. And so, you know, there's a. There's a sort of instability in that. So these bigger things. And I'll notice like, whoa, I'm a little stressed out right now. You know, there's probably some danger signals going on. And there is a. Oh, this would be a good time to slow down and feel. And I'll. Maybe I'll. Maybe I will. Maybe I will for like a moment. And then it's like, oh, this is so uncomfortable. Where's my. Where's my phone? You know, and it's like, yeah, distraction city.

Or.

Or what you said, like these more sort of almost adaptive, quote unquote ways that look not so as bad as distraction, like problem solving. Being in my head about it being really rational with it. And whether it's that or the pure distraction method, sure enough, I can almost feel it's like this accumulation is like a garbage can that's not being taken out. And it starts to build, build, build, build. Then I'll feel more emotional stress and then, you know, pain will kick in.

And those things that you do, like look at your phone or things like that, that probably does reduce some of your anxiety in the moment. Um, and so that's why you just keep on doing it again. But in the, you know, long term, it's actually reinforcing danger.

Yes. Cause it's waiting right there for me. It's like, it's like. It's like sort of putting it on pause. Right. And the second you put it down, it's there, but maybe even a little worse. Right. Because what am I engaging with? I'm engaging with ma. That may also cause other feelings or stimulate, you know, fear, other things in me. So it's definitely Not a. But I think your point is really interesting. And that's probably true for all coping strategies if they, they have a temporary analgesic effect. Well, while you're eating the Oreos. All as well.

Exactly, exactly.

Okay, so there's knowing what to do, right? Like being with the sensations, and then there's the practice of doing it. And I'm curious, obviously, if someone's in the session with you, it's more likely it's like, okay, let's do this. And they're like, okay, that's what I'm here for. How about making it a part of their lives?

Absolutely.

How do you support people in making those changes long term?

And you know what's so interesting about it is that usually when pain patients come to me, they're so preoccupied with their bodies and they're so preoccupied with their pain. And what we're actually doing is helping them kind of be more aware of what's going on with their body. So it almost sounds like the same thing, like, be aware of when you're hungry, be aware of when you're tired, be aware of when. And so we're asking them to be more in tune with their body, but the energy with which they're doing that is very different. One is with fear and preoccupation and problem solving and self criticism and shame perhaps. And then the other is with love, with care, with what does my body need? And so although in both cases they're in tune with their body, the energy is really different. And so it's helping patients take care of themselves. And I think that's kind of where your work would come in, which is how do we build confidence, how do we build self love? How do we get someone to actually give a shit about themselves so that they have the motivation to take care of themselves in a nice way instead of in a really kind of mean, bullying, inner critic type of way.

Yeah, yeah. I've seen there can also be like an indifference to or a coldness that I've seen with clients. Definitely myself too. It's not, it's not so much purely. I mean, there's like the overt self attack, like I suck and I'm so bad. And then there's this middle range that's kind of like, oh, I'm hurting, whatever, you know, come on, just go, let's go. And it's very. If you imagine being that way with a child or something, it's very, it's pretty harsh, pretty cold. But I think that's a very common style that that also does not produce a sense of soothing or safety.

Absolutely. And by the way, that is one technique that I use. I mean, I have three kids and I think you. Do you have kids as well?

I do, yeah. The get over it technique is my favorite. Is that what we're talking about? No, I'm just kidding.

Yes. I'm like, well, I. With my kids all the time, it works wonders. They stop crying, go away, it doesn't.

Matter, don't know, don't care.

But I think it's, you know, it's getting. Sometimes I'll bring up my patients, children with them. I'm like, well, how would you react to your kids if they had this problem, if they were in pain, if they were feeling this way and that can help them kind of get in touch with that more compassionate side of themselves? It wouldn't work for me because clearly I'm not compassionate with my kids, but it would work with someone else.

Do as I say, not as I do. Yeah. Well, actually, in seriousness, I have noticed that I feel like there's. With kids, there's a never ending opportunity to grow in my capacity to give and receive love. And whenever I think I've reached that, there's more. And I'll notice sometimes, like some ways that I learned to cope with pain, physical pain, is to kind of turn off and just grit through it and. And there's certain times where they're hurting or something. And my attitude is like, oh, let's go. Like, you know, you're. You're tougher than this kind of thing. And I'll kind of catch myself. I mean, because you can kind of teach that in a skillful way. Like, hey, you're stronger than you think. Like, but not. Then there's an unskillful way. Like the other. Not that long ago, my son, he's six, had like, he had a little burn on his finger from a stove, actually. And it was like maybe five or six days old, and it was kind of healing up and it was still hurting him and he was wanting to get a band aid on it. And so I said, oh, yeah, the band aids are in this, you know, thing. And so he went over into the bathroom to put the bandaid on and I heard him kind of making this, like, sound, which is the universal sound of like, I need help or I don't like it. And I was doing something else and I kind of had this moment of like, oh, he's got it. He can put a band aid on his own finger. Like, it's not that sort of. Logistically, it's very within his. His range. But then I had this moment of like, oh, he's like, sort of quote alone with it in there. And what he's wanting is he. He just wants, like, soothing. He doesn't need physical help putting the band aid on. And I kind of noticed that my initial impulse was like, oh, he's got it. And I was like, oh, that's what I do with myself all the time. Like. So I went in there and was like, oh, hey, you want, you know.

Right?

I didn't even ask. You want to help? It's just like, how's it going? And he's like, look, you just want me to look at it? And I was like, oh, yeah, does it hurt here? And wow, look at. It's healing up. And we just, you know, 30 seconds of attention and he's like, bounding out of the bathroom. Fine. So I think there's a great lesson there for me about how I can be more. The more closed off I am to myself, the more I'm going to practice that with people around me.

Absolutely. And I think that's such a good point, what you said at some point about kind of like a subtle bullying. And so it's not really like you weren't actually being mean to your son of thinking, like, okay, he could do it himself. But there's this subtle message there of like, you know, I don't care in this moment and I'm not going to hold you and I'm not going to be with you. And I think that we all do that to ourselves throughout the day. You know, when I'm in middle of work and I really need to eat something and I feel like hunger pains, but I'm like, let me just finish up this whatever until, you know, maybe in an hour I'll take a lunch break. And what I'm actually doing is I'm. I'm kind of being mean to myself and sending the message of like, you don't really matter so much. And the fact that you're hungry, it doesn't really matter so much and I'm not there for you. Right. And that can communicate subtle messages of danger, you know, beneath our awareness. And then at some point we all blow up and we're so. We're so hangry that I'm just kind of yelling at everyone. My husband called. I'm like, yelling and myself. I think the idea is like, we want to have the power to not power through. Right. We want to listen to our danger. Signals. We want to give ourselves what we need. We want to give ourselves and our children that emotional support that maybe they don't necessarily need, but we all kind of do. We all kind of need to be taken care of. We're all that little kid, like deep within us. We're. We get. We're a bunch of, you know, big children and grown up bodies.

Right. And. Well, another way to say that is we do all have that child part inside. And you know, as. As we're talking, I'm even seeing how there, There is a. There's a necessity as a, as a. As you mature to delay gratification to. I can't get everything I want instantly I need to do uncomfortable things. But sometimes people will say that and then use that as an excuse to be very harsh with themselves. And it's like, well, there, there's an optimal way to do that. You know, it's optimal to say, okay, I know I'm hungry right now and I really would like a snack and I'm doing this thing or. And I can't get to food right now. Okay, let me give myself some reassurance, like, okay, I'll get to food in an hour and you're okay. And like, just like a minute of being just like 30 seconds with my kid in the bathroom. And I feel like as we're talking, I'm realizing, oh, there's another level. I could be doing that with myself even now in my life, like taking moments to acknowledge. Even if I'm not, there's nothing I can do about it to stop the discomfort or whatever in the moment. Just the. That emotional being with is so much what kids need. And as you said, the kid inside of us all needs.

Yeah. I mean, even from what you just said, it sounds like you're just so used to even very subtle self neglect.

Yeah, that's how you become an achiever, Daniela. It's my strategy. Right there.

I see.

Okay, so I have a question for you about expanding that sense of. So. So to recap what I'm hearing is to be able to notice the sensations. Provide a approach yourself and your sensations with compassion, with more of that warmth and love perspective. What about. Okay, so let's, let's talk about how to expand this sense of safety. So. So one way we just say, well, just do that more often. Which totally makes sense. One, one thing that can come up is this whole idea of safety I think is really interesting because I remember I worked with a client who had. It wasn't just social anxiety, it was pretty generalized anxiety, right? It's like, and the sort of, to sum up the fear and almost like way of life was bad things can happen at any time. And I remember she listed like a variety of things that, that truly could happen. They weren't like made up phobia, you know, like the spider is going to get my face. It's right. You know, it's like car. And you know, not surprisingly actually her mother had died in a car accident. She was young. So there's this sort of sense of like everything's okay and then everything's not okay. And I don't have any sense of when that's going to occur. And so now that she's in her 30s and still kind of has that imprinted in her way of approaching life and so she could access a sense of safety in this moment. But she's like, but what about later? What about tomorrow? And how, how can I really sue? And she had children at this time and it was kind of like, how do I relax and tell myself I'm safe when they could die? I mean that's a, that's a fact of life. So I thought that was a really interesting sticking points and I'm really curious your thoughts on that.

Wow. I mean that is a really great question. And yes, bad things can happen to any of us at any time. And it's so funny that you brought up this like car example, but I actually had a client that was terrified about the same thing, that every day that her children will leave, leave the house, she would say, what if they get hit by a car? And so I remember it was during the session and it was a phone session. So I quickly looked up like, what are the chances of someone getting hit by a car? And it was like 1 in 4,000 and like 292 or something like really big. But yet she was scared 100% of the time for that one chance that one of her, that really small chance that one of her kids could get hit by a car. And yes, it could happen. But you know, what is the benefit in spending 100% of our time worrying about something that is just 1 in 4,292, right? And like, what makes one person have the ability to lead their life with a sense of ease despite that small chance of getting hit by a car versus another? So the question is, what's underneath that level of fear? And it sounds like with your clients there's something that happened, right? Someone did get hit by a car, someone did die. And so what's underneath? You know, her fear is. It's, you know, she has a fear of not having control. She has a fear of uncertainty. Where does that fear come from? Right. Why is the brain so severely misinterpreting the level of danger now and then? How can we regulate. Once we recognize that our brains are gravitating to those fears over and over again? Because it's kind of a habit. Right. Our brains will continue to go to a certain place that feels really familiar and that, you know, that even though it's doing more harm than good. Right. Being worried so often for something that's there, such a small chance of happening is not very beneficial.

Right. And as you're, you're talking, it does seem like that that worry pattern is yet another form of distraction. Right. There's some. There's some pain there. And it does seem to be the case. Now, I don't, I mean, I haven't sat to think of this as universally true, and maybe nothing's universally true, but it does seem like that there's, there's the. Even if it's something of a fear of something in the future, the, the imagined pain, because the anxiety. I'm scared. What are you scared of? I'm scared of the pain. In this case, emotional pain. Right. So. But the emotional pain that we're imagining is probably referenced from something in the past.

Yeah.

And so I think there's something really interesting. One thing that I've done definitely in my own life and guide a lot of clients through is to work with that fear of uncertainty. You know, there's. It's almost like a sort of. The word that comes to mind is like stark, but that's. That makes it sound uncaring. It's almost just like a. Beyond the vicissitudes of fate. In my own life, there. There is this kind of being able to experience anything that life has in store and know that you can do that I found to be a. Almost a necessary component to really resolve. Because if it's like. But what if, what if, what if? To really go into that what if. And maybe sometimes it's the past thing, like the pain of the loss that was not felt or the pain of something happening. And it's kind of paradoxical. It's like by going into it almost with that mindful somatic tracking approach, like, and really being able to face, well, what if I do lose my job? Or what if I do get left, or what if my child does die? And by going into it, I know it's like that's the last thing a parent wants to do.

No, I had like a visceral reaction to that.

Right. And sort of going into it on purpose for like 20 minutes or something. And not in an anxiety spiraling kind of way, but in like, let it rip, like feel all the moving, you know, sensations I found, you know, again and again it kind of you pop through to the other side of something that's like, that does allow for that. Yes, that can occur and it's very unlikely. So I'm going to live my life fully now, but I think there's some willingness needed that I've discovered to really access that sense of safety. It's very counterintuitive on how to get there.

Yeah, absolutely. And I think that there are two ways to go about this. It's one, like you were saying, there's that cognitive approach of like, okay, let's play out fear, right. Let's go into it on more of like a logical level. And then there's, let's go into our bodies. What are we experiencing right now? Right. It's like I'm feeling really anxious because I feel out of control. There's a lot of uncertainty. I feel unsafe because anything bad can happen at any time. How does that feel like in my body? And let me regulate now, instead of resorting to what I usually do, which is distraction, preoccupation, problem solving, worrying, whatever, any of those things that further reinforce that uncertainty and having a lack of control are dangerous.

Yeah. And to zoom in on that, when you said, let me regulate now, would that simply be like kind of a mindful, somatic tracking way of just simply being with the sensations, Is there more there to help regulating?

So with somatic tracking, which is what we practice, and I can't go too deeply into that because of time, but it's a mixture of mindfulness of safety, reappraisal, which is communicating safety to your brain. I am safe now. Yes. I feel, you know, a lack of safety, but in this moment, I am safe. And again, this is like really client dependent because there are some clients that are in unsafe situations and that leads to a bigger question of, okay, then what do we do with those clients who actually have a lack of safety? Then how can we help them find safety in their lives and latch onto safety or find pockets of moments of safety in their lives? So it's again, mindfulness, safety, reappraisal, and then positive affect induction, which is just a big word for like telling jokes and lightening the mood. And so when I'M doing a somatic tracking exercise with my clients in order for them to kind of like, lighten up and like, look at their body and the sensations that are going on in their body in a light way. Like, I'll just be silly and I'll make jokes and I'll just like, make fun of myself or make fun of the situation. And then that usually eases them up from being super intense or like watching the sensations with like. Like a hawk, basically.

Right? Yeah, kind of. Then there could be even more tension in that. Like, it's really tense, like stern. And I've seen that too, when people take on meditation or something. It's like, I'm going to meditate so hard right now and it's sort of counterproductive.

And yeah, I'm going to be the best meditator ever.

Like, yes, yes. Okay. I feel like there's a thousand questions. I'm just going to ask one. And this isn't even, you know, like a big, big philosophical one. It's just a pretty small one. But it's really interesting and I'm curious your thoughts on it because it kind of bridges some of the. You know, the original teacher I had in this area was. Was Dr. John Sarno and read his books and found them. Yeah. Life changing. And in one in there, he talks about this thing called the symptom imperative where you have pain in your back. And then let's say you maybe you start to notice, like, oh, hey, this, this pain is not structural, which starts to unhook you from the pain fear cycle. Then you do some of the safety reappraisal, like, okay, I'm okay. And then I got. My back's feeling better. And then the next morning you wake up and your foot hurts. And then, you know, you do that and the next morning your head hurts and. And you know, the way that Sarno made sense of it or the narrative he put it into was like, well, your body is going to try to, you know, bring the pain to different places to try to hook you, to try to get your attention. And. And if it can bring you back, you know, now it's your head and all of a sudden you haven't had pain there before. So maybe this is, you know, maybe I am having. Maybe I'm gonna have a stroke. Right. So your mind goes back to a structural explanation which can re. Induce the fear. The way that Sarno phrase, it was almost like, you know, the unconscious versus the conscious mind and that the unconscious mind is like plotting to keep you.

Yeah. It almost sounds like the brain is trying to hurt you.

Well, it's trying to prevent you from his was like it's trying to protect you from feeling the emotion. So go feel the emotion was his sort of his thing. And I'm curious how it. When I do have the symptom imperative, I do have a little bit of that like you crafty sob like you're. You're trying to get me here. And I'm curious how you guys, you know, have you seen that with your clients there, patients there? What do you maybe. How do you see it? Do you see it differently in some way? But let's talk about that, that pattern of repeating pain in different areas.

Yes. So I feel like, okay, so when that happens with a client, I don't really want to say to them, okay, let's find the unconscious emotion because I think that that can also feed into the preoccupation or the tendency to preoccupy or stress about something and it's kind of manifesting in pain. But then if I switch it and I say, okay, now focus on the emotion and preoccupy around the emotion and try to dig up all of the anger and the sadness, that's just another. It's feeding into their addiction to being preoccupied with something. And so sometimes I just like to play it off and it really is client dependent, but I'll like to play it off like, okay, well, it's so great that it's coming up in a different area of the body. Like, that's awesome. That's evidence that this is neuroplastic pain. Like, that's a bit more evidence. What are the chances that you'd have chronic pain in multiple areas of the body? Like, that is just evidence that there's nothing wrong with your body and that it's way more likely that there's a structure that there's an underlying cause to this that are, you know, neural pathways in the brain and not something physically wrong. So that's awesome. Bring it on.

You know, love it. That's such a great reframe. And then this does lead me to my truly last question, which is because you just said something there that I have to address which was stood out, really fascinating was the addiction to preoccupation about something. And I definitely resonate with that because I noticed that I would have, of course, like years and years and years of preoccupation with my pain. And as I started to unwind that and I would be out of pain, I noticed I have this, like, really, it was like an addiction to preoccupy about something. And yeah, and sometimes it could be worry. Sometimes it wasn't even like a, quote, dangerous thing. It was just like, I don't know, I get really. I'm going to get obsessive about something. I'm going to study this thing. And it's not just like, oh, I'm passionate, let me study. It's like I'm going to, you know, spend all my time thinking about it and use it as another form of preoccupation. I kind of had this moment at some point in my life. I was like, what do I even do with my consciousness if I'm not preoccupied with something? It's like, so living in this kind of lower mental thinker mind. So I guess that's the. Maybe the bigger question that I'll end with you is, what have you found for you? For clients, what do we do with our consciousness when we're not preoccupied? Like, what's that like? What's life like that like?

It's so hard because we're all so preoccupied now that we have, you know, the cell phone, right. Or constantly scrolling through social media or our emails or our text messages. And so our brain is so used to that feeling of being preoccupied with something that to the point where none of us are okay with just sitting around and doing nothing and being still. And so we all kind of are so addicted to a feeling state of being productive and doing something. And so with my clients, I try to get them to get better at feeling good and feeling calm and feeling still and getting practice doing nothing. And it's interesting because I'm actually an Orthodox Jewish woman, and so I observe Sabbath every week. And on Sabbath every week, I put away my phone and I don't use my phone for like 24 hours. And that's actually so amazing for me because it's one day where I am not allowed to be preoccupied with my phone or really anything except for being with my children, sitting around, spending time with them, playing games, relaxing. And it's like, I sometimes tell my clients, like, you can observe Sabbath whenever you want. You can on a random Tuesday night, put away your phone and go sit down with your husband and have a Sabbath meal, Like a fake Sabbath meal. But I think that there's something to that of, like, how can we all get better at feeling good, right? How can we all kind of turn these things off that are pulling us to being preoccupied and distracted? And how can we create a new default setting of being okay, being calm and still and doing nothing.

That's a really fascinating question. I love that story too, about the Sabbath. And it's something that I'm in inquiry in my own life, having seen the relationship between preoccupation and pain. But then even in the absence of more severe physical pain, the preoccupation, relationship with just dissatisfaction and like, okay, what's a life of, like, fully lived, meaningful experience and connection and joy and purpose? And I see that in many ways, much of the use that I have with tech is not going to produce that, at least not the full level of that life. And so I personally have actually been considering and experimenting with more radical things, like, well, what would it be like to, you know, not use a phone except for an hour a day, you know, for where I set up on purpose to respond to messages. And I don't mean like go on Facebook for an hour. I mean, like, it's a way I use it to communicate, do the things I need to put it down. And so I experiment with that. And then I noticed I'd be at my desk working, quote, unquote, and all of a sudden all that garbage patterns would come out during my workday. I was like, oh, so it is, it's a, it's a puzzle. But this conversation is further reinforcing for me that it's going to be the road less traveled in this era. And yet I'm getting more and more convinced that for me, I can't speak for anyone else, but for me personally, the life of the highest joy and meaning is going to probably involve a radical departure from what is, quote, normal today. Because I do think that it diminishes and does tend to that, that preoccupation. So I think that's a, that's a whole fascinating conversation itself. Overall, this has just been so interesting and illuminating. Daniela, thank you. And if people want to learn more, you mentioned something about, you know, tele sessions, telemedicine, so people can perhaps work with your clinic even outside of, I believe you guys are in California, so maybe just a little bit about where to find more information and if you guys work with people, what's this? Where do you work with people remotely? A little bit of info so people can go further if they'd like.

So I work at the clinic, the Pain Psychology center, but my main gig, I guess, is that I own the Pain Reprocessing Therapy center where I train clinicians in pain reprocessing therapy. So for therapists, therapists can find us at painreprocessingtherapy com and for patients@painpsychologycenter.com and that'll be where you can see therapists that are trained in pain reprocessing therapy.

Oh, that's great. And so that. That can be done through that clinic. You're training therapists all over the country, all over the world in this.

All over the world.

Beautiful. And so is there a directory or someplace that someone might be able, if they wanted to find someone local to their area?

Yes, on painrepressessingtherapy.com there's actually a practitioner directory, and you can find not only therapists, but also doctors that can help diagnose whether there's a structural issue or whether it's neuroplastic pain. I think that's really important for someone to buy into this work is to know, is there something wrong with me or is there not? Because how can you say that you're safe if you're not? We do have a lot of physicians that are knowledgeable in pain reprocessing therapy on the directory as well.

That is really cool because, I mean, that's a big change. Even say, 10 years ago or so when I was first discovering TMS and stuff, to find a TMS doctor was like, really strange and hard. There was a. There was a small number, but it was like a harder list to find. So the fact you guys are making this more widespread and really plugging it in, you know, with, uh, randomized controlled trials and studies and everything, is super exciting. So thank you for not just being here with me today and sharing, but also the work that you. You are doing to spread this. This is truly liberating for people beyond, you know, beyond what they could even imagine going into, like, oh, my back hurts. Maybe I can get a little better to, like, no, you can actually be free. And so it's such a. Such a gift. Thank you so much, Daniela, for being with us today.

Thank you. My gosh, such kind words. Thank you. Thanks for having me.

That brings us to the end of the interview, but not quite the end of the episode. There is one more thing we got to do. Time for action. Action, action. Your action step for today is to observe. And specifically, what I want you to observe is you remember when we were in the interview talking about how we relate to ourselves, and it can be very harsh self criticism or it can be this kind of subtle cold indifference. And Daniela teased me about having a way of being where I practice, like, subtle self neglect. And she nailed me on that one. It's true. Even after all these years of teaching self compassion and writing this book called On My Own side, where I guide people to that. Why do I teach that stuff so much? Because the teacher needs to teach what they need to learn and reinforce in themselves. I have the perpetual gift of being a jerk to myself, and so it gives me an opportunity to keep practicing what I'm teaching here, which is noticing those ways you can be subtly dismissive of yourself. That's what I want you to pay attention to and start to redirect. Start to ask yourself the question during the day, how am I doing? What do I need right now? What does my body need right now? Is there any way I can take care of myself right now? And that could be in really subtle ways or that could be in, you know, maybe change what you're doing. Or you go stop a certain activity and start something else. You know, you'll get answers to those questions, but the key thing is to slow down and ask those questions. Beautiful. Thanks for being with me today. And until we speak again, may I have the courage to be who you are and to know on a deep level that you're awesome.

Thanks for listening to Shrink for the shy guy with Dr. Aziz. If you know anyone who can benefit from what you've just heard, please let them know and send them a link to shrinkforthshyguy.com for free blogs, ebooks and training videos related to overcoming shyness and increasing confidence, go to socialconfidencecenter.com.

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