#136 - Stuck in Fight or Flight: Rethinking Chronic Stress and the Nervous System with Dr. Kevin Butterfield

When we think about chronic stress, we tend to focus on what we can see: muscle tension, poor sleep, fatigue, pain, elevated heart rate, or a patient who just never seems to fully relax. But what if some of these seemingly separate complaints are actually different expressions of the same problem— a nervous system that has become increasingly stuck in a state of high alert? Welcome to The Factor Podcast, where we talk about the stuff they didn't teach you in school— how to grow your practice, refine your clinical skills, and get better results for your patients. We're here to help you navigate the real-world challenges of being a healthcare provider, from delivering top-notch patient care to running a business that doesn't run you into the ground. Whether you're fresh out of school or scaling your practice, We're diving into effective cutting-edge treatments to get patients better faster. We'll also talk about business strategies and tactics to help you work smarter and not harder, and the mindset shifts required to thrive as a top performer in your field so you can build a career you love without burning out. If you're ready to learn what works and what doesn't from leading experts, industry innovators, and respected clinicians across a wide range of specialties, You are in the right place, my friend. Let's dive in. Welcome back to The Factor Podcast. where we explore the latest evidence, emerging technologies, and clinical strategies to help healthcare providers deliver better outcomes for their patients. I'm your host, Jessica Riddle. Thanks for tuning in today. Over our last 2 episodes, we explored neurofeedback through the lens of athletic performance, looking at brain mapping, neuroplasticity, concussion recovery, and the pursuit of better cognitive and physical performance. Today, we've invited Dr. Kevin Butterfield and Seth Kalan, of Hippocampus Labs, a member of the Factor Podcast Network, to come back and take that conversation in a very different direction. Today, we'll be focusing on chronic stress and what happens when the nervous system has difficulty shifting out of a persistent fight-or-flight response. We'll explore the relationship between sympathetic activation, the HPA axis, sensory processing, sleep, pain, muscle tension, and autonomic regulation, and consider why some of the symptoms clinicians encounter every day might not be as disconnected as they initially appear. You'll also hear how Dr. Butterfield uses qEEG and neurofeedback as tools for examining and influencing aspects of that stress response system. The bigger question, though, extends well beyond any single technology. When a patient continues to struggle despite addressing the obvious musculoskeletal pieces, could persistent nervous system dysregulation be part of what we're missing? Let's get into it.

Stuck in fight or flight. I mean, I think we can just stop there and say, who isn't, right? I mean, in this high-tech, fast-paced world, I think everyone has a little bit of fight or flight in them. And how do you resolve that? Or how do you help that or help get unstuck? Right? Besides turning off the TV and stop watching the news. So we're going to go over that on how we can address the brain, which is the software. Chiropractic and everyone else that does from the neck down is more of the hardware stuff. And we're going to show you that there's an essential symbiotic relationship between the central and peripheral nervous systems. It's a very good relationship. Now we have to go over our disclaimer. I won't read this, you guys can read it. We're not giving you any medical advice. We're not treating you, diagnosing you, or doing anything like that. That's what your doctor's for. We're just going to have an informative little get-together chit-chat. Okay, who are we? Well, I'm on the left. I've been a chiropractor for 25 years. Very, I had a very high volume successful chiropractic practice for about 25 years. I stopped doing that about 10 years ago just to focus on the brain and neurofeedback because I wanted to help all the kids that came in with their parents when they got adjusted. I knew there was something going on with them as far as the blank stares or the lost look. It's because they were on the medications for ADD, ADHD. So I wanted to help those kids. My history is I'm the son of a neurosurgeon. So brains have always been around in my life since I've been growing up. I've advanced on, I've seen everything from the spectrum disorders to the concussion detection mitigation stuff, all different kinds of conditions. If you can trace it back to the brain, I've seen it. Now I do a lot of neurofeedback peak performance training for like NASCAR, IndyCar drivers, and NFL players, pro athletes, because there's a definite need for that. They want to have the best brain to be on top of their game, but so does little Timmy that's suffering with ADHD. Or he's on the spectrum, he needs help too. So that's why I started focusing solely on that. I've been doing neurofeedback for 26 years now. And Seth, you can go ahead and mention you or talk about you and then mention Dan.

Yep. I love talking about myself. So I know, I know. So you, don't we all? My background is in the nutritional lifestyle recommendations. I worked with a large whole food supplement company, Standard Process. Many of you have heard about before. But holistic healthcare is really just— is my focus. What's the non-invasive way that we can help support the patient get the best outcome? I was a nutritional therapy practitioner, board-certified holistic nutrition, and I've worked with hundreds of chiropractors, thousands through network, but directly with hundreds. And just what works with patients, the systems and the processes and the nutrition protocols that We were doing for over a decade. And with neurofeedback, I've learned so much over the past— since I've met Dr. Kevin back almost 10 years ago now about how the brain waves impact the body. And I'm fascinated about how we can influence the metabolic portion of the body with nutrition and lifestyle, how that can support the brain. And now with the tool of neurofeedback, how we can influence brain energy and the brain waves to influence the metabolic system as well. So, the bidirectional relationship there is really just how we're going to be continuing to support our clinics that implement our system on how to get the best results with those 2 things implemented both. Dan Court was one of my largest accounts in— with Standard Process in New York, nutritional consultant, was extremely successful with nutrition with Standard Process, was extremely successful in the past with 3 companies that he start and grew to be able to sell to New York Stock Exchange companies and NASDAQ companies. And so combining this with Dr. Kevin's experience, with my experience with nutrition, and with Dan's experience with nutrition and business, combining those all together, our goal is to take neurofeedback and make it a much more well-known service that chiropractors and healthcare practitioners in general implement into their support. into their offices to just maximize the results. And we have the best of all worlds really is we're supporting the brain energy, we're supporting metabolic system, and we're supporting the business aspect to make sure you get success from all aspects of patient results and clinic results. Because if you're not earning more income with this, then you're not able to help more people. And our goal is to help as many people as possible. So really excited about that and just glad to be here. I appreciate everybody's time. And I think you're going to get a lot out of this tonight.

Yeah, before I scroll down, I just wanted to give a little— neurofeedback's been around since the 1950s. Technology today, you can pinpoint more areas of the brain than ever before. And everything we're going to show you here, does it fit under your scope of practice? And the answer is yes, because we're not diagnosing mental health conditions nor treating them. Okay, I just want to get that out of the way up front. So why it matters now, of course, chronic stress is a new subluxation. You know, everyone has that. It's invisible. They sense it. It causes a lot of muscle spasms. It causes a lot of sleep disturbances. Even when I was a chiropractor, there was stress back then. You adjust them, the muscles relax. And what do you say before you adjust them? Relax. Okay. That they relax for a second automatically so you can make the adjustment. But then when they get up, they feel great. They go home. They keep coming back because the stress doesn't go away. And that causes them to go back into fight or flight mode and the muscles to spasm up and subluxate the vertebrae again. So it's like a repetitive cycle, which frustrated me when I was a chiropractor. I mean, what am I doing wrong here? Why do they keep coming back? I love my patients. I didn't want to adopt them. I just wanted to get them better and get them on their way. But I just didn't focus on the neck and that relationship between the sympathetic, parasympathetic, and the central nervous system peripheral. So this actually causes, this is why patients plateau usually. Even if they come in as many times as you tell them to come in, there's always this parts where their stress level doesn't go down. Their muscle spasms are there and it causes the bones to, the muscles to spasm and pull the bones back out of alignment. So they have the chronic muscle tension and you got the sleep. I mean, whether they say they sleep well. Are they really sleeping well? Is that REM sleep? Do they have enough REM sleep? This perpetuates the pain sensitivity and the fatigue as well. And the heart rate variability instability and blood pressure spikes, you definitely see that with the baroreflex impairment and the reduced vagal tone if you don't have the brain functioning as well as it should be. And limbic overreact Activation, of course, that sustains anxiety, extends the— it keeps you in a perpetual fight or flight mode. It's like your sympathetic nervous system's on overdrive and your foot's on the gas pedal, not coming off. You never hit the brakes. That causes this repetitive loop where the pain returns between the visits. The spasms are still there. These aren't separate complaints listed. They're just— it's a unified signature of the nervous system locked in survival mode. Fight or flight, high alert. Ready for something bad to happen. It is not, but it is just the stress level is way too high. We all know this patient here, a professional that comes in with— he is stressed out all the time. He has got chronic neck pain. He cannot get enough sleep, mood swings. His emotional reactivity is off the charts and his blood pressure instability is across— it goes up and down all the time, mostly up. Because when you are stuck in fight or flight, all the blood vessels Constrict, and it leaves you in a bad space, a bad space. And the missing variable here is that their nervous system is hardwired into the chronic fight or flight state. And if you stay in that state long enough, it eventually turns into PTSD. It just does. I don't know the timeframe. I don't think they know the timeframe, but just, you have, you cannot live in a state of fight or flight all the time. Like this, the subluxation, the structural correction, Physical therapy, that addresses the hardware, but the neural software, of course, is the brain, and we can regulate that to get them unstuck out of the fight or flight mode. Will neurofeedback get rid of stress? No. It will lengthen the fuse if you got a short fuse. It will make you process stress a lot better so you can get through the day, so things don't bother you as much. That's a fact. Yeah, this sympathetic lock-in. Your sympathetic's overdrive again. Your foot's on the gas in the fight or flight mode. You're not even touching the brakes. This activation drives muscle guarding, spasms, vasoconstriction, reduced tissue perfusion of the blood for sure, chronic tension. And that's sometimes why we can't get people to adjust easy or adjust. There's just too much of it, especially in the thoracic spine. I have a lot of that. I've seen a lot of that. And a limbic lobe overactivation that amplifies the pain sensitization with the pain tracts that go up and down your spinal cord, mood dysregulation, and it perpetuates this fight or flight on the edge of your seat on high alert all the time. That's a bad place to be in, but a lot of us have been there for a long time. And the prefrontal cortex, it's underactivated. Your frontal cortex is the CEO of your brain. You need that to function properly. And of course, we talked about the baroreflex suppression also will increase the blood pressure and cause you problems there. Now, if we unpack, of course, the critical brain-body connection, the somatic inputs, postural stress, segmental dysfunction, the subluxation, fascial restriction, They can all be from long-term fight or flight status. Okay. They send all the afferent signals up to the central nervous system and upregulates the limbic tone and driving sympathetic dominance. Again, your body is putting you in that fight or flight mode because we didn't hit the brakes on it yet. We got to break that loop.

Before we get into this next portion of it, I just wanted to just ask a question about everyone that's on the webinar. Do you currently do anything to assess adrenal function in your office? The results, 67% yes, 33% no. Okay. So there's obviously other tests. There's hormone tests. There's many different ways that you can assess the adrenals. Muscle testing is one of those, but neurofeedback is one of those. Brain mapping is one of those that you can assess that. So I just wanted to talk about that a little bit. Hans Selye's General Adaptation Syndrome, when people are out of gas and they go through these phases. Of the, the sympathetic mode, as Dr. Kevin mentioned, that's the fight or flight. That's the alarm phase that they're ready to run. Sabertooth tiger's after you, you're just running down the street. The resistance phase is when there's an elevated amount of stress over long periods of time, which is really the chronic state of a lot of the world, Americans these days, is there's a chronic amount of cortisol and other hormones that are in the bloodstream and the The body does not want to accept that hormone anymore at such high levels, so it becomes less resistant. So, over time, there's gonna be fatigue markers. People are gonna start to have more brain fog. People are, are not gonna have as much energy throughout the day. They're really in that resistance phase. And that exhaustion phase is when they are just like burnt out. They can't make it through the day. They may have migraines. There may be some things that just shut it off where they're just completely exhausted They need to lay in bed, they need to recover. And there's this process that you go through, through this, this getting out of gas. But what is interesting is what the qEEG reveals is we can actually pick up some of these processes and what stage that they're in with brain mapping. So as an example, if there's like active alarm phase, the hypervigilance, there's a lot of high beta that's showing up on the brain maps. If there is a cognitive fatigue that they can't get throughout the day, without maybe taking a nap each day. There, there's excess theta a lot of times that we can pick that up on the brain map. So if there's exhaustion, poor recovery, and low resilience, that's the alpha collapse where not enough alpha. So that these can manifest in, in, in, in so many ways. So one, if you're not— if you are, since most of you are, are doing some type of adrenal testing in the office, this is just one more tool where you can match it up to Really just give you further data that supports your findings. And for me, when I was working functional medicine and just helping with clinicians, adrenals are— it's a go-to. Everyone knows that the adrenals are the main output of the hormone production and the— as far as like our stress response, us being able to get through the day. We need energy. So that's— we always need adrenals, adrenal support in our protocols at some port. Point through the phases that an individual is going through with nutritional therapy, but it manifests in many different ways. It's not just adrenal support that they need. There may be some GI symptoms. There's a lot of chronic stress inflammation that's impacting the gut-brain axis with—

with—

there's a long-term adrenal exhaustion that's going on and inflammation that's not being taken care of. There's that cardiovascular reactivity that Dr. Kevin mentioned and respiratory issues. Where there's that tight chest, shallow breathing, and heightened arousal, and just, just overly on edge all the time, where the simplest thing, which shouldn't make somebody overreact or just start yelling all of a sudden just because it was something simple that came up, they should have a better stress response. And that's what neurofeedback does, is it helps dampen down our stress response so we don't overreact. bidirectionally, it will help with the adrenals be able to recover because it's helping with that feedback loop. So, misconception that I not necessarily had, but I always would focus on because it's the tools that I had available to me at the time, was always go to adrenals, go to adrenals, go to adrenals and adrenal support. But now, with this top-down approach of supporting the brain to be able to support the HPA axis, the stress hormones really come from What that initial limbic threat is, what that response is. And that's where neurofeedback really is so powerful, is because it intervenes directly at the source. It helps to retrain the limbic system so we can recalibrate how the body and how the mind assesses the environment and assesses the situation. So that way we can actually reduce the amount of adrenal response before it ever starts, because our brain is initially assessing it and not responding. In a hypervigilant way when it doesn't need to. The thalamus dysfunction and sensory overload. So it's a brain— the brain's primary sensory relay as far as like what it allows to get through. It's the filtering system. So under chronic stress, that filter basically just stops working as properly. So it becomes a flood of information where it's just too much sensory information coming in. PTSD is classic where there's just too much information that's coming in, they can't control it at all. So, where this is overwhelmed and we need to use brain mapping, kind of focus in on what we can enhance because there's— with low alpha power you see there, it indicates poor thalamic gating. So, disrupted rest states. When there's high beta activity, that reflects the cortical overload and sensory hypersensitivity. So, there's classic stress signatures that you can see on the brain maps and things that you can target with neurofeedback to help that stress response overall. And, this is just another way of talking about really the autonomic nervous system, the polyvagal theory, the vagal brake, the 3 branches mainly. In my background, we would always talk about just sympathetic and parasympathetic. This is really focused more on identifying exactly What state an individual is in when they are stressed, that ventral, or not stressed, if they're able to manage stress. So the ventral vagal is really just a social engagement. You're relaxed, you're around your, your peers or friends or family, and you are just in, in a place where you feel safe, you feel calm, and you feel supported. That's sympathetic dominance. That's nervous system. That's that where the threats are detected. But the dorsal vagal is where we're just shutting down. Where you have someone that you don't want to be around ever, and that individual's in your house sometimes, and you just, you can't even function when they're around. And this is that PTSD case as well, where they're just, they're not able to function in certain environments at all because they're just, they, they perceive everything as a threat. And it's just chronic stress. And it's that neuroreception, neuroception, the concept of the term that it kind of pulls, it pulls in the thalamus. It pulls in the amygdala. It's really the concept of the brain is constantly scanning the environment, constantly scanning the situation at hand to survey if there is stress, if there is danger, if there's threat. And that is through that process is it basically puts our, our nervous system into one of these 3 states. So with neurofeedback and brain mapping, we can see when there's frontal rhythm that's asymmetric, when there's a high amount of electrical activity on one side, on the left hemisphere versus the right hemisphere or vice versa, that's reliable to see if there's some type of reduction in the vagal response, in the vagal tone. And, when the prefrontal cortex cannot generate coherence balance, it decreases the ability on how the brain can respond appropriately. So, with neurofeedback, we target that and help the body to be able to respond, the mind be able to respond more appropriately, which then has the downstream effect. Of decreasing those hormone outputs to allow the body to respond more appropriately.

That wraps up today's conversation on chronic stress, autonomic dysregulation, and the relationship between the brain and the body. And while neurofeedback was one of the tools discussed throughout today's training, I think the more important takeaway is actually much broader. As clinicians, it's easy to separate what we see into individual problems— pain over here, muscle tension over there, disrupted sleep, fatigue, poor recovery, heightened emotional reactivity— but the nervous system doesn't necessarily experience those things in isolation. Persistent stress can influence how the brain interprets incoming information, how the autonomic nervous system responds, and ultimately how effectively someone is able to move between states of activation and recovery. That does not mean every patient with persistent pain or poor sleep is simply stuck in fight or flight, and it certainly doesn't mean there's one technology or intervention that solves all of the problems. But it does mean that when progress stalls, it may be worth asking a bigger question. Are we only treating what we're seeing downstream, or have we adequately considered the systems influencing the upstream? That's ultimately where conversations like this become valuable. As always, we've included some additional resources from today's episode in the show notes, so be sure to click those links. There's an incredible white paper with some research. provided by Hippocampus Labs, as well as some visuals from the webinar recording that was featured in today's training. You can learn more about some of the clinical applications of neurofeedback, of course, by visiting the hippocampuslabs.com website. And as always, if you enjoyed today's episode and found value in this content, please be sure to share it with a colleague, friend, or classmate, and visit our website at factorpodcast.com To leave us a review or a five-star rating, or of course you can do that right there wherever you listen to your podcasts in the podcast player. We'll be starting a new training next time around, focusing on AI and its use in your clinical practice. We'll see you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at factor-store.com. That's spelled F A. Ktr-store.com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands-on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links as well as info about our sponsors in the show notes, so be sure to check those out.