Welcome to Episode #10 of the Healing Pain Podcast with Dr. Howard Schubiner!
Today we are joined by Dr. Howard Schubiner, MD.
Pain hurts and it’s awful, but you CAN get rid of it! Maybe your diagnosis was back or neck pain presumably due to arthritis, a bulging disk or spinal stenosis. Or the diagnosis was tension headaches or migraine headaches. Or fibromyalgia or whiplash or chronic tendonitis. Or it might have been stomach pains or pelvic pains with diagnoses of irritable bowel syndrome or interstitial cystitis. Your doctor prescribed drugs. You took them and they didn’t really help. Maybe you even had surgery, but that didn’t help either!
Here is what most people are missing… Pain is a decision of the brain!
The real problem is your brain is producing pain because it’s manifesting unresolved stress, possibly from your childhood, or from stressful events in your adulthood, or from your present circumstances, and as a result of your personality traits (which affects how you respond to stress and how much pressure you tend to put upon yourself).
If you haven’t been helped by traditional or alternative medical care, the diagnosis may be the Mind Body Syndrome and most people have some form of it.
In This Episode You Will Learn:
- Why the brain is the generator of your pain.
- How even if an injury completely heals, pain can still persist.
- How emotions can cause pain.
- Why X-Rays, MRI’s and other tests are not telling the entire pain story.
- How to heal from past trauma.
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Welcome to the Healing Pain Podcast. I am your host, Dr. Joe Tatta. On the podcast today we have Dr. Howard Schubiner who’s going to talk to us about the neuropsychological basis behind persistent or chronic pain. He’s an internal medicine physician and an expert in pain management as well as a professor at both Wayne State University and Michigan State University’s School of Medicine. He’s the author of the best selling book, Unlearn Your Pain, a 28 Day Process to Reprogram Your Brain. Dr. Schubiner, welcome to the Healing Pain Podcast. It’s great to have you on today.
Thanks for having me. I appreciate it Joe.
I’m really looking forward to learning more about you. You’ve written an awesome book which we’ll hear about later in the podcast and your practice as well as other wonderful avenues people can hear about you. I know one of the things that you talk about is obviously the brain and it’s implications on persistent or some people call it chronic pain. Can you just start out by telling us why is the brain and the function of the brain so important in helping people recover from pain and getting us out of this persistent pain cycle that many people have been in for a long time.
Right. I think what I’ve learned in this last decade or so is that people don’t understand the brain. Doctors don’t understand the brain, the power of the brain or what it does or how it works, number one. We don’t understand pain. The first thing that I do with my patients and in my book is to teach people about those two things.
First of all, we know the brain can cause symptoms that are severe. I mean, people have died from voodoo. The brain can cause people to be paralyzed, unable to speak, unable to see. It’s called hysterical blindness. We know about these things as what we call conversion disorders. There’s something they used to call pseudo seizures where the person is having seizure like activity. When we do medical testing and evaluate the brain waves by EEG, we realize they’re not actually having the seizure. It’s their brain and it turns out it’s the subconscious part of the brain that has all this function. The subconscious part of the brain controls our body. The power of the brain over the body is immense, number one.
Number two, pain occurs in the brain. All the pain is a brain function. It turns out if you have an injury, you may have pain but you may not. In other words, the brain can control if pain occurs or not. It does. That’s its job because pain is basically a message that the brain is giving us. It’s an alarm. The reason pain comes is because the brain is alarming us to something that’s important. The neuroscientists call it the salience network.
The brain is alarming us to something. If it’s an injury, then it’s alarming us that we need to take care of the injury. It turns out emotional stress an emotional injuries or emotional threats are handled the exact same way in the brain as our physical injuries or physical threats. With those two things I think is the key points of what I learned about pain and about the brain.
I want to try to explain this a little bit better for people who are watching or listening. Obviously, you’re talking about pain being a construct of the brain. A lot of people, we’ve had a medical system where we have treated pain in one way for a long time. We’re now only really starting to understand integrated strategies that really takes to heal people who have had chronic pain or persistent pain for months or even years. Let’s take something as simple as osteoarthritis. People go to the doctor. Let’s say they had back pain. Obviously it’s the biggest one. They’ll have an x-ray of their spine and it’ll show some osteoarthritis or some arthritic change in the spine, which quite frankly are common in almost all of us. It doesn’t necessarily mean that pain should be occurring but how can we start to educate people that an image may not be the cause of their pain and that the brain is actually producing that pain or alarming that pain in them? Try to make that something easy for them to digest.
It’s one of the problems that we face in talking about pain caused by the brain, is that people don’t believe it. It just goes way out of their wheelhouse. It’s way out of what makes sense to me. Frankly, doctors feel the same way. We have this idea that the body is injured and the brain just reflects that somehow. In actuality, we can only feel what we expect to feel. This concept is called interoception. It’s akin to exteroception. Exteroception is you can only see what you expect to see. That’s why eye witness accounts are unreliable. People point out the person who they think is the kind of person who would have committed that crime, as opposed to the person they saw. Do you see what I mean?
Yep.
Our brain perceives what we expect it to perceive. The same occurs with our bodies. Because in our culture, in our society, people expect to get back pain. They expect to have pain when they do something, when they move in a certain way that their brain will actually create that. The problem is, as you said, is that the data that we have is that 80% of 50 year olds have degenerative changes in their spine. 90% of 60 year olds. 40% of 30 year olds have degenerative changes in their spine. These are the people without any back pain. As you said, it’s the norm to have these changes. We have to reeducate people to think of a degenerative change in the spine as being gray hair. It’s a normal part of aging. Gray hair doesn’t hurt unless you look in the mirror I guess.
All right. My question for you would then be if a patient goes to a practitioner. I’ll just say practitioner because there are a lot of people that one can see when you’re in pain, and let’s say that they take an x-ray or MRI and they hold up and they say, “Oh you have degenerative disk disease in your spine.” Is that practitioner explaining to a patient that they have degenerative process. Is that alone enough to be a pain generating event for that person, in their brain, in their mind, so to speak?
It certainly is. It’s enough to be a pain reinforcing event. What happens is is that the reason that pain occurs is because of the danger salience mechanism in the brain. A danger is something that we perceive as something scary. In other words, danger is fear. If you get an injury, you have pain because of that injury. Then when the doctor shows you the x-ray or the MRI, that causes more fear. Now instead of you saying, “I have back pain, but my back’s probably normal,” now they’re telling you, “You have back pain and your back is really messed up.” I’ve had many patients where doctors have told them you’re going to be in pain the rest of your life. Look at this MRI. I mean it’s ludicrous. It’s really sad.
Yeah.
What they’re showing them is I would look at these MRIs and I’d say, “That looks normal. Normal for you, normal for your age.” That when you say that, you’re reducing fear. When you show them how bad it is and how damaged it is, and how messed up you are, that’s increasing fear so that causes reinforcement pain. That vicious cycle, every time you have pain, you become more afraid of it because you’re worried about being crippled and how bad your back is. Every time you have fear, it gives you more pain.
Right.
That’s a real abyss that’s real easy to fall into.
How many people do you think we have out there that have experienced pain because they’ve been given let’s say tests or x-rays or MRIs or some may have even had surgery, had injections that they may not need. They still a lot of times those procedures fail. Some studies show that up to 50% of back pain surgeries absolutely fail. People have that pain, comes back within a year or five years later. It wasn’t a mechanical reason there. There were other generators of that pain.
How do we explain to people that their pain is not mechanical at times? It’s from other causes and what are those other causes?
The research on back surgeries shows there’s never been a randomized controlled trial that showed that back surgery was better than a different form of therapy, whatever it was, exercise, physical therapy, or whatever. There haven’t been analysis of spinal injections show that in randomized controlled trials, spinal injections are not better than placebo injections. We’re not doing all that well with invasive treatments for back pain. An important study by Richard Deyo showed that 85% of back pain cannot be diagnosed. 85% of the people with back pain we do all the testing and exam and everything and the answer is, well we’re not really sure. Doctors don’t feel comfortable saying I’m not sure or I don’t know. They’re more comfortable saying this is it and this is the problem and you can try this. You can try that. I’ll give you this intervention or that intervention. The bottom line is we never entertained the idea that it could be the brain that could be stressed. It’s really sad. There’s 85% of people get back pain in this country at some point in their life.
A friend of mine who’s a doctor in Iraq told me that people in Iraq almost never have back pain. It’s not we have this idea that our backs are really fragile. Everyone gets pain. Certainly, we certainly everyone does get pain from time to time, given certain exercises or activities. Becoming persistent pain, a lot of that has to do with your pain fear pain cycle.
How to get people out of that is the first step is really educating them. It’s really educating doctors. We’ve started a training institute where we’re beginning to train people and teach people through webinars like yours and through live trainings for how to begin to understand this. The more people see it the more it’ll become common knowledge. To me that’s the key because right now the common knowledge is, all back pain is due to a disease in the back. Now, some back pain is due to a disease in the back but there’s certainly conditions, like spondylitis, spinal tumors, spinal fractures, spinal infections that are clearly generator of pain.
In a lot of people, it’s not that. Then when you think about it’s not just back pain, but how many people with headaches have a generated. Not very many.
Yeah.
How many people with stomach pain and pelvic pain? A lot of those, we’re talking about millions and millions of people.
Yeah.
Common problem and I think if we can begin to understand that the brain effects the body and that’s common knowledge, how many times in my life have I had pain or other symptoms that are caused by my brain? Answer, lots. It’s common. It’s really just because I’m human. Have you experienced anything lately?
Yeah, as a physical therapist I’ve had a number of things that I’ve hurt and patients come to me often and they say, “You look so healthy. How do you do it?” I say, “Well, of course there are lifestyle habits that I adopt. I eat a proper diet. I exercise. I know how to modulate my stress.” I also realized that if pain starts, that my physical therapy brain may look to a biomechanical reason first. As the neuroscience and the neurophysiology has kind of weaved it’s way through the physical therapy profession, I also know that if I had a really stressful day where had a lot of patients or I had a deadline to meet or whatever it was, that there could be other generators of pain there. Stress is obviously a big one and something I wanted to talk to you about, is talking about stress and other emotions. I think emotions are really kind of the key to talk about. What other types of emotions can effect someone’s pain or cause pain and how do we talk to people about starting to alleviate those?
The idea that stress can cause a physical symptom, or that emotions can cause a physical symptom is pretty obvious. Most people can see that they’ve had that in their life. When you get embarrassed your face turns red. What’s that? If you have to give a speech in front of a lot of people, your stomach may turn to knots. Your voice may be raspy or something like that. I’ve given so many lectures and I often ask people, “Where do you hold stress in your body?” Most people have an answer for that in some way, shape, or form. The idea that stress can cause physical reactions is pretty much common knowledge. What we’re doing is we’re extending that and helping people see that because stress can cause physical symptoms and because physical symptoms can cause more stress, and because in some cases stress can be chronic or persistent, or severe, we really look closely at it. You can begin to tease out and see just as you were seeing when I have a pain, sometimes I’ll recognize this was a stressful day.
When people look for those connections, they always find them. That’s the amazing thing. By taking the time to look, once you’re open, once you understand the concept and you’re open to it, the next step is really investigating. Most people can prove to themselves basically, once they have this kind of information, that they will openly and honestly and carefully look closely at their life, they’ll see that the times when they had pain, onset of pain or exacerbation of pain, those are the times when they’ve had a significant stressful event in their life.
Yeah. You asked about when the first time I had pain was and when I really think about it, the first time I had pain that I actually got involved in the medical system as far as being a patient with pain, because it can be a real challenge was when I was in physical therapy school. Physical therapy school is tough. There’s a lot of coursework. Not unlike other types of medical degrees, a lot of knowledge that you have to cram into about three years. I had back pain. I went to see my professors. I had a doctor gave me an [inaudible 00:15:43] that really upset my stomach that I really didn’t need and now when I look back on it, that pain was generated because I was under a lot of stress. Now that I know that, I think of the challenges that people go through in our current medical system, to try to get themselves to a point where they can actually find a qualified practitioner. There are a lot of us that really are working on pain from this perspective. Some are physical therapists. Some are psychologists or psychotherapists. We’re out there but it can be a challenge for people to kind of get over those hurdles.
Yeah exactly. That’s why education is so important and connection is so important. We’ve developed a Google group that’s a really nice place for people who understand mind body medicine to talk and interact and support each other and ask questions. It’s been really great and so that’s one thing that I would recommend that some of your listeners consider joining is our list serve. I can send you the link for it. That’s one thing that I’ve found really useful. There’s also another website called tmswiki.org. Tmswiki.org and it’s a peer run, no advertising, no financial conflicts or anything like that. Just the peer run support group for people who have symptoms that they thing may be related to their brain. It’s got a ton of resources on it. Those are two sites that we’ve been working with and have found really helpful.
Those are great. If you give those to me I will include them on this podcast, which will be a great resource. I want to peel the onion kind of back one more layer regarding emotions. There’s a lot of research that talks about people have a history of trauma and those traumas can be physical. They can of course be emotional traumas. Those can be the generators of pain.
Yeah.
I think it’s really important that we talk to that group because often times those are the hardest people to help and get on board with this type of work.
Yeah. Excuse me. A lot of when people look at this, there’s one reaction that people have. The one reaction is well, first of all how are you saying that my childhood has anything to do with my back pain now? That just makes no sense. It’s just like so out of the realm of what’s normal. It turns out that stress and trauma sensitize the danger signal in the brain. It’s not a Freudian concept. This is a behavioral concept because the more you’re exposed to something, the more it trains your brain to respond in ways that protect you. Eric Kandel won a Nobel Prize for showing this response in a little sea slug, little marine animal.
You could train that marine animal to be afraid, to have fear and respond and that’s exactly what happens in people, particularly children who are in situations where they’ve been hurt or they’ve been victimized or they’re powerless. That trains their brain so that that brain that’s trained or sensitized to stress and trauma, the danger signal is hyperactive so to speak, hypersensitive.
Then later trauma in life, whether it’s a physical injury, that’s why people with mild car accidents or mild back sprains often develop pain for months or years, even though the injury has healed. It’s because their brain has activated the sensitized brain danger signal has been activated by the physical or emotional trauma later in life. Everyone has that to some degree. That’s why this happens. The emotions that are involved are really at the core of it as you mentioned.
I think what’s interesting point from what you said there is that you can have an actual injury. Let’s say a car accident, where maybe your back or neck is injured but we now know that tissues heal within a certain period of time. Unless you have some kind of autoimmune disease which would prevent the healing process or some kind of nutrient deficiency or a disease that prevents healing, most injuries will heal within you know three to six months depending on what it is.
Pain will persist beyond that point. When pain persists beyond that point, that’s from an overly sensitive nervous system. Can you describe what an overly sensitive nervous system really means?
What it means is that the brain learns pain and then creates its pain. It’s that concept of interoception that I mentioned. When the brain expects to have pain when you move a certain way, or we stand up or sit or whatever, walk, whatever that is, what’s happening is that the brain is actually creating that pain as a way of protecting itself, as a way of reminding us that we’re in danger. It gets stuck in this position.
Right.
It’s really hard to see that that’s the case because you feel like this is a physical problem. It hurts in my back. How can that possibly not be a back or neck or arm problem. It’s amazing but when you see it and when you look closely, one of the most helpful historical facts that we find is that people say, “It’s there all the time.” Well, maybe it is there all the time for some people. Well it is. Often times, there’s some time when it goes away. It turns off or it lessens or it worsens. If you can pay close attention to what those times are, sometimes those times are emotional. Emotional event can trigger pain to be much worse. If you look for that, you’ll find that.
The other thing is that sometimes, something will trigger the pain to be much better, like a vacation, being on a boat for a day or something that just turns that off in the brain. When you see it turn on and off, that’s the sign of a neuro pathway. It’s neuro pathway issues to learn and to not lean.
All right. I think that’s key. Obviously there are emotions or instances or circumstances in your life that turns pain on, but your wedding day, or your honeymoon, or your child’s birthday, you probably don’t have pain at those moments because those are positive experiences for you. That tends tot kind of dampen your nervous system and the whole endocrine response that you’re having.
Even just going to a movie. All of a sudden, they’ll say, “I didn’t notice it then.” If it’s neuro pathway generated pain, if it’s pain generated by the brain, if not noticing, that’s the same as it not being there, in the way I look at it.
Right.
Now a lot of people say, “Well I had a really good childhood. How does this apply to me?” It turns out that some people are more sensitive. Some people are just the kind of person who tends to take care of others, not put themselves first, be perfectionistic, high expectations of themselves, very conscientious, overly self critical. Those kind of people, like me, may have a milder stressful event, milder trauma but still they can get these kind of symptoms. The bottom line is, these kind of symptoms are just being human.
Right.
Everyone has them to some degree in some way, shape or form. We can understand that, I think we’ll be much further ahead.
When you and I talk as practitioners, one on one and we understand some of the science behind this, we say that pain can exist after injury is gone. We’re not saying that pain is not real, that your pain is not real. The pain you’re feeling is actually real, but for you, it may not be a joint or a biomechanical reason for it.
All pain is real. All pain occurs in the brain. We say, “Well it’s in your head.” Well of course. All pain is in the head because your brain is in your head. Sometimes people have made great progress when they say, “Oh. I thought you were saying it’s in my head. I’m glad it’s not that. It’s in my brain. Okay good. Now I can deal with it.” You’re making a really, really good point because there’s a stigma against psychological issues. There’s a stigma against stress causing. People feel that if you say it’s a psychological issue or it’s a stress issue. What you’re saying is it’s not real. They feel invalidated, offended, insulted. It’s the opposite of what we’re saying. What we’re saying is that we get compassion for you because we know you’re in pain. We know your pain is real. We need to get to the bottom what’s causing it. Treating it symptomatically with drugs or injections or surgery is not a way to make it go away. It’s a way to manage it.
Right.
Most people don’t really want to manage their pain. They really want it to get better.
Yeah. When someone comes to see you, your background is in internal medicine. Obviously you branched out into the pain would. When someone comes to see you, what kind of treatment or what does your program entail? What can a patient expect from it?
I have an initial visit where I spend two and a half hours with somebody so I really try to go into depth to find the cause of the problem for the person. The last thing I want to do is tell someone they have a mind body problem turned into a pathway problem when in fact they have a physical. I look carefully. I review their medical records, their x-rays, their MRIs, examine them, take their medical history, take their life history, put it all together and see if we can make a clear and accurate diagnosis. Is this a mind body problem, a neuro pathway problem. Is this really a physical problem, structural problem, or is it a combination of the two?
From there, then we go on into what forms of treatment we need to do. I divide the treatment up into four categories. The first is education, just what we’re doing now, helping people understand how this works and why it’s true for them, how they fit into this pattern if they do. The second arm of treatment is behavioral interventions. Those things are quite familiar. It’s helping people to stop fearing their pain, start actually taking control of the pain, doing things, being more active, rather than less active, whether it hurts or not, challenging triggers to the pain, and relaxing knowing that they’re going to be okay.
That is often hard for people. It takes courage and bravery to stand up and say, “I’m going to walk even if it hurts because I know there’s actually nothing seriously wrong, so I’m going to keep walking.” If they keep walking, and they give themselves affirmations and tell themselves that they’re healthy and they’re strong and there’s nothing wrong and they’re going to be fine. They tell the pain to leave and stop because they don’t need it anymore. Taking control over it and it sounds silly to talk to your back or talk to your stomach, but the bottom line is that number one, affirmations have been shown in functional imaging to activate the [inaudible 00:27:05] frontal cortex which is part of the brain which dampens the fight or flight danger response.
Also, what we know is that the conscious can actually control our subconscious. If you don’t believe that, think about a time you had to pee and you were standing in a long line. Most people don’t pee in their pants. They hold it. It’s a brain function. You’re telling your brain not to pee now. In essence, you’re talking to your bladder. Telling your brain to relax your bladder, whatever it is. You can do this. You do this all the time.
Right.
The third type of intervention is emotional intervention. It’s more complicated, more in depth, but it deals with looking at the emotions that have [inaudible 00:27:51] or continuing to the [inaudible 00:27:53], looking at sadness, looking at anger, looking at guilt, and helping people develop the methods through working with Dr. [inaudible 00:28:04] in Halifax Nova Scotia. We’ve developed operationalized methods for helping people deal with[inaudible 00:28:11].
The first part of the program is making changes in your life. Your in an abusive relationship, in an abusive job, or a situation where you will be hurt in some way, in an ongoing way. You may have to make changes or set boundaries with certain people in order to change the ongoing hurts that you’re feeling. Those are the four components.
You mentioned movement a little bit in there, saying that people eventually have to confront their fear and eventually start to move. There’s a lot of research out there that says that movement can actually help desensitize people the brain because if you’re scared to, let’s say, lift a bunch of laundry that you’re doing, that eventually you’re going to have to start doing those types of activities again. In doing that, you’ll teach your brain that it’s okay and these things don’t hurt you any longer.
Exactly. One of the simplest things I’ve found, and I do this all the time with patients, is I try to find something, like some movement that bothers them. If it’s side bending or forward bending or moving their neck or something. Then I ask them to, let’s say it’s forward bend. Bend over and tell me how far you can go before. They bend over, you know 10 degrees or 15 degrees. It hurts. Okay good. Now, stand up straight and strong and powerful. That changes your body as you take a powerful position. Repeat this. I am healthy. I am strong. There’s nothing wrong with me. I can do what I want. I’m in control. I’m in charge. I can get lost and I’ll be fine. Then I say, “Okay, now bend over.” Then they bend over 30 degrees or 50 degrees. It’s better. Good do it again. What they’re doing is they’re taking their conscious mind and challenging those fears, overriding the neuro pathways of pain, and they can often dramatically change their pain right on the spot once they understand that they’re actually not as damaged as they thought.
It brings me to my next point which you started to articulate a little bit in the beginning of our conversation. In our medical society, in our system, we have to label everything. Obviously there’s reasons for that through insurance and we have to do those practitioners and there’s a good reason for that. When we give people labels like chronic pain or fibromyalgia, which is really a form of chronic pain, are we really hurting people in some ways and should we really start to change the language around what we tell our patients when they come in?
Absolutely. I was talking about this with a patient this morning. The label and the name can be quite damaging, just as the picture of the MRI and the interpretation of the MRI can be in that sense damaging because it creates more fear. What happens is, in this internet world people read online about things. If you have fibromyalgia, what does that mean? Fibromyalgia just means you have pain all over. It doesn’t say why you have it. What it means is you don’t have a structural problem. You don’t have a structural problem. In essence, if the diagnosis is fibromyalgia, in essence should be relieving. Oh great, I don’t have a structural problem.
Right.
It turns out, when you read online about it, it’s like people don’t recover. They have pain for years. They have all these other symptoms. It’s horrible. The medications don’t work or they cause side effects which make more and more fear and more and more pain. The label is really important in the sense that people often times begin to identify with the illness. I am that illness.
Yeah.
That illness is me. I’m a person with the bad back as opposed to a person with back pain. I’m a person with fibromyalgia which means, therefor by definition, I can’t do A, B, C, and D.
Right.
That becomes more and more [inaudible 00:32:15]. Huge issue.
Right. I think as a society, we really need to focus less on the label and really more on the transformation for people.
Exactly. Yeah.
Can we talk just a little bit maybe a sentence or two about our opioid epidemic and how some of your work really maybe should be first like of treatment versus an opioid. How do we really start to move practitioners, of course. They’re physicians, and nurse practitioners and other professionals that still go to opioids first for common types of pain, and really probably should start to put different things on their prescription like the cognitive behavioral therapy that you’re talking about or physical therapy or other alternative types of interventions.
Yeah. It’s really sad when we found ourself in the United States use is 90% of the prescription opioids in the world. 28,000 deaths per year due to opioid overdoses. The best advice is don’t start. It’s hard because people you get a wisdom tooth pulled and the doctor gives you 60 tablets of Vicodin or something. It’s really wrong because of what’s going to happen to all those tablets? Then they get stolen, used by somebody else. Teenagers get their hands on them. Then it’s so dangerous, the pharmaceutical industry has been very prominent in marketing opioids to doctors and telling them how safe they are. There’s a big lawsuit. There’s a couple pharmaceutical representatives who are now being actually criminally prosecuted, when that’s happened in [inaudible 00:34:01] lawsuits. It’s just a horrible situation.
A lot of people are on opioids when they come see you, with chronic pain. There’s two ways to deal with it. One way is to get them better and then wean the opioids. If they feel better, the opioids are generally not doing all that much anyway. Take them in a chronic way. The other way is a lot of times people will feel better when they do wean their opioids, or switch to a different agent like [inaudible 00:34:33] methadone so it can be a complicated situation, but best advice by far, even though it may seem cruel, is don’t start.
Can opioids actually be making their pain worse? Can it change the function of your brain so that pain is worse?
Yeah that’s exactly one of the things that happens. It’s a sensitizing effect of opioids. That’s why a lot of people actually when they get off opioids, they actually have less pain. They’re afraid to do so.
Yeah.
There’s a reinforcing effect of opioid, of any medication, but in particular pain medications. You have to be pretty brave and courageous and confident that you’re going to be okay in order to do that.
Yeah.
When you take one less pill, you’re very much afraid that you’re going to have more pain, then you will have more pain. Not necessarily because of one less pill but cause of the fear.
Yeah. Excellent. Got some great information there. A good friend of mine who’s a psychologist gave me your book about a year ago. It’s called, Unlearn Your Pain, and it’s really a wonderful resource. Can you tell us about your book and where we can find you and some of the activities that you’re working on?
The book is Unlearn Your Pain. It’s available online. The first part is the science behind the brain and pain. There’s a chapter on diagnosis for helping people self diagnose or understand how they can decide if they have a mind and body type of pain as opposed to a structural pain. The rest of the book is a self guided recovery program that reads emotional expression writing exercises, teaching people how to do emotional intervention work, teaching people how to do behavioral interventions and reprogramming the mind. There’s a CD with meditations that comes with it. It’s got a variety of things and resources for practitioners as well.
We have as I mentioned there’s the tmswiki, I’ll give you that link, which has a list of practitioners who do this kind of work around the country. We’re engaged in research. We just finished a large NIH funded research trial on fibromyalgia, comparing the cognitive behavioral therapy to emotional expression therapy. The results are just coming out now, but it’s looking like they’re going to be quite positive.
Then we’re training people. With people that are interested in training in this kind of model, we’re doing that on the east coast, west coast, in the mid west. Going to be doing some online webinars, training type of things. There’s a lot of activity going on and one of the best places to find out about it is on that list serve that you’ll be sending out as well.
Excellent. Can you tell us your website? I know you have a website where people can find you.
Yeah, it’s unlearnyourpain.com.
Unlearnyourpain.com. Okay. Excellent. It’s been a great interview and think you’re really doing some groundbreaking work. I think it’s information that needs to get out there to not only professionals but of course, people who are struggling. It’s been great to have you on the Healing Pain Podcast. Please check out Unlearn Your Pain. It’s a wonderful book. Check out the links on this podcast page and sign up for the podcasts each week at www.drjoetatta.com and stay connected. We’ll see you next week.
About Dr. Howard Schubiner, MD
Dr. Howard Schubiner is board certified in pediatrics and internal medicine and is the director of the Mind Body Medicine Center at Providence Hospital in Southfield, MI. He is a Clinical Professor at the Wayne State University School of Medicine and the Michigan State University School of Medicine. He has authored more than sixty publications in scientific journals and books. Dr. Schubiner is on the board of directors of the Psychophysiologic Disorders Association. He is also a senior teacher of mindfulness meditation. He has been included on the list of the Best Doctors in America since 2003. Dr. Schubiner lives in the Detroit area with his wife of thirty-three years and has two adult children.
To learn more about Dr. Schubiner visit www.unlearnyourpain.com and www.tmswiki.org.
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If you would like to appear in an episode of The Healing Pain Podcast or know someone with an incredible story of overcoming pain contact Dr. Joe Tatta at [email protected]. Experts from the fields of medicine, physical therapy, chiropractic, nutrition, psychology, spirituality, personal development and more are welcome.
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