The Story Behind the Symptoms: ACEs, Triggers, and Widespread Pain

[00:00:00]I needed to learn that I could express every ugly thing that I felt, every so-called negative emotion, everything in the presence of an adult female, my therapist, and know that she wasn't going to shut me down. She wasn't going to abandon me.

[00:00:19]She wasn't going to judge me. She wasn't going to tell me, "Oh, you're too sensitive." She wasn't going to shame me for feeling.

[00:00:29]And I think that if we can just get everyone to realize [laughter] that that it's that it's that shame that dreadful shame we carry around for actually having feelings that you know like we always talk about it's not our parents' fault. They did the best they could. They didn't have this knowledge.

[00:00:48]They didn't have this training. But we somehow end up with this message that we can't express our true feelings without being abandoned. Welcome to the story behind the symptoms. Your host is David Clark, MD, a board-certified gastroenterenterologist who successfully diagnosed and treated over 7,000 patients with neuroplastic pain or illness. We'll dive into our guests life experiences to uncover their deeper causes of their symptoms. By listening to their story, you will gain insights that advance your own journey toward knowledge that becomes healing.

[00:01:22]>> Hello and welcome to the story behind the symptoms podcast. I am your host, Dr. David Clark and on this podcast we talk to people who have experienced neuroplastic symptoms and try to understand where they came from and how people recovered. My guest today is Sarah Hobber and please introduce yourself Sarah.

[00:01:43]>> Thanks David I appreciate it. Um yes as you said my name is Sarah Hober. Um I was completing my PhD actually uh which I had conferred in January of this year and my topic of interest was chronic pain funny enough. Um >> that's appropriate. [laughter] >> So yes and so maybe a little bit different from a lot of the people you've interviewed of which I've listened to many of these podcasts. um they're absolutely wonderful, but unlike many of the people that you've interviewed, um I had a lot of information based on the science. And so when I was writing my thesis, I live in Europe where a dissertation is called a thesis for your PhD. Um I experienced chronic widespread disabling joint pain um for the first time in my life. And because of my research and my understanding of the large body of science out there about neuroplastic symptoms, I actually recovered in a relatively short amount of time. But um as many of your guests have said, this was not my first neuroplastic symptom. Um, I realized when looking back that I have been somatizing my emotions and feeling my emotions in physical symptoms probably since I was born and if not then at least um from a very young age. So I have many episodes that I can recall of um neuroplastic symptoms, going to many many doctors, um having all the tests, everything normal, you know, this the same story that you hear every time you interview someone. So the difference for me this time was that I didn't go to doctors. Um I knew how to treat this absolutely debilitating pain. I c I can describe it to you and it's hard to believe when I look back just how debilitating it was.

[00:03:46]>> Yeah, please do describe it. And if ever proof was needed that neuroplastic pain can happen to anybody, uh if it can happen to somebody with a PhD in pain psychology, it most definitely can happen to anybody. But yeah, let's let's talk about exactly what the symptoms were and then then go back and talk about the ones you had when you were younger.

[00:04:08]>> Sure. Yeah. [snorts] So, I literally from one day to the next, I woke up with widespread joint pain. And when I say widespread, it was uh my shoulders and my wrists were probably the worst in as far as pain goes, but also my hips and one of my knees. So, it was all of these joints. all at once. And um literally woke up with this pain one morning and it was such that it started out very much as like um joint inflammation. So my joints actually felt puffy. I had never experienced this in my life before. So there was pain and it felt like I had gel capsules or pillows in my joints. Um, I couldn't use my wrists. I I there's no way I could have opened a jar. I even had trouble turning the key in the in the lock of our front door.

[00:05:09]Um, and the the strangest part about it was so this went on in total for about eight months, which for a lot of your guests is is a tiny amount of time compared to decades, right? Um, but what was interesting was the the disability involved in that I I could not lift my arms higher than this. I could not straighten my arms above my head. I couldn't use the the muscles my shoulders, they're called deltoids. I had no use of my deltoids. I could not laterally raise my arms at all. And I had been a very active person. I had been a yoga teacher. I had been a fitness trainer. I love to ride my bike.

[00:05:51]I love to be active and in my body and my body just quit working. It just wasn't I couldn't do anything.

[00:06:00]>> Wow. That's that's very intense. But as a physician, I have to ask you, was there any visible change in the joints?

[00:06:08]You say they felt puffy. Did they look puffy?

[00:06:12]>> The only ones that I could really see properly were my wrists. And I would say that they looked puffy. They looked like they had fluid in them.

[00:06:22]As far as the other joints, I don't I don't know. [snorts] >> Okay. Well, this would make me very suspicious as a physician that, you know, the sudden onset that you had, the widespread uh nature of it. Uh and I [clears throat] would be certainly putting a neuroplastic condition high on the list. I might also wonder about uh an acute u autoimmune uh situation or possibly a uh viral infection, but those would be fairly uh readily checked out.

[00:06:54]And I would then be going on to ask you about what was happening in your life to see if there was a uh a trigger that might have occurred. But we'll get back to whether there were any triggers. I'd love to hear about symptoms you had when you were younger.

[00:07:09]>> Yes. And I just want to say sort of piggybacking on what you just said. Um because I knew so much about the science. Um that's the reason I didn't go to any doctors right away and I was instead watching the pain and it changed every day. And because it changed, I knew it was neuroplastic. And this is a point that I think is so important. Even the quality changed. It changed from joint inflammation and pain to nerve pain, which is absolutely excruciating.

[00:07:44]And I like literally if in bed I could hardly sleep, if a blanket happened to just touch my wrist, it would be shooting electricity all over my arms.

[00:07:56]It it was unbelievable. And then eventually it sort of settled into joint pain and um muscular pain which was very well known to me having been a fitness trainer for so long. I understood muscular pain right but it did not start as muscular pain but it changed into that over time. And so it was that it was that changeability that oh one day my wrists are worse, one day my shoulders are the worst, one day my knee is really bad that led me to understand okay this this is clearly neuroplastic.

[00:08:26]>> Yeah. organs and structures tend very much not to do that.

[00:08:32]>> Right. Right. So as far if we go back if we go way way back um I remember very clearly as a child having a lot of ear and tonsil uh inflammation and infections. So going to doctors quite frequently for those two um areas. And then as an adult the a couple of large episodes stick out to me and one I would say so I was having always throat issues, tonsil issues. my tonsils would get enormous if I got any sort of viral infection and one was so bad I had gone to my GP um and she at that time I I broke down crying uh in the appointment and she said you know there's so you obviously are under so much stress like what's going on I think you need to see a psychotherapist and at the time and this was 25 years ago I thought what what is she talk what is she talking about? Like I had no understanding how that would help me in the least. So I continued just doing what I was doing. And um I suppose it was about 15 years after that. So just about 10 years ago. So the the joint pain and everything that I just described happened almost exactly a year ago. So this would have been 2025. So about 15 years prior to that, I had an episode in the middle of the night that awoke me from my sleep. And it it literally felt like I had had a stroke.

[00:10:15]Um I couldn't feel my hands, my legs were tingling, my heart was racing. It was I had no idea what was it was terrifying.

[00:10:28]And um I called the hospital near me. I lived near the hospital and I said what was going on and they said just come directly to the ER. And so I went to the emergency room and you know all the tests, all the heart stuff, all the circulatory everything and they diagnosed me with a panic attack and because nothing nothing was showing up in all the tests. And so I went on the journey that so many of your interviewees go on. I went to the neurologists and I had the MRIs and I had all the blood tests known to man and a nerve conduction test and oh my god horrible horrible. Those things are evil. Um and yeah, there was nothing there was nothing wrong. So that >> was Was there a trigger for that episode?

[00:11:18]>> 100%. Yes. For all of these episodes. I mean all of them. I mean, I I know from the most recent episode, it was very obvious what the triggers were.

[00:11:28]>> All right. Well, let's let's talk about those. Let's find let's talk about what the triggers might have been because we don't talk about triggers enough. Uh it's something that every health care professional should know about looking into and it's something that every patient who suffers from this should be aware of.

[00:11:46]>> Yes. Agreed. Agreed. and to the point where I feel from my perspective I think the most important question that can be asked when a neuroplastic symptom is suspected is tell me what's happening in your life right now because there's always a trigger there and so in my case last year uh with the widespread joint pain I had taken uh a few months leave from writing my PhD thesis is because in uh January of 2025, I had received notice that my work contract with the US government had been cancelled. And this was a job that I was so looking forward to starting. I mean, it was really a dream job uh working as a social scientist for the government. I was working with people that I knew and respected. I would have had just an amazing um work life that I was really looking forward to. And when that contract was cancelled, it it just threw my life into absolute turmoil. So all of the plans that my husband and I had been making had to be very quickly modified. Um so that was the trigger, the major trigger.

[00:13:06]Um >> yeah, for you and and many thousands of others uh during that era, >> I would imagine that a lot of people in a similar position to me also had neuroplastic symptoms at that time unless they had the tools to to handle it um immediately. So, uh, that was a major major trigger. And then I had gone back to writing my thesis. Um, and that was going well, but I was unable to find a job. And I bring that up because um, my husband and I had moved uh, to Europe. We had that opportunity. So, we did that. Um, but never in my life have I been unable to find a job. And if we look way way back, I have felt responsible for the financial well-being of my loved ones for a very long time.

[00:13:58]And here I was not being able to do that. And so if you want to talk about triggers, it was it was that feeling of being totally helpless, totally uncapable of being the responsible one. And so that was um the the main main trigger for what happened last year.

[00:14:20]>> Was there something early in your life that um made that sense of responsibility particularly strong for you?

[00:14:29]>> Yes, there was. Absolutely. And um this is the part that I find so interesting, the whole neuroplastic bit, right? So our brains obviously develop in our close attachment relationships. When we're growing up, our brains are growing up, but they're growing up based on our relationships with our close family members. And my parents divorced when I was nine. And after that, I have so many clear memories of this worry about money, you know, how how are we going to pay the bills? Where's the money going to come from? Uh it was just sort of always there in the atmosphere.

[00:15:10]And unless a child is told directly explicitly, this is not your worry. You do not need to be concerned about this.

[00:15:21]You know, mom and dad are handling it in the best way they can. Whatever. Just some information to let me know as a nine-year-old. This is not my fault.

[00:15:29]This is not my responsibility.

[00:15:32]>> Children feel responsible. If there are bad things going on in the household, children will usually try to fix those issues and they will take that upon themselves. They uh perceive themselves to have a lot more influence and power and capability than they actually do and they can feel pretty negatively about themselves when they fail to solve um those problems. Um >> yes. C >> can I also ask if um you know obviously divorces happen after um some issues that have gone on for some time. Were you aware of those issues in in a way that you might have felt like uh it was your task to uh help your parents' marriage or did it come as a complete shock when they divorced?

[00:16:23]>> No, I wouldn't say it came as a shock.

[00:16:26]Um it was the there was so much arguing and so much fighting and just a lot of emotional chaos and and this is the piece that also I think isn't talked about enough when we talk about adverse childhood events or aces that it's not necessarily the adverse event like divorce itself. It's I think Gabber Mate talks about this quite eloquently. It's who who was there to help you unload your emotions as a child when this massively emotional thing was happening. And so in my case, yes, my parents fought all the time. I felt like like you said, as children, we think everything is our responsibility.

[00:17:12]Everything is our fault. It's all about us. It's because our brains are not fully developed yet. So we cannot understand that it's not all about us.

[00:17:20]So I felt it was my fault. It was my responsibility to make things better. I couldn't make things better. But when the divorce actually happened and during all this scary fighting, which I thought was my fault, where where could I turn to feel scared and to, you know, have my emotions held by someone? There really wasn't anyone there.

[00:17:42]>> And you so you have to take your emotions and stuff them somewhere because they're only going to get in the way of your solving these problems.

[00:17:50]>> Yes. And in fact, the expression of my emotions seemed like it would just make the problems worse. So, >> exactly. Exactly.

[00:18:01]>> I'm solving problems by not having problems, which clearly [laughter] that doesn't work. It just, like you said, it gets shoved into the body and that's where all of these symptoms were coming from later on in life, too.

[00:18:14]>> Yeah. And you know it's important for people to recognize that the personality traits that are commonly associated with neuroplastic symptoms also typically derive from this kind of experience that you are trying to be the perfect child.

[00:18:30]You are um witnessing uh problems in the household and and feeling responsible and therefore likely to be highly self-critical. Um your focus on the needs of others uh is so strong that you tend not to take time for for playing as a child should uh take time for personal joy and that carries on into the adult years. Um had you observed those traits uh in yourself?

[00:19:04]You know what's interesting is that so you're 100% correct and the way to feel valued um in my household was to achieve. So if I achieved then I could be seen and you know we all have the need to be seen and heard and valued and loved. And so, um, I, like many, many people with neuroplastic symptoms was getting straight A's and, you know, only bringing back the perfect report cards and all of this. And that's an enormous amount of pressure. And you're right, it did get in the way of, yeah, just being a kid a lot of times.

[00:19:50]And so what's interesting is that while my my father died when I was 25 and that was the trigger for the first episode where my GP said I think you should see a psychotherapist and I had no idea what she was talking about because I had no idea what grief was. I had no idea that there was this emotion called grief that I needed to feel.

[00:20:13]>> Yeah. None of us has a parallel life to compare ourselves with. So, we just live the life that we get if if we are parachuted into a dangerous environment as a toddler. Um, we just have to endure.

[00:20:29]>> Yeah. And I love that metaphor. I've heard you say that metaphor and I think it's absolutely perfect. Um, it explains so much about how also um when we hear oftentimes about other people's neuroplastic symptoms, we go, "Oh, that's that's nice for them, but that doesn't apply to me." It's sort of the same thing with life. Like, oh, this is my unique story. It has nothing to do with anyone else. And it's like, oh, we're all parachuted into a separate jungle and just finding our way out.

[00:20:59]Yeah, it it is um something that took me a very long time to learn back in the 1980s when I first started doing this work was that this kind of environment that you're describing is every bit as challenging for a child as environments that are more obviously harming. um you know the physical sexual abuse, uh violence in the home, serious substance abuse in the home, everybody recognizes those as extremely difficult, problematic, harmful, but the kind of environment that you are describing um matches that in terms of the long-term consequences and it took me hundreds of interviews before that became clear.

[00:21:46]>> Yeah, absolutely. And I agree with you.

[00:21:49]I feel like when I first learned about ACEs or adverse childhood experiences, I thought, okay, so I had, you know, the divorce of my parents at age nine and my father died really before my brain was fully developed. I think we really don't stop developing our brains until 27 28.

[00:22:09]Um, so I really was still an adolescent in in as far as like neuroscience would say. Um, but I didn't understand that emotional neglect or as I love Dr. Bruce Perry, the way he talks about it is um, relational poverty. I think that's a really lovely way of saying it.

[00:22:30]>> I often refer to it as an emotional desert.

[00:22:33]>> Yes, an emotional desert. And that seems to be the common thread under all of the other aces. So, if you have someone who can help you feel your feelings and sit with you while you suffer and sit with you while you grieve the loss of a parent or even the loss of a pet or or a friend or what have you, that's a very different experience and it it doesn't necessarily have to have the same long-term impact on your central nervous system because you can feel those feelings. And so I just want to get back to what you had asked me previously about um not being able to just have fun, right? Having to sort of be the perfectionist or or work hard to be responsible.

[00:23:22]It wasn't until my father died that I fully swung into I have to make everyone else's life better mode. And so it was like I had contained it for my father like okay if I can just make him happy right by achieving and by doing a job that he respected and by making him proud of me but then when he was gone it's like I needed I needed the world to fill that gap. Oh how can I make everyone else's life easier? And so many of the interviews that I have heard of yours and people saying, you know, always like you say, putting everyone else first and I didn't even exist on the list of people that I was taking care of.

[00:24:08]>> Exactly. Yeah. It's so difficult um when you have learned a pattern at such an early age and your your self-esteem and your self-image are tied into um helping others uh as to the maximum level uh possible. I mean there's no limit on it.

[00:24:27]you know, the world is an infinite place and um some of my patients with chronic fatigue have, you know, been in that situation and the only thing that stops them from trying to save the world is when their own body shuts down. Um, okay. So, here you are, you are a pain psychologist and you have these enormous burdens that you are carrying. I I make another analogy to Olympic weightlifters who are carrying 50 pounds more stress than the world record for their weight class. Um but you have um intellectual skills that can be applied to this situation. Um what happened?

[00:25:11]>> Yes. I just want to correct you quickly.

[00:25:13]I'm not a pain psychologist.

[00:25:15]>> Okay.

[00:25:15]>> But my topic was chronic pain. I was actually in a physiootherapy department.

[00:25:20]So I was in an allied health department but no I'm not a pain psychologist just want to clarify that.

[00:25:26]>> Um >> right. So what was it that helped me?

[00:25:29]Well initially what helped me was just purely understanding that this was a stress response that my joint pain was sending me a message that I needed to get to the root of and I needed to really get to the root of it. Unlike in my previous neuroplastic symptom experiences, I was able to sort of move beyond and do other things that maybe helped me cope or get through the situation. But those symptoms lasted years and years and years. And only with the tools that I used this time around have I actually cured myself. Um, and so what can I start with? Um, I had been practicing EMDR or eye movement desensitization and reprocessing uh, as a form of therapy since I started my PhD.

[00:26:25]And that was because, uh, one of my previous neuroplastic episodes. Um, I had just spontaneously been introduced to EMDR by a stranger, just a complete chance.

[00:26:41]And it really helped me at that time, but I um I only went as far as I needed to go. Let's put it that way. I was not ready to fully dive into the whole pool.

[00:26:55]So when the when I woke up with the joint pain, I think I had been taking a break from therapy for a while at that point. And I called my therapist and I said, "You'll never guess what what is happening right now." And so I doubled down on digging into the emotional past that had led to my present situation being a trigger.

[00:27:23]Um, and at Francine Shapiro, who actually discovered and and then fully developed EMDR therapy, I think she's so good at explaining how when emotions are not felt and and allowed to be felt in the moment, the past is present. And that's what EMDR therapy helps to do is to process those original emotional memories which have sort of become stuck.

[00:27:54]And so that's what I did. Uh that's all I did. I I didn't do I couldn't do anything else. I couldn't do yoga. I couldn't even sit on my mat. I couldn't get up afterwards. If I could sit on the floor, I could not get myself up. Um I had gone to my doctor about five months in and this is a new doctor because we had moved to Europe. I had totally new um uh healthcare system everything and I had specifically told him here where I live they use the word psychosmatic and instead of neuroplastic and I said I have psychosmatic pain and I'm working with a therapist but I still don't have full use of my arms. I would really like a referral to physiootherapy just to help me release some of the muscles in my shoulder. I knew which muscles they were. I'm highly trained. I understood.

[00:28:45]I just couldn't do it myself. And for me, it was an act of showing myself that I could ask for help, which was really important because, as you know, a lot of people with neuroplast, we're going to do everything ourselves. We can do it all, you know.

[00:28:59]And unfortunately, this this guy matched the qualitative literature that I had spent four years studying.

[00:29:08]And he didn't listen to me. He didn't honor my request. He gave me a referral to an orthopedic specialist even though I told him that wouldn't help me. This was psychosmatic. I don't I would not use that referral.

[00:29:21]Um and so I never went to the physiootherapist and I never went to another doctor. [laughter] >> Well, [clears throat] yeah. European [snorts] doctors are supposed to be a little bit ahead of us in this regard, but uh clearly not uh not always.

[00:29:35]>> Not everyone. Yeah.

[00:29:37]>> Okay. So, what were the ideas that made the difference for you?

[00:29:44]>> Well, let's go back to about 2011 because that's when I first was exposed to um Dr. John Sarno's books and I had read the divided mind which I think a lot of people don't talk about.

[00:29:59]They talk about healing from back pain or whatever the back pain books are. Um but I had read the divided mind and I could fully understand what he was talking about there but it was only an intellectual understanding if you will.

[00:30:13]Um then I was introduced to EMDR in about uh 2015 and reading Francine Shapiro's books also solidified for me, oh yeah, there's a lot more emotional stuff here in my past than I realize.

[00:30:30]>> So it was the ideas that we've been talking about in this interview that more insight into those connections.

[00:30:37]more insight into those connections. And I would say also what supported me was interviews like the ones you do, but I didn't find you until after I had heard about Nicole Sachs and her the cure for chronic pain podcast.

[00:30:58]And so I had been listening to various of her podcasts and again it was confirmation. Like that's what I needed.

[00:31:07]I needed the support of other people's stories to say I am on the right path. I I fully believe right. I had no doubt in my mind that this was neuroplastic, that this was based on the my emotional past, that I was on the right path, that I had the right support, and I just had to trust myself that I was going to be okay. And that um this is something that I don't know if this is a bridge too far to talk about but in the original episodes in my childhood and I think this would be consistent but I have not studied this yet and I would love to.

[00:31:53]The whole point of developing symptoms was to maintain a relationship with my caregivers. Like I I'm not getting the care I need emotionally, but I know that if I get tonsillitis, at least they'll take me to the doctor. So there was the attention and the care. I was getting care. And I knew that as long as I didn't get angry with them and I didn't express my hatred at them for fighting all the time and all those things that children just cannot do, >> um I knew that they wouldn't abandon me.

[00:32:29]So it was like this this way of maintaining my attachment relationships.

[00:32:34]>> Yeah, that's un unbelievable pressure.

[00:32:37]>> Unbelievable pressure. And I brought that pressure into last year. So here I was I am married. I love my husband.

[00:32:47]He's extremely supportive. But my body was convinced that if I express the rage that I felt over having to leave, you know, this dream job and move back to the city where all my friends and family live and be so disappointed that we had to come back to Europe and live in a place I don't really like. And if I expressed all those feelings, my body was convinced that he would leave me. But that is not based on present at all.

[00:33:18]It's fully based on what I learned as a child. And even what I learned as a child was false. You know, we just don't have the capability of understanding the complexity as our brains are developing.

[00:33:31]So >> yeah, it's one of the questions that I always try to answer about my patients is [clears throat] what did you learn about yourself as a child that isn't true? I mean, did you learn that you need to take care of everybody else's problems? Uh did you learn that you are unworthy in some way? Did you learn that emotions are not a good thing to have?

[00:33:52]Um and it's also true that as adults, one of the most difficult uh challenges is to feel negative emotions um about people that you still care about.

[00:34:06]How were you able to uh to cope with that in some way that you might have, as you've already mentioned, u tremendous amounts of anger at um both parents um that had been repressed for a long time, but now it's knocking on the door. How were you able to cope with that? Because that's that's a huge challenge for for my patients.

[00:34:29]>> That is a huge challenge. I would say it's maybe the challenge is realizing that you can be absolutely furious at someone and still love them. And um that I would say is maybe the purpose of psychotherapy that is focused on childhood trauma. is the way that I put it is I needed to learn that I could express every ugly thing that I felt, every so-called negative emotion, everything in the presence of an adult female, my therapist, and know that she wasn't going to shut me down. She wasn't going to abandon me.

[00:35:12]She wasn't going to judge me. She wasn't going to tell me, "Oh, you're too sensitive." She wasn't going to shame me.

[00:35:20]for feeling.

[00:35:22]And I think that if we can just get everyone to realize [laughter] that it's that it's that shame that dreadful shame we carry around for actually having feelings that you know like we always talk about it's not our parents' fault. They did the best they could. They didn't have this knowledge.

[00:35:41]They didn't have this training. But we somehow end up with this message that we can't express our true feelings without being abandoned, without being ashamed.

[00:35:54]>> So that's what I experienced.

[00:35:56]>> Such an enormous flip when you're finally able to um feel those emotions consciously and put them into words. As I often tell my patients, the more they're able to put it into words, the less um those emotions need to go uh into the body and cause symptoms.

[00:36:16]>> Yes, absolutely. And I think that's where I did actually start um using Nicole Sax's journal Speak um as just sort of a maintenance method. Like I know there's stuff in there if I ever feel agitated. I know there's a lot more stuff in there than I want to admit and just getting it on the page is so so helpful and it is transformative. And I think that's what a lot of people don't realize unless they experience it. When you put all your screaming tantrum on the page, it changes and you no longer feel that way anymore. It's like getting it out. It's like if you had an emotionally regulated adult as a kid.

[00:37:05]You have a tantrum and then a minute and a half later it's over because someone is sitting with you and you know that it feels better after you let it out. And I'm not saying going out in public and you know hurting other people. I'm saying putting it on the page in front of you and just realizing that yeah, I have those feelings and it's okay to have those feelings and now I feel better.

[00:37:30]>> Yeah, it's a crucial transition. Uh that's not easy to do at all. And people deserve tremendous credit for being able to accomplish that because you're basically learning an entirely new way of living and thinking and feeling uh than you ever had before. And it's not easy to do uh in midlife when your brain is wired uh in a different way. Uh what about the um ability to take time for your own joy? That's a critical essential human skill for my patients.

[00:38:06]Uh did you find that you're now able to put yourself on the list of people you take care of?

[00:38:12]>> Yes. And um it has been a process. It has really been a process. Um [snorts] I've been very aware of the tendency to put other people first. And even as far as a career goes, it's very easy for me to choose something that makes someone else's life better versus something that really fulfills me just in the doing.

[00:38:41]And so, um, that's been a big a big learning experience for me as well. But identifying what I like to do just for me, just for fun, just for not having a result come out of it, that has been one of the hardest things I have ever done.

[00:38:59]>> It is.

[00:39:00]>> You would think it would be easy. I mean, just I tell my patients, I want you to go out and learn how to play, you know, and if you gave me a couple hours a week to just do something to play, um, I can think of all kinds of things to do. But people who have never done this, it's a huge challenge. Uh not least because of the guilt that they feel while they're doing this. Yes. The guilt. And for me, it was the feeling of something has to come out of this. Like there has to be a result. There has to be a product. There has to be something showing that I It's the achievement thing that I grew up with. But play isn't about achievement, you know, enjoying myself. Life shouldn't just be about achievement. There has to be a joy in the doing. And um yeah, that's been a real process. So I I've been trying everything. I music is one of my favorite things in the world. So I spend a lot more time now just deeply listening to music. Um, comedy, watching comedies, one of my favorite things ever, specifically and intentionally making time to do those things pretty much on a daily basis. Um, it just makes my life a thousand times better >> and I'm not constantly obsessing about like, oh, how can I create something that helps other people all the [laughter] time?

[00:40:28]>> Yeah. Well, you can you can always fool yourself a little bit and say, you know, this is um productive because it's good for my mental health.

[00:40:36]>> Yes. Yes. Exactly. [laughter] Which it is true. [snorts] >> Absolutely. Um >> Okay. Um and then another transition that many of my patients are able to make uh eventually is that when they experience symptoms uh in the future, they are able to immediately use that as a form of communication that their mind is in a state of distress and to try to figure out what that distress is. And that turns whatever the triggers are into useful information instead of u a cause of disease.

[00:41:13]>> Yes.

[00:41:14]>> Have you been able to um to make that transition where if if symptoms crop up uh you use them uh to look at the environment you're in and and events that are happening?

[00:41:27]>> 100%. 100%. I mean, literally ever since I woke up a year ago and my joints hurt.

[00:41:33]I I haven't been to the doctor for a symptom since then because once I identify the triggers and I write about it and I sit with myself and I have conversations with myself, the the symptoms go away. I mean, that again, it's like being the the adult with the regulated emotions in the room. like, oh, I'm sitting with the younger me who's feeling something big and scary and then it goes away. So, I I'll share just one um example of that. So, you've heard of rosacea?

[00:42:10]>> Yes.

[00:42:11]>> Yes. And >> skin rash for our our viewers.

[00:42:14]>> Yes. Skin rash and you know sometimes very very bright red cheeks and sometimes peely they look like acne but they're not acne.

[00:42:23]And I had been getting these uh on my face in particular my cheeks sometimes my nose um when I would do certain things. So if I would be I don't know having a conversation with someone about something personal um I had just presented my case study actually at a psychosmatics conference and I was practicing my presentation with a friend of mine and it was like my cheeks were on fire. I mean, just so bright red.

[00:42:55]And I I know that rosacea is also neuroplastic.

[00:43:00]And so I started to really sit with that and journal about that. And there was so much shame, so much shame about sharing my story, about going back and don't go back and look in those closets. You know, your childhood was fine. Don't don't tell other people about all that messy stuff. And that's the kind of stuff I just wish we could normalize, you know? I wish we could just have these conversations and be like, you're human. You're this is what hap this is what we do with a human brain and a human body. Like if you can't feel it because it's too scary, your cheeks are going to get pink, you know? Like it's there's nothing wrong with it. It's just >> like you say all the time, it's just telling you something. And two people who appear the same, who appear to be carrying the same burden of stress, um they're not quite frequently. Um you know, my very first patient was carrying an enormous burden of stress and nobody knew except her husband. Uh and but [clears throat] as far as anyone else in her life, in the workplace, amongst her friends knew, um she had lived in a perfectly ordinary life from childhood onwards. and it was anything but um and all of that uh stress that she suffered as a girl was u having a massive impact on her body at age 37. But again, if if you just met her casually, if you were working at the desk next to hers in the workplace, um you would never know what she was carrying.

[00:44:42]All right. One [clears throat] last transition I want to ask about is that many of my patients come out of their childhood experience uh with a long-term sense of unworthiness um that they are just not as good as uh other people. And that [clears throat] is a very hard thing to turn around uh because you've acquired it at such a young age frequently from the people who are most important to you uh in your life. Uh and I encourage people with that parachuting into the jungle analogy to recognize how much they endured. uh you know to imagine a child they care about growing up in the same environment and how they would feel about that child's heroic perseverance in coming through all of those experiences to try to generate a a change in their self-image and how they look at themselves because that has ripple effects on so many other areas of life in in your relationships both personal and and workplace uh [snorts] your ability ability to take time for personal joy without guilt is a lot easier if you think of yourself as a worthy human being. Um have you observed anything along those lines uh yourself?

[00:46:05]>> Oh yeah, absolutely. Yeah, there was definitely and you know for me it was all associated with the my worthiness coming from what I produced or what I did for other people.

[00:46:22]So it was associated with my job or with earning a paycheck because then I'm you know contributing to the finances of the family. that the idea that I could be worthy and unemployed was one of the biggest caverns that I had to cross. I could not fathom. How can I be worthy if I'm not earning money? I I started a job when I was 12.

[00:46:51]I mean, I started a business when I was 12. I I just I have to be contributing financially or I'm nothing. That was really deep for me. So now I'm still unemployed. Here I am a year after the pain started. I have no pain. I have no disability. I'm perfectly fine. And I know with 100% certainty that I also have value despite not being able to find a job where we live.

[00:47:20]>> So but yes, it was an enormous problem.

[00:47:24]Well, you've you've done this in an incredibly short space of time, especially considering where you started out. I mean, these um are neuroplastic changes uh in the brain that are I don't know like learning to pull vault from scratch. I mean, it you know, when you learn to pull vault, it's an enormously difficult task. You have to do 10 things correctly to make it happen. Um, and a a tremendous amount of neuroplasticity has to take place before you, you know, don't hurt yourself. And, you know, if you get even nine of the 10 correct, you're still likely to hurt yourself.

[00:48:04]Um, and yet uh, you know, that transition is something that uh, you have managed to do um, in a short space of time. And I should give yourself tremendous credit for uh for pulling this off cuz it's uh uh something that any human being struggles with.

[00:48:26]>> Yeah, thank you for that. I appreciate that recognition. And I just also want to say it's I mean it's been decades in the making, you know. I mean I I've been studying this and learning it intellectually for 20 years. So it's it wasn't new information to me. It was just a new embodiment, let's say, like I was I was in a supportive relationship. I can't stress this enough. I have an incredible partner who supported me through all of this and let me be completely broken down on some day. I mean, the emotions were huge, David. I can't stress this enough, but I had a safe place for them in my relationship. A lot of people don't have that. And I also had an amazing therapist who was also extremely supportive and not trying to get me to change and focus on my beliefs and change this and she was simply a supportive presence who understood that she needed to relate and support me in a way that I needed. And I couldn't have done it without that. If it was just me or if I had, you know, several children and I was a a single mother. I I don't know how many many people are able to do this work. I was in a very privileged position.

[00:49:53]>> Yeah. That support makes um such a difference. and and the style of psychotherapy that you had also is the difference between helping people cope with their symptoms and helping people relieve their symptoms.

[00:50:07]>> Bingo. Yep.

[00:50:08]>> It it reminds me also that many people who grow up in environments where they are needing to be highly supportive of the adults around them have a tendency to choose partners that need that kind of support as well. and those that you know they choose people who have problems or issues or um that are demanding of uh support and the relationships end up uh quite unbalanced. Um and that's uh as you can imagine a perfectly natural place to end up when you have learned um that that's your role in life is to be supportive of other people and fix other people to wind up in close personal relationships where you're doing exactly the same thing. So finding somebody and feeling worthy of somebody that uh gives back to you as much as you are giving to them uh is really difficult to pull off um based on talking to a lot of people. So um that was um another accomplishment uh that uh goes against what you learned as a kid.

[00:51:20]>> Yes, absolutely. And I can tell you with 100% confidence, if I hadn't already had that first experience, with a very good EMDR therapist prior to meeting my husband, I I wouldn't have recognized that I deserved someone so supportive. So, you're absolutely correct. all of my previous relationships, it was like I was lurking looking looking for the people who needed the most support, you know. Um, and without having healed that belief and that feeling that I had that I have to I have to help everyone else um it it never would have happened. I never would have been able to find someone who is so amazing. Yeah.

[00:52:05]>> Yeah. One of my patients um didn't find that person until he became her husband number five um at age 54. [snorts] Um but once she found him, you know, just they uh couldn't have had a better relationship, let's put it that way. But husbands one through four, um not so much.

[00:52:29]>> Not so much. Y >> Okay. Okay. Well, I have tremendously enjoyed this conversation. It's been incredibly insightful uh with so many uh excellent ideas in a short space of time. Uh do you have anything else that you'd like to share or any questions that you have for me?

[00:52:49]>> Thank you, by the way. I really have appreciated the conversation, too. Um, you know, I just I wrote down a couple of things because I'm so happy that the ATNS exists and I'm curious.

[00:53:03]Are you doing research in this area? Are you somehow able to get funding to, you know, research those of us who have recovered? I feel like there's so much depth here and we need to put it in the hands of clinicians because they have so much power in this scenario and so many of them just don't have the training. So can you tell me a bit about like what are you doing as far as research and how are you going about educating clinicians?

[00:53:34]>> Yeah, we uh absolutely uh support research. We uh crowdfunded the Boulder back pain study and the success of that um led to u unlocking the doors for a lot more funding from much bigger research uh institutions and some of those studies have now been published and there are many more um in the pipeline. At that very first study, nobody wanted to study this. Um, and so we finally found somebody who was willing, uh, which was the CU Boulder group, but they said, "You have to fund it." And so we got, um, a crowdfunding site going and received donations from over 500 people from around the world.

[00:54:21]And that really unlocked the doors uh, for much of what was to come. We also uh support um national public opinion surveys about neuroplastics and we've published two papers on the first survey and the second survey is currently being analyzed. So um our whole mission is to educate health care professionals and the public um about diagnosis and treatment of this condition. and that's what the ATNS uh is for. And we are doing that in a variety of ways. And we're recording this in the summer of 2026 and expecting in a few months to have a brand new website. Um but we're always doing uh new things um on uh public presentations and social media to uh get the word out. Uh I I personally have done hundreds of uh television and radio broadcasts, podcasts, um uh print journalism articles um to try to uh spread the word about this. Um and we're we're having much more success uh today than we were even just a few short years ago. And expect that to u continue to accelerate. And a tipping point is coming in which it will be common knowledge that your brain can create symptoms uh in the body and that will change everything because people will wonder well why is my brain doing this and they will start uh investigating everything that we've just been talking about.

[00:55:53]>> Yeah. Yeah. I I just want to get it into medical education. That's like my my big dream is to just have it a part of the medical education system.

[00:56:02]>> Me too. I'm teaching [snorts] in my medical school. Um, my first [clears throat] my first book, they can't find anything wrong, was used as a textbook uh in both medical schools in Slovenia, not far from where you are.

[00:56:14]>> Great.

[00:56:14]>> I've been teaching physician associate uh uh students uh for 30 years. I've been teaching internal medicine residents for 30 years. Uh so um it's at least in my community of Portland, Oregon, it's uh it's there and um that acceptance is going to be shared um everywhere before too long.

[00:56:37]>> I hope you're right. [laughter] >> Yeah. Once it's because once you see this, you cannot unsee it. And it uh people who are medical professionals um enjoy this. There was a doctor who learned these concepts from one of our online courses >> and she took me aside at a conference and said that these ideas had put the joy back into her work.

[00:57:02]>> Yeah, I believe it. Yeah. And it it allows it allows clinicians to connect with people again instead of treating symptoms. Do you know like being a human with another human instead of investigating a car like a mechanic?

[00:57:22]It it it's just a different way of being, I feel like.

[00:57:25]>> Yeah, you can look at the patient uh instead of your keyboard and your screen.

[00:57:32]>> Yeah, [snorts] good point.

[00:57:33]>> All right, Sarah, thank you so much.

[00:57:35]This has been incredibly enlightening and I'm very grateful to you.

[00:57:39]>> Thank you. I'm grateful to you as well.