The Truth About Managing Chronic Pain (w/Dr. Rachel Zoffness)

Why do we reduce humans who suffer with chronic pain to simple molecules and receptors? Pain psychologist Rachel Zoffness, P.h.D. returns to talk fibromyalgia, stomach pain, anxiety, the role of trauma, and much more.

Key Topics:
0:00 Intro
1:14 The bio-psycho-social nature of pain: phantom limb pain, the limbic system & emotion-pain connection, social contributors
9:00 The stigma of “psychological” pain and holistic approaches to managing it
16:15 The concept of “pain volume” and how emotional states affect it
18:56 Releasing negative emotion: the idea of “tea-kettling”
26:21 Fibromyalgia & trauma, pain amplification and “central sensitization”
33:14 The importance of desensitization practices for chronic pain
36:14 The benefits and risks of narcotics, the danger of removing them too fast
40:41 Sympathetic nervous system, the interaction of trauma and adverse childhood experiences (ACEs)
47:44 Placebo & the mind-body connection
53:34 Anxiety/Depression and overmedicalization by Big Pharma
1:00:00 Non-pharmacologic treatments for pain, anxiety, and depression
1:04:06 The mind-gut connection: Irritable Bowel Syndrome, performance anxiety, and more
1:11:14 Emotional repression, fear of speaking and exposure therapy, PTSD
1:18:28 Imposter Syndrome and Dunning-Kruger effect, gender roles (vocal fry/uptalk)
1:25:00 The problem of emotional repression, and solutions
1:28:37 How biofeedback works

[kborges]

The fact that she doesn't ever lose her train of thought even with all your shenanigans 😜. Seriously though - very eye opening. I think I need to get this book!

[loraemerkle]

This is one of the best discussions/interviews that I didn’t know I needed!! Bravo! Can you make her a monthly content contributor?? 😍😉😊🥰

[derrickforeal]

I have severe cervical stensosis with formidable stensosis. 8 buldging disc and 7 herniated disc with severe early disc degeneration. Pain medication in my case is a must and my brain cant overcome this pain on its own. I dont wish my pain on anyone, but sonetimes i wish these people could live in my body for a day, i dont think many could handle 2 minutes.

[shannonsayer]

Rachel, thank you for pushing through your anxiety! I'm an ortho and GI nurse and we use narcotics for pain all the time, but it feels like an incomplete treatment plan. This was so helpful to learn about all the other factors that can be affecting my patients' pain too. I will remember this in my nursing. Be well!

[sd]

Thank you so much for this. I couldn't stop crying. I felt validation in this. I have been suffering with pain since I was 14 and diagnosed with endometriosis when I was 25. I was brushed off for so long and then became a guinea pig when it became a topic. I have had childhood trauma. I always knew it was linked. Thank you

[ladyfotoartist]

I have Ptsd, fibro and other issues I cried through this whole talk. I understand myself so much better... thank you! I have hope after living with pain since I was a teenager. I plan on purchasing the workbook soon.

[jennifersharper]

Thank you!!! I have lived with chronic pain and depression for 20 years. Went to school for nursing and psychology, and never finished because I always felt so broken. When Dr Z stated that our brains are not broken I truly tea kettled. The guttural pain filled scream that tore from me startled my 2 huskies and they both howled with me. Thank you for explaining the science and validating the pain is real and not just physical or crazy pain. It seems like my doctor always tunes out when I talk about the pain and refuse his push of big pharma. Holistic doctors are hard to find particularly in the conservative mid west. Thank you again. Makes me wish I lived In California just to see Dr Z.

[nanidogmomstevens]

I have never heard such complete explanation of chronic pain. Thank you so much, doctors. Be blest☦️👩🏻‍🦳❤️

[aimeereed]

This is absolutely fascinating!!! As nurse who works in pain management I found this quite helpful. Thank you!!!

[iacomus]

Would love to see a specific episode on migraine with Rachel. Migraine is the number one pain condition globally.

[nanidogmomstevens]

Pre pandemic, I was in moderate clinical depression that would not respond to medication. Thank God, I met a psychiatrist who had studied TMS. I was as compliant as I could be. At 69. It was a life saver! Thank God, Medicare covered it. Thanks for your sharing all this info. Be blest☦️👩🏻‍🦳❤️🌸

[Jason]

I live in chronic pain and quit pain meds after 10 years and my pain decreased after a few months.thank you for explaining that I have the power to influence my own body from with-in.You made it so easy to understand and explain to my family .I know God can and does heal but He gave us magnificient brains to heal, too.I loved this show and both dr.s.

[cindywannamaker]

Rachel, you should put together a curriculum for teaching grade schoolers about emotion. It would be great for primary school counselors!

[Hibernia]

Having been through the chronic head pain mill, a big problem is dismissive doctors who don't understand the psychological aspect, or they just assume it's "just migraine", when it's not. So many people I know have left doctor's appointments in tears.

The book is phenomenal.

[jefgroesbeck]

As a doc that (successfully) helps patients to resolve pain and other persistent symptoms through this model - THANK YOU. Just wish there were more of us. Every article and video like this helps!

[susandameroncote-eagle]

My husband and I just finished listening to this show. Thank you so much, Zubin and Rachel! This is literally a life saving message that so many need to hear! I am definitely sharing!

[kellieedwards]

I am blown away. I started into this episode to try to understand my fibromyalgia and other chronic pain patients a little better (I am a gynecologist - emotional pain anyone? Everyone blames my organs and hormones!!!). I absolutely loved all of it and then we came to the public speaking part. Fight or flight I’m familiar with... but FREEZE struck a nerve x 100. I have to pass my oral boards this year to keep my job and I’ve failed twice. I promise I’m a good doc. I know my stuff and I’m an awesome surgeon for the things I do. But when I get to oral boards I am FROZEN. I say crazy shit and I even hear myself saying it and I can’t believe what I’m hearing. I cried so hard listening to that segment and I appreciated it all so so much. I also am a California native and raised as a female very deferent to males so that all made so so much sense. Thank you for the blinds analogy, I think I have a plan involving oral board interviews which I don’t look forward to but are probably the only way to desensitize my brain. Slash gut.

I work now in a rural setting in Oregon. I love it here but there is SO MUCH socioeconomic and psychological component to every patient. Being a gyn, of course people come in and say I’m in pain/hormonal/depressed and anxious because of my hormones. There is no access to psychological care (Ltd SW available at best) and no insurance coverage. I FEEL so so deeply about the issues you raised. I have always understood the mind body life connection and it is so so difficult to try to treat patients appropriately when they don’t want to hear about anything but pills and the insurance co won’t cover anything but pills. It’s a huge system ERROR.

I will order your book and send it home with patients I think need it. After I consume it of course. An hour and 40 was a big time commitment for me but that was time SOO well spent. I will watch again at least a few times and use with my patients to my best ability. Thank you for not letting fear overcome you and doing this interview. You helped at least me, and any patient I can get through to with the things I learned here. 🙏🏻

[barbloft]

My young adult daughter has debilitating endometriosis... heartbreakingly debilitating. This information gives me hope! I just bought the workbook, so I can learn more (I'm an RN and LPC, but have never heard much of this before.) Thank you SO much for this!

[wareontherun]

Absolutely loved this discussion. The whole process of getting a fibromyalgia diagnosis 15 years ago felt like I was pieced & parted & each doctor looked at only one piece & I was told it was in my mind or I was depressed or has anxiety. I went through every drug put there with terrible side effects. One time I was placed on Zoloft with major side effects & when I removed myself & saw the doctor, he said I should have stayed on the medicine because I was anxious. I was Anxious because he was not listening to me. Over the past 11 years, I had to quit my job & I have listened to my own body & removed myself from all meds except a small amount of savella. I have learned to roll with the good & bad & understand I have a lot of control. Thank you for this session. It was wonderful.

[elizabethlewis]

I am a successful RSD/CRPS patient. Wish I could explain how i was successful in getting into remission to others suffering. It has so much to do with mind & body healing together.