- This is a woman who came to see me.
This is her first visit.
She has pain with sitting, right?
So when she sits, she says, my sits bones are so tender,
it's like bone on bone grinding.
That's what it feels like for her,
it's been going on for three years.
It started when there was a conflictual situation
in her family.
And she can't sit for more than a minute on the chair,
any chair, without squirming and having to stand up.
When she stands up, the pain goes away.
When she sits down, it comes back.
So it seems like it certainly could be structure,
when you sit down it hurts,
when you stand up it doesn't hurt.
But I had gone through all of them, all the work,
et cetera that we do.
And I had determined that this was a mind-body pain.
So now we're gonna do this kind of activity just like we did
with Esther's help with touch.
But now we're gonna do it with imagining the trigger.
Like she could imagine if it was rainy weather,
she could imagine going out in rainy weather
and see what her brain does.
In this case, I'm gonna have her stand up
and ask her to imagine sitting down and see what happens.
So what happened is I asked her to imagine sitting down
and she said, I feel it in my stomach. Right?
She didn't get the sensation in the butt
where the pain occurs, but she felt it in her stomach.
What is that? Tension, fear, anxiety.
And so I'm saying, yeah, your brain is afraid of sitting.
It's showing, it's afraid of sitting by getting this tension
and anxiety in your stomach.
So now I'm asking you to just breathe and calm the brain
and just see what happens as you watch
that sensation in your stomach, without fear,
without worries, basic mindfulness activity
in relation to a sensation.
And then it'll calm down.
- So this is, you know, amazing.
I mean, she can't sit down for three years.
And then in the space of one visit
and just changing the neural circuits
by bringing on the fear purposely,
just by imagining sitting, getting fear,
and then calming that fear.
Imagine sitting again, getting fear here. Calming the fear.
Imagine sitting again, feeling her legs pull up.
And each time she increased the amount of stimulus
on her own from a soft chair to a hard chair,
to a dock, legs dangling, is amazing.
And then she could sit down.
Now when she goes home, is that pain while sitting
gonna come back?
Yes, it will. (chuckles) Absolutely.
That's not gonna totally change the neuro circuits forever.
I mean, some people it actually might,
but usually it doesn't.
So she'll have to do this again
and she'll have to work with it.
But now she knows, she can see, I can sit, I will be okay.
I'm gonna be fine.
And I just have to keep training my brain out of this
fear, danger, alarm reaction.
And I'll feel better.
And then she ties it to emotion.
You know, all of a sudden, all the emo-
She was yawning that whole time, right?
That yawning is emotions coming up.
And then she just started to cry
and let everything come out, which made me very happy.
It was so great when someone cries, I'll show you tomorrow.
It's a good sign. So it's an amazing little encounter.
But we do this every day.
We do it with imagining weather, imagining driving,
imagining sitting, imagining bending,
imagining turning your neck, whatever the trigger is,
you can use the brain's imagination to bring on a sensation.
And this works, this, in my experience,
it works about 70% of the time, which is really high number.
It's pretty amazing.
But 30% of the time, roughly it doesn't work.
You say, yeah, I imagine turning my head,
I didn't feel anything.
There was no reaction or I imagined sitting down
and I had no reaction at all.
In that situation I just keep going.
What I do is I say, well, we know this...
And what I'll say is, this is really a good thing.
Oh, that's great. You didn't have any reaction.
You know, some people, you'd be surprised,
but some people, when you have 'em imagine sitting,
they actually get the discomfort.
Their brains are so sensitised.
So I'm using it in a positive way of saying,
"Hey, you're not that bad."
Not to say you're not that bad.
You know, not to minimise it,
but to say, you know, your brain is not so sensitised.
We can work with that.
So then I'll just go to the next step,
because I already know from my other criteria,
the functional, the inconsistent, the triggered,
all the exercise, everything we did yesterday,
I know that it's a mind-body condition, if I know that.
I wouldn't be doing this, if I didn't think,
if I didn't know, it is a mind-body condition
in the first place.
So then I just go to the next thing.
I just go right to the affirmations and I go, okay,
well let's do the affirmations and then we'll have you sit,
let's do the reassuring and the calming and the smiling.
And then we'll have you sit
or we'll have you turn your head.
But if it's sitting, I might have 'em sit for five seconds.
Just a small amount, 'cause you wanna sit without fear
for a certain amount of time and then get up
and then sit without fear again
and then sit without fear again.
So you're training the brain, like training a puppy dog.
Or if it's neck movement, you'll see on the video,
if you look on my website, these videos,
there's Jenna, my niece was acting for me.
And if someone, if they have pain with turning their head,
I'll say, well just start a little.
Just a little turning your head and you're smiling
and you're saying, I'm safe and I'm not in danger.
And you turn your head a little,
then you turn a little more,
and then you turn a little more.
And then you do it with freedom.
And then you do it with joy. And you do it.
And then you're just training your brain.
And pretty soon they're turning their head the whole way.
And then they can do that at home.
If it's walking.
Pain with walking, you'll start with doing
all these exercises, imagine walking.
And then imagine walking with joy basically. And safety.
Joy and safety.
And then walk with joy and safety for five steps.
And then 10 steps, and then 20 steps
or half a block and then a block.
And then you gradually build up.
- What would you do if the problem is not something
that hurts, but having a thought
and you just need to stop thinking about something.
- Oh, a thought? - Yeah, a thought.
- Oh yeah, yeah, yeah.
Yeah. Definitely. Yeah.
We work with that all the time.
- But what would be the procedure?
How you're thinking about the pain.
But you're thinking about thinking.
- Yeah. So sit here...
And tell me what thought first pops into your mind.
Mindfulness 101. Let's welcome the thought.
Embrace the thought. Look at the thought.
Separate from the thought. Watch the thought.
Say thank you.
Any other thoughts? What's your scariest thought?
Bring it on.
So we wanna expose people to the thing
that they're most afraid of in small doses.
And thoughts, definitely, I work with scary thoughts
all the time because your brain is going to...
When your brain is fearful, it has to,
wants to send a message,
in order for a message to be effective,
it has to be loud or you know, you have to notice it.
A message that you can't notice is not gonna be effective.
In essence, the message has to be scary or alerting.
And our brains are very good at sending physical messages
of fear, such as pain or anxiety or fatigue
or depression or insomnia.
But our brains are also really good at
sending scary thoughts.
Every patient I have has physical scariness
and thought scariness, every single one.
So we wanna treat the thoughts in the same way.
We're treating these sensations
by calming the brain in relation to the thoughts,
making the thoughts less dangerous, less scary.
And I always tell this story
'cause when I drive across a bridge or on a highway,
I have this thought
and the thought is, maybe I should take the car wheel,
turn it very fast, and flip the car over and crash.
That's a scary thought. (chuckles)
When you think about it, it's a suicidal thought,
it's a depressed thought.
If I wanted to believe that thought
and make that thought my own
and see that it's really an important thought,
and why am I having that thought?
I can analyse that thought.
And it might take me down a path of therapy,
antidepressants, all sorts of things.
But I don't do that 'cause I keep having this thought
and I'm not actually depressed.
It's a thought.
And it's not even my thought.
Where's this thought coming from?
It's coming from my brain.
It's not my thought. It's not my higher self.
It's not who I really am. It's my brain.
My brain has this thought and I just say,
"Hmm, thanks. That's interesting thought brain."
And I've had it so often that it doesn't bother me anymore.
And then I'll have it less often.
And I can't tell you how many people have said,
"Thank you for telling me that, because I have these
really scary thoughts."
Everyone has really scary thoughts.
- [Student] Aren't all thoughts from the brain?
- What? - Aren't all thoughts
from the brain?
- Yeah. And 95% of our thoughts are actually subconscious.
You're not even aware of most of the thoughts we have,
which is really mind blowing.
And you can't control what you think.
Your thoughts are gonna come all over the place.
Happy thoughts, scary thoughts, silly thoughts,
scary, evil thoughts, petty thoughts.
How many times have I had a thought that's kind of evil?
Like maybe I should, you know, do something bad or wrong.
I have those thoughts, you know?
And if I was Catholic, good thing I didn't grow up Catholic.
No offence. (chuckles)
But if you grow up Catholic, sometimes they say
having the thought is just as bad as doing the thought,
which is really not good, I don't think,
to teach children that having a thought is
you're an evil person 'cause you had an evil thought.
Everyone has evil thoughts.
How many little boys think about masturbating?
My God. (laughing)
Anyway, so we work with thoughts a lot.
It's a really important question, really important thing.
And I think of it in a similar way.
Oh, one more. Yeah. In the back. Sorry. Yeah.
- Same idea, that same person, if they disconnect,
they numb out because it's a trauma reaction
when they're even imagining it,
but they can't feel it.
How do you deal with that?
- Yeah, if they're so sensitised that they dissociate
or they become completely numb with
a very small sensation,
they're probably gonna need some emotional processing work.
I would think.
- In that moment you...
- I would stop. - You stop the process?
- Yep. - Yeah, I would stop.
Because you have to kind of bring them back.
You have to orient them back to where they are.
'Cause their brain is saying, "Oh, I'm not doing,
I'm outta here."
Boom, I'm over here and we want them here.
And so yeah, that...
And that's a sign that the stimulus was too strong
for them at that time.
And so we either have to start with smaller stimulus
or we have to do emotional work to help them
in the sense of how their danger signals being turned on
by even the slightest thing.
And those are hard, difficult situations.