Your Mind-Body connection drives the ongoing process of IBS, chronic pain, fatigue, or chronic illness. It can also be your greatest strength in helping heal these and other difficult chronic problems.
Despite what many people say, there is hope for healing Irritable bowel syndrome, fatigue, chronic pain, and other chronic illnesses so that you can live a satisfying and meaningful life. One of the keys to healing, is to understand the complexity of these syndromes, and the underlying biological imbalances that give rise to the symptoms.
The first two posts in this series talked about the systems-biology model of chronic illness. They show you how these syndromes of chronic pain and illness arise from the integration of your body-wide-brain, digestive system, immune system, hormonal system, and so-on. These are the principles that have helped me to help many people who were thought to be helpless. A word of caution: if you learn this stuff, you might know more than your regular doctor about it, so be careful.
This post is going to help you understand why and how you can mobilize your mind-body connection to help yourself heal.One of the most common mistakes that I see people make, is to do all the dietary, nutritional, and exercise stuff, while they don’t adequately take charge of the power of their mind-body connection.This lesson answers crucial questions that you should understand, if you want to heal:
How does the Brain-Immune-Gut-Hormonal integration create and perpetuate chronic illness and chronic pain?
What is the influence of the vagus nerve on all this?
How can you stimulate the vagus nerve to start reversing the disease process?
Why should you care that your brain and stress-response has cognitive, emotional, and physiologic aspects to it’s function?
What is the cell danger response, and why is it important in your healing process?
What are the six steps of mind-body healing?
In the near future, we will talk about the healing power of movement. Even if you feel too tired, weak, or have too much pain to move, there are things you can do to build your freedom and capacity for movement. And movement is one of the best medicines we know!Please comment or reply and share your thoughts, questions, and comments.I look forward to hearing from you.Scroll down for full transcriptSLIDE PDF so you can take notes if you want.
Did You Know:
Dr Shiller is responding to the chaos and overwhelm of the corona pandemic by offering regular free stress-busting mind-body training sessions on zoom. You can get the schedule and register at www.mindbodygroove.com
Dr Shiller is available for telemedicine consultation worldwide regarding chronic pain, fibromyalgia, autoimmune disease, fatigue, and stress-related illness. Contact the office or schedule a consultation at www.drshiller.com
Inner Healing Essentials is an intensive six-week course taught by Dr Shiller, which teaches you the Six Steps To Inner Healing. It empowers you to transform stress into vitality, and begin to take back your life from chronic pain and illness. A new class begins quarterly. To get more info and be notified of the next start date: https://andrew-david-shiller.mykajabi.com/inner-healing-essentials-waitlist.
Hey, my friends, welcome back.We are talking today and then continuing to talk about three things that you should not miss in healing, fatigue, irritable bowel, chronic pain, and allow the symptoms that go along with or can be associated with those things. Today, we are going to get into the nuts and bolts of like, okay, how is the person actually healed? What do you need to do and what do not you want to miss? So, listen up to this. We are going to focus today talking about your mind-body system and how foundational it is to your healing process. So, a little background, the first couple of videos really talk about the complexity of your health and the complexity of disease and the different underlying physiologic imbalances that give rise to it, and we talked about a particular case. We talked about a guy who I saw. His name is Robert. He is in his 40s. He is a great guy, intelligence, sweet, motivated, really wants to do good things with his life, but he has completely stuck and cannot function. He has got so much abdominal pain and digestive symptoms that he cannot leave the house in the morning, he is fatigued, he can barely do stuff until the afternoon. He has got increasing anxiety. Lately, he has been sleeping so well at night, and he really feels like life is getting away from him, and he is not accomplishing what he wants to accomplish in life.–Next Slide–Okay, so here is Robert’s case, like I just shared about what was going on with him, and to give an overview of what I developed in those first two videos, which I really encourage you to watch, they go into a lot of depth and it really might illuminate a lot to see those first two videos about how to understand all these things [01:36] you, but as an overview, okay. Your mind is more or less the main place that you perceive stress, danger or challenging circumstances as a profound impact on your body, and why? One of the main things is that connection of your brain and your gut. There is something called the gut-brain axis that we have known about for centuries and centuries, a lot of the early philosophers talked about, all disease starts in the gut, and science is starting to finally figure that out and pretty much every professional journal, every professional specialty is talking about gut-brain axis as it relates to diseases in rheumatology and psychiatry and orthopedics in everything, and one of the main ways is that we have got this gut-brain axis. When a person has stressful, dramatic, difficult experiences, some of the changes that we see are dysbiosis which is a change in the actual biome of what is living in your gut, something called increase intestinal permeability as well as the tendency towards more inflammation, both locally in the gut and systemically. It gets more complex than this, right? Because those changes affect the immune system and you can get dysregulation of the immune system, that can show up in a lot of different ways, and again whether it is allergy, autoimmune disease, chronic illnesses that have an immune component, chronic pain which is related to immune disturbance or a variety of other clinical issues, immune dysregulation is part of that, and we are more and more seeing that the gut is part of which drives that and that an immune dysregulation feeds back into the gut. Oxidative stress is the shift in fundamental metabolic processes or biochemical process that happen all of yourselves that is related to immune dysregulation and again it is a two-way street where they affect each other and immune dysregulation feeds back in your brain. When a person gets a virus and feels sick and tired, it is because immune chemicals are circulating from the immune system, fighting that virus or infection and they go to your brain and they make you like lie down and sleep so you can heal, but what happens when the immune system is chronically dysregulated as you get this chronic impact on the brain, which can affect things like brain fog, energy, cognitive status, and brain inflammation, which can do a lot to make you sick, and then what is going on in your brain feeds directly into your immune system. One of the biggest stimulators of your immune function is acute stress and that actually empowers immune function, and one of the biggest things that impairs your immune function is chronic stress. So, again a two-way street of relationship, and then immune dysregulation has an impact on pain transmission, and we learned about how pain is not just like an electrical wire, it is an electrochemical flow of inflammation from the place that hurts to the part of your brain where you experience it, and your volume can be turned up, and then pain in itself could actually affect immune dysregulation, and that is intimately connected, what is going on in your brain and stimulating your stress response and feeding into all of this, and your cellular function, the core level of yourselves, your cellular energy production, metabolism, and DNA synthesis is influenced by immune dysregulation, influenced by stress and mind-body issues and influenced by what is going in your pain transmission system, and so this is a web of relationships. It is a cycle of relationships that evolve to protective you but frequently is what keeps you sick, and so that is what we are going to start about, talk about unpacking. So, let us like get some more layers here so that you can understand what I am talking about. –Next Slide–So, we talked a bit about the way we think about things in functional medicine as compared to conventional medicine. We think about antecedents, these were like early life stuff that set the stage. Triggers, transient events that happen in life that can shift the system, and then mediators, persistent changes in your biology, your biochemistry, your immunity, your gut function, stuff that like perpetuate and keeps you sick. So, antecedents like genetics and early life stress or trauma; triggers like stressors, infection, drug or chemical exposure; mediators, stuff like dysregulation of hormones, not sleeping well, stress and anxiety that persists, immune dysregulation, the fundamental things that go on in irritable bowel, like pain, dysbiosis, malabsorption, inflammation. These feed into your whole system in social circumstances, and all of these changes become like a process that flows downstream overtime. Disease does not just happen. It develops over the course of months and years, and frequently there is a trigger that takes your underlying situation and shifts it, and so it starts to shift the process that perpetuates, and that is why so many people seem to have a kind of a chronic thing that develops after they have some sort of injury, illness, toxic exposure, stress or whatever it is, and then they just keep getting worse, and they go to various doctors who were treating things individually, like, oh, you got this symptom, that symptom, that symptom, but they are not looking at the underlying issues. So, we are talking about treating as much as we can going upstream, getting at the underlying issues, unwinding the cycles that make people sick and that keep you sick.–Next Slide–Okay, so like we are talking in the case of this gentleman who saw me, who has got irritable bowel, who has got chronic abdominal pain, who is not sleeping, who is got anxiety, and who is got probably some degree of chronic inflammatory stuff going on, because it is irritable bowel or association with it, and he also has hormonal dysregulation, where his normal production of cortisol is not like it should be and it is low in the morning. These are what is going on in him, but the issue that I want you to see in this slide is that those can be underlying so many different kinds of problems. So, if you have got chronic pain or fibromyalgia, abdominal pain, fatigue, depression, anxiety, migraine headaches and neurodegenerative diseases like dementia, Parkinson’s, multiple sclerosis, neuropathy where your nerves get sick, autoimmune diseases, chronic fatigue. These share common underlying physiologic imbalances, some of which we have talked about in this case.–Next Slide–So, what you are going to do about it? You probably heard me talk about the three Ms, right? And this is just what I have come up with over 20 years of practice as three handles or windows through which you can come or look at your system and you need to address off three of these, and if you miss one or two of these, you frequently are not getting at the complexity of what is going on when you have a chronic illness or chronic pain. So, obviously mind is your mind-body connection. Movement, your movement system, metabolism is all of your biochemistry, your immune system, your hormones, all of that, and these all interact with each other, that is why these circles are intersecting, and what is really happening is right in the core of it, where everything comes together, and to my perceptive, you have also got spirit, you got an aspect of your being that is beyond measure, that is beyond what science can put a finger on, and pretty much almost everybody in the world senses that in some way, and that is part of what influences everything too, because it might be part of what integrates everything.–Next Slide–So, let us go further and talk about this. I am not going to try to talk about all three Ms today. I am going to kind of run through the metabolic biochemical stuff and run through the movement, mechanical structural stuff and spend more time on the mind-body axis, and then we will talk about those other two in more depth and we will drill down into those in the later videos. So, metabolic/biochemical, what is relevant for Robert who has got the condition we talked about or first of all diet, food sensitives, nutrients that can actually reduce irritability of the gut and low antigen diet that is full of antioxidants that actually tends to irritate the gut less and can help reduce inflammation and few radicals which produce oxidative stress. We are giving some adrenal supports and botanical substances that have actually been shown in research to support mood, energy, and to have an influence on that hypothyroid pituitary adrenal axis, which is involved in our chronic stress response. There was a substance called LDN or low-dose naltrexone that I use with a lot of people with chronic illness. It is worth reading about and understanding. It an off-label use, but very common drug called naltrexone, and it gets used a lot in irritable bowel, inflammation, pain, autoimmune diseases. It seems to be pretty safe. The research that we have shows that a lot of people get benefit who have not gotten benefit from anything. So, it is very well in my experience for irritable bowel, for inflammation, and frequently for mood. In terms of dealing with stress, we talked a bit about adrenal support but there are nutrients that can help your body deal with stress, stuff like B-complex and magnesium, other substances that can be either depleted or support your system in dealing with stress, addressing dysbiosis which is that alteration in the biome that is living in the bowel, which is mainly about probiotics and prebiotics. Sometimes, we get more aggressive and actually treat it with antibacterial stuff, whether it is botanical or pharmaceutical depending on the circumstances, and then addressing leaky gut. Basically, your immune cells which get broken down from various sources, whether it is dysbiosis, toxic drugs, toxic exposure, stress. When you feed them what they need, they frequently heal, and if you do not feed them what they need, they often doubt, and again this is supported by various levels of research that certain things like L-glutamine and zinc and vitamin A and E and vitamin D and omega fatty acids help the gut heal.–Next Slide–So, let us talk about the movement/mechanical system. Movement is medicine. Your body was made to move. When you get regular exercise, and regular exercise could be aerobic, stretching strength training, or some kind of mindful movement like yoga or tai chi and various other movement arts, dance, lots of different kinds of exercise, walking. It actually stimulates hormones, reduces inflammation. It can enhance sleep, reduce pain, enhance neurotransmitter function and make you feel good, and there is a lot of depth to understand what is appropriate for you given your circumstances. Depending on your level of health, depending on how much pain you have or what kind of condition your musculoskeletal system is in. So, there is subtlety to this, and I will drill down into this some more in a later video.–Next Slide–So, let us talk about mind-body healing. When most people think of mind-body healing if you are looking up on the internet [13:05] a biomedical web search like PubMed or something, you might see things about relaxation exercises, mindfulness, visual imagery, psychotherapy, CBT, various things like that, and these are all techniques that have been used and studied to see the effect they have on the overall stress axis, to see the effect they have on various symptoms and disease complexes, and there is a lot of research over the course of 20, 30 years that show that, you know what, these things make sense. They tend to be very low risk. Once you learn it, it tends to be very low or zero cost, and the potential benefits can be very great, especially depending on how much stress, trauma, difficult stuff was going on and how overactive your stress response is, and certainly my own clinical experience of using these techniques for over 20 years in my own life and with lots of patients is seeing profound impact, and this is one of those things that people miss, because I see a lot of people who come in and they are doing all this nutritional stuff and may be they are exercising, they might have chronic pain or fibro, IBS, or chronic fatigue, or autoimmune disease or whatever, but they are not really getting at their mind-body axis, and it is complex and it is subtle. So, lot of reasons why not. Some people just are not into it. For some people, there is a stigma, like whenever they have gone to a doctor over the course of years, and I have seen this with so many people like, who will sit down and go through all the science about why mind-body medicines are really important? Why it is a therapeutic tool? Why it is not that you are crazy? It is not to do something wrong with your mind, it is just that you know what, this is a therapeutic tool that can help you, and after like, so you means it is all in my head doc? And the unfortunate thing is lot of people have been stigmatized in that way. They have had problems that their doctors could not understand because they were never perceptive and then the doctor who cannot figure it out blames the patient, and so [14:58] nuts. It is all in their head, they need to take an antidepressant. Whenever it is complex, antidepressant actually have physiological effect that are not just about dealing with anxiety and depressant, but that is part of what this all talk is about that there was so much integration of the neurotransmitters that are involved in depression and anxiety as well as lot of other brain chemistry that are involved and actually generating and perpetuating symptoms and helping symptoms develop overtime, like that wave that flows downstream. Back to our topic, these things are techniques that get used a lot and they have been researched and let us talk more about why, just unpack this so you can see a little bit. Again, I talked about some of this in the previous talks, but I want you to seeithere, because I really want to see how important this is, how real it is, how scientifically validated are these connections between your mind-body system and the rest of your systems as they relate to your level of health orillness.–Next Slide–So, these are some slides from the journal. The journal of basic and applied sciences that talk about normal stress response, chronic stress pathology, and chronic stress and cortisol resistance. So, this is the pathology and of things, right? Where person is healthy. There is a connection in physical, mental, oxidative, biochemical stress go into the brain and a signal goes out to what call the HPA or hypothalamic pituitary adrenal axis, stimulates not only epinephrine/norepinephrine with cortisol release, epinephrine/norepinephrine activate your immune system. Cortisol kind of like slows down inflammation and turns off that stress-related inflammatory response, so that you do not get sick, right? Because if you can imagine if you are out in the forest and you fall down and break your leg and you got an open wound or you get injured or something like that, your immune system needs to come in for defense and repair. So, it is a good thing that your immune system revs up with acute stress, but then when the stress is over, you want to quiet down. In some circumstances, we talked a lot about this in the previous two talks that stress does not turn down and that can happen because you got ongoing stressors, you got ongoing illness pain, injury, an environment in your life that is stressful, dangerous, whatever it is, or it could be that you got early life adverse childhood events that turned your stress response on overdrive, so that you get triggered by an illness or injury, your stress response just gets kicked for an armful and it keeps going, and you are like, hmmm, and you start to not even notice it after a while, but meanwhile, your stress response is going, going, and what happens there is you get kind of disconnect in this feedback loop and the adrenal glands are putting out cortisol, cortisol in response to this chronic stress and then that holds thing with your immune system being reactive is feeding into your brain and creating more biochemical stress from the immune overreaction, that is one of those vicious cycles, and the other thing that we have discovered over the years, because all the research you are now looking at, well, okay, chronic stress that affects health or maybe it is because of the cortisol, but wait a second, people with chronic stress do not always have the elevated cortisol, right?, that was the finding, but what they discovered is that in many cases, there was actually a loss of sensitivity to cortisol. So, it is not just that the cortisol goes high, high, high. Sometimes what happens overtime is that cortisol stops being elevated and the cells are like resistant to cortisol, the receptors downregulate. So, basically a person cannot even mount an immune response to a stressor, and that is when people start to really burnout and get that chronic fatigue, and we said this, it is probably why people start to burnout and get that chronic fatigue, immune weakness. The guy who says, “gosh, I get sick every year, anything, anybody has I get it.” I see a lot of people like that, and it is probably related to this chronic dysregulation of the HPA axis along with resistance to cortisol, so they cannot even mount a proper immune response to stress, it is of the more complicated than that, but this is part of it.–Next Slide–So, let us move forward. Let us talk about pain, whether its abdominal pain or peripheral pain in this whole feedback loop. Stress feeds this loop. We just talked about the HPA axis, and then it feeds into what we call sensitization of spinal pathways and central pathways in the brain, and central sensitization means your brain is turned up and it is like your pain processing is turned up, and peripheral sensitization means the actual nerves in your gut or your back or your knees if you have arthritis or your nerves if you have peripheral neuropathy, they become sensitized by various biochemical changes, which were all influenced by the stress response, and so this chronic stress response with all of the changes turns up sensitization in the periphery, meaning the rest of your body as well as the sensitization which is your brain and spinal cord. So, that is part of how pain gets worse. So, okay that is all the bad news. Let us talk about the good news. The good news is you have a system inside of your body that is actually there to help you cope in deal and it is probably of how mind-body therapies can help you and it is related to the something called the vagus nerve. The vagus nerve, here is a diagram that is coming from Frontiers in neuroscience and its talking about, this is not where this is coming from, forgive me. That is from another slide. Cut that. In any event, this is just a diagram that is an anatomic slide. Here is your brain, here is your spinal cord. You have got your vagus nerve pumping out here and it is connecting to all of your internal organs. Here, it says vagus right, and that is giving input to your heart, your lungs, all of your digestive organs, and then you have these other parasympathetic, which is the same branch, it is the, you know, just to review again, you have got your stress response and your relaxation response. Your relaxation response neurologically is mediated by your vagus nerve and some of the nerves in your brain as well as your pelvic splanchnic nerves that go to your pelvic organs and sexual organs and the end of your bowel, and this is all parasympathetic relaxation response. So, you can send relaxation signals to your gut and those seemed to have an impact on people with leaky gut and irritable bowel syndrome and also people with pain.–Next Slide–So, let us unpack this some more. Maybe we will see Dr. Bonas as you slide here in a moment.–Next Slide–Okay. So, vagus nerve to the rescue. What are we talking about? This looks complicated and technical and geeky and it kind of is, right? But that is the way scientists think and communicate with each other and I am part scientist, so I can hear them. Hematoencephalic barrier, that means your blood-brain barrier, right? It means your brain is protected from your nervous system, I mean from your immune system and from your blood and what it is it more or less, but the point is like this, that you have got vagus nerve fibers that are going out that actually have an influence on intestinal permeability and have an influence on inflammation in your gut. Vagal outflow has an influence actually on the bacteria in your gut. The population of bacteria in your biome that are part of what gives arise to this gut inflammation and systematic inflammation, and so vagal outflow, when the vagus nerves starts to act and gets strengthened and have increased output, it shifts a lot of the changes that give rise to complex chronic disease. This is such an important thing that, you know, most of the articles when you look in the medical literature, you look at vagus nerve and chronic illness, and you have got companies that are investing huge amounts of money in developing vagal nerve stimulators. A lot of them are invasive things where they actually like put something in your neck that stimulates your vagus nerve as it comes out, gives it like an electrical charge, and then noninvasive once they do it through the skin, and that is how really great and cool, and there is early research that shows unbelievable things, like, okay, these people have rheumatoid arthritis with really bad inflammation and deformation of joints, and they did valgus nerve stimulation and it stopped. People with chronic pain, vagus nerve stimulation, ooh, volume turns down. People with various kinds of chronic, really difficult problems, the conventional medicines often fails to deal with, and they use this invasive or noninvasive vagus nerves stimulation and you get some degree of effect. I am not here to push high tech, very expensive invasive tools that are there to stimulate your vagus nerve. I am here to push you to consider that in between your ears, with your free choice, with your mind-body connection, and your intelligence, you have the capacity to actually stimulate your vagus nerve. You have the capacity to stimulate neuro-parasympathetic nervous system and get benefits that come from vagal nerve stimulation, which seems to do a lot to turn down the volume on chronic pain, chronic illness, chronic inflammation and so on.–Next Slide–Let’s unpack this some more. Right, from Curious Immunology, Dr. Bonas has again. He loves this. He loves this. I think he is developing actual stimulation devices, but he is even talking about hypnosis and meditation and acupuncture as ways to stimulate different aspects of what we call now the vagal or cholinergic anti-inflammatory pathway that is stimulating the parasympathetic nervous system, which is the relaxation response, stimulates the anti-inflammatory pathway, and there is a bunch of biochemistry to it, right. The vago-parasympathetic reflux vagus nerve stimulates fibers that go in and elicit various kinds of neurotransmitters like acetylcholine and nicotine agonist and etc, etc. We do not want to go too much into the overwhelming detail. The point is that those things block things like tumor necrosis factor alpha. That is a cytokine, that is an inflammatory chemical that is involved in almost all of these chronic destructive illnesses like rheumatoid arthritis and chronic pain and fibromyalgia, TNF alpha, and other inflammatory cytokines like interleukin 6 are showing up as major determinates and drivers that are involved in things like diabetes and heart disease, Alzheimer’s disease, dementia, degenerative illnesses inflammatory, and vagal nerve stimulation is anti-inflammatory, and that is huge as potential game changer from other medicine. What I would predict is that in 20 or 30 years when various technologies, whether they are high-tech invasive stuff versus just knowing how to teach people to evoke the relaxation response and to get in all the aspects inside the heart and soul of a person that interrupts that relaxation response and stimulates the sympathetic or a stress response. When we really learn how to do that, we have a powerful set of tools for actually changing the course of chronic illness, and that is why we are here talking about this.–Next Slide–So, let us talk a little more. We are talking a lot about how stimulating relaxation pathways affect biochemistry, affect the way to gut, processes stuff, and the dysfunction in the gut that can be proinflammatory and create all sorts of brain toxic stuff and how we can turn that down. We looked at various ways that parasympathetic stimulation relaxation response stimulation can actually reduce inflammation systematically, but here is another aspect which is a direct effect on the pain pathways, and the fact that pain is really complex and this could be, you know, several hours long conference in itself to talk about the complexity of pain and chronic pain, but the point that I want you know is perceived pain is profoundly integrated with emotional distress and maladapted belief systems, and these are things that most of us do not really get taught how to deal with. My own experience over 20 years is teaching people how to deal with these things and seeing profound influences on not just perceived pain but the amount of distress and interruption and dysfunction in life a person has because of pain as it has processed through emotional distress and adaptive beliefs, and this is a vicious cycle, and every skilled pain management clinician, whether they are pain management, anesthesiologist or physiatrist or neurologist or the behavioral medicine people that work through the mind-body connection. This is really clear. It is really well understood. If you go to a well-equipped pain center almost anywhere in the world, they are going to be working with you on your mind-body healing.–Next Slide–Okay, so that has been kind of an overview about how chronic pain and chronic illness are really a multisystem, multifactorial problems, and how they develop overtime, and the important thing to know is that, that is part of why these things are workable and why probably you and many other people can actually have significant yield even though you have done the best of conventional medicine, but you probably have not looked at it in kind of a holistic an integrated way, and that is where the therapeutic leverage is, is addressing the different aspects that are all working together, and I talked a bit about the three-part model that I used that looks at three Ms, which are your movement or mechanical system in your body, your metabolic or biochemical system in your body, and your mind-body system, and we went into a little bit of detail about some of the scientific underpinnings of why your mind-body system is so powerfully integrated in the development of chronic pain and chronic illness, and why it is so crucial to address that in the healing process. Because you or some of the people watching this might have kind of decreased energy or attention span, because that is part of what chronic illness and chronic pain do. So, I am going to stop now and break this video into two parts. The next part is going to get more into kind of an overview really of what you should be thinking about when you are addressing mind-body healing and the different aspects of it, kind of a landscape and the overview of what mind-body healing is and some other places where people sort of fall down the pitfalls, the things that you can miss if you are not paying attention to it. So that is the second next part of this, go ahead and watch it now if you want to or you can come back to it later when you have more energy and you want to spend another, I think it is about 20 minutes or so. So, as always, feel free to share this video or this blog post wherever you are seeing it, and I am going to continue to produce information that hopefully is going to be inspiring, empowering, and transformative for you around healing from chronic pain and chronic illness. So, if you have not signed up for the newsletter, do so, and you will actually get notified when and new blog posts come out, and we will be in touch that way. On my email community, I shared various aspects and different things that inspire people. So, looking forward to seeing you next time. Thanks a lot.
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