The Revolutionary Science Of Recovering From Chronic Pain, Fatigue, Anxiety & Depression with Dr Howard Schubiner #662
This episode features Dr. Howard Schubiner, a leading expert in chronic pain and the mind-body interaction, discussing his five-part model to reverse neuroplastic pain. He debunks common myths about pain, MRI scans, and highlights how emotions and stress contribute to chronic conditions like pain, fatigue, and anxiety.
Deep Dive Analysis
16 Topic Outline
Introduction to Chronic Pain and Brain Connection
Myths About Pain: Structural Damage and Incurability
Pain in the Absence of Injury and Brain's Role
Neuroscience of Predictive Processing and Stress
MRI Scans and Misdiagnosis of Back Pain
Distinguishing Structural vs. Neuroplastic Pain
Impact of Nervous System State on Health
Childhood Trauma and Neuroplastic Conditions
Personality Traits and Vulnerability to Neuroplastic Symptoms
Dr. Schubiner's Five-Part Model: Assessment
Dr. Schubiner's Five-Part Model: Education
Dr. Schubiner's Five-Part Model: Reappraising Symptoms
Dr. Schubiner's Five-Part Model: Emotional Processing Therapies
Dr. Schubiner's Five-Part Model: Making Life Changes
Hope and Recovery for Neuroplastic Conditions
Resources for Neuroplastic Symptoms
6 Key Concepts
Predictive Processing
The brain's fundamental process of generating our experience, including what we see, hear, and feel. It means our brain actively creates our reality based on predictions, rather than passively receiving sensory input.
Neuroplastic Pain
Pain created by the brain in response to a perceived danger signal, rather than actual tissue injury or structural damage. This pain is real but arises from learned neural pathways and a sensitized nervous system.
Structural Pain
Pain that is directly caused by clear tissue damage, injury, or pathology in the body, such as a fractured arm or an infection. The brain still creates the pain, but it's in response to actual physical harm.
FIT Criteria
A mnemonic (Functional, Inconsistent, Triggered by innocuous stimuli) used to help determine if pain is likely neuroplastic. Functional means it's in a broad area without physical precipitation; inconsistent means it moves or turns on/off; triggered means it reacts to non-damaging stimuli like imagination or weather.
Emotional Awareness and Expression Therapy (EAET)
A therapeutic approach used to help individuals recognize, understand, and safely express their feelings (e.g., anger, hurt, fear) that may be fueling neuroplastic symptoms. It aims to resolve underlying emotional conflicts.
Neuroplasticity
The brain's ability to reorganize itself and change throughout life by forming new neural connections. This concept is central to the idea that learned pain (neuroplastic pain) can be unlearned and reversed.
7 Questions Answered
No, pain is not always caused by structural damage; the brain determines whether there is pain, and you can experience pain in the absence of injury.
No, chronic pain, especially neuroplastic pain, is not irreversible and can often be reversed by understanding its brain-based origins and applying specific treatment models.
Not always; MRI scans often show "abnormalities" like disc degeneration or bulging discs in people without pain, meaning these findings are not necessarily the cause of chronic pain and can even induce fear.
Stress and emotions activate the same parts of the brain as a physical injury, meaning emotional distress can directly contribute to the brain generating physical pain signals.
When the nervous system feels under threat, the brain's alarm system can produce a vast array of symptoms, and having multiple seemingly unrelated symptoms often indicates a neuroplastic origin.
Personality traits such as people-pleasing, perfectionism, self-criticism, guilt, and avoiding anger, especially when excessive, can lay the groundwork for neuroplastic conditions.
Yes, traumatic experiences in childhood, including not feeling seen or heard, can sensitize the brain's danger signal, making it more likely to react with neuroplastic symptoms later in life when other stresses occur.
10 Actionable Insights
1. Understand Pain’s Brain Origin
Recognize that all pain is created by the brain, not solely by structural damage. This understanding is foundational for changing how you perceive and address pain.
2. Question Chronic Pain’s Cause
If pain becomes chronic (3+ months), consider that it might not be due to easily reparable structural damage. Many chronic pains are neuroplastic, meaning the brain is generating them due to perceived danger, not actual injury.
3. Reappraise MRI Findings
Do not assume that common MRI findings like disc degeneration or bulging discs are the definitive cause of your pain, especially if you’re older. These findings are often present in people without pain and can induce fear, worsening symptoms.
4. Cultivate Self-Awareness of Symptoms
Pay attention to how your thoughts, perceptions, and stress levels impact your symptoms. Recognizing these connections (e.g., pain worsening with stress or specific situations) is a crucial step towards understanding and addressing neuroplastic pain.
5. Give Your Brain Messages of Safety
Actively reassure your brain that you are safe and not damaged, especially when experiencing pain. This helps calm the nervous system and can reduce the brain’s danger signals that produce neuroplastic symptoms.
6. Address Underlying Emotions
Recognize and safely express emotions like anger, hurt, guilt, or shame, as these can fuel neuroplastic symptoms. Unprocessed emotions activate the same brain regions as physical injury and contribute to chronic conditions.
7. Challenge Limiting Beliefs
If you’ve been told your chronic pain is incurable, challenge that belief. Understanding that neuroplastic pain can be unlearned offers hope and agency, shifting your perspective from being broken to being capable of recovery.
8. Make Necessary Life Changes
Identify and address life circumstances or personality traits (e.g., people-pleasing, perfectionism, self-criticism) that contribute to your symptoms. Setting boundaries, changing jobs, or re-evaluating relationships can be crucial for long-term recovery.
9. Use Affirmations for Brain Certainty
Employ affirmations to consciously provide your brain with messages of safety, health, and strength. This practice can help rewire neural circuits, reducing threat perception and promoting recovery from neuroplastic conditions.
10. Process Traumatic Memories
If past trauma is linked to your symptoms, engage in therapies or techniques that allow you to reprocess these memories. Changing the narrative and giving compassion to your younger self can alleviate associated pain.
7 Key Quotes
You can't understand pain unless you understand the brain.
Dr. Howard Schubiner
You can have an injury and have no pain, and you can have pain in the absence of injury.
Dr. Howard Schubiner
Pain is generated by a decision, it's so weird, a decision made in the brain. A subconscious decision.
Dr. Howard Schubiner
If pain, and we'll talk about anxiety, depression, fatigue, if those sensations can be learned, they can be unlearned.
Dr. Howard Schubiner
Your brain is not your enemy. It is your protector.
Dr. Howard Schubiner
Most people will develop some form of neuroplastic condition at some point in their lives. It is simply a byproduct of being human.
Dr. Howard Schubiner
If you don't say no, the body will say no for you.
Dr. Rangan Chatterjee
1 Protocols
Dr. Schubiner's Five-Part Model for Reversing Neuroplastic Pain
Dr. Howard Schubiner- Step 1: Assessment: Rule out structural problems (e.g., cancer, infection, fracture) and rule in a neuroplastic condition by looking for clues like pain shifting, turning on/off, or being triggered by innocuous stimuli (FIT criteria).
- Step 2: Education: Understand how the brain works, including predictive processing, and that neuroplastic symptoms are real but not imaginary, offering validation, compassion, and hope for reversal.
- Step 3: Reappraising Symptoms: Change your perception of symptoms from dangerous to non-dangerous, calming your nervous system and reducing the brain's threat signals by telling yourself you are safe and okay.
- Step 4: Emotional Processing Therapies: Recognize and safely express underlying emotions like anger, hurt, guilt, or shame, which can fuel symptoms. This involves methods like journaling or safe emotional release to resolve feelings.
- Step 5: Making Changes in One's Life: Address personality traits (e.g., people-pleasing, perfectionism) and life circumstances (e.g., toxic relationships, excessive demands) that contribute to symptoms, setting boundaries and making necessary changes for long-term well-being.