I needed to be carried to the bathroom.
I was in excruciating pain.
Sometimes the pain was so sharp that if I moved in a certain direction, I would scream out loud.
Nicole Sachs is a renowned psychotherapist whose groundbreaking approach to chronic pain is changing the lives of thousands.
Her new book, Mind Your Body, it dives deep into the connection between unresolved emotions and physical health, offering a surprising counterintuitive approach to transforming pain into peace.
There is a mind -body connection that I understood and then have spent the rest of my career teaching that underlies everything that we feel.
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so when I was 19 I was a freshman in college and my back went out completely so people understand that experience I needed to be carried to the bathroom I was in excruciating pain sometimes the pain was so sharp that if I moved in a certain direction I would scream out loud so I really do understand the acute
pain of that kind of a situation I was brought home from college And I underwent, rightfully so, all the tests that you should go through if you're going to get checked out.
I had x -rays, MRIs, orthopedic surgery consults, and they did find a rather impressive finding, which is that I have and had and still do degenerative spondylolisthesis, which means a pretty severe abnormality of the lower spine.
And so when they saw this, they made the obvious connection that my severe back pain in that exact area was the result of this spondylolisthesis.
And nobody, I mean, this was 1990, but only to say that it's been a minute since this happened, I don't think the situation is much different today, which is when there is a finding that's that clear and that obvious for, you know, any professional, they would imagine that's the reason for your pain.
So of course, I agreed and bought completely into that.
And they told me, spinofusion surgery is the only option we have, but it does not come with a guarantee of pain cessation, and it will decrease your mobility for life.
So at 19, otherwise healthy, they didn't think that they were going to recommend that right now.
So they said, if you live in a very specific way, you will be fine probably until you're in your 30s, maybe 40, but you're not going to live your whole life without the surgery.
But if you're very careful and there's no more exercise, no more travel unless it's absolutely necessary, sleep in very specific positions as to not destabilize your back.
And the kicker was the likelihood that I would have a biological child was slim to none without what they said would be like seven to eight months of bed rest because the weight of the baby on my back could be like a really catastrophic situation.
So I kind of went on at that point with a heavy dose of denial and just repressing most of the thoughts of the future.
And I just like, with enough steroids and muscle relaxers and painkillers, I went from acute pain to chronic pain, which meant that I could walk, I could return to school.
They put a handicapped sticker on my car so I could drive to class.
So I was able to function, but not really the preferable life, certainly for anybody at any age.
And I lived in immense fear.
I would say fear was my driving force.
Oh my goodness, do I have enough pillows underneath my legs to put my back in the right kind of position?
Or am I riding in the car for more than an hour because they said the bumping motion of the car could also destabilize my back?
So there were a lot of instructions of how I should live.
And I lived that way.
And I really lived in a lot of, I paid a lot of attention to the things I did, how heavy was something that I was lifting, right?
I think a lot of people can relate to this experience.
And so as time went on, I was a psychology undergrad, so I got my bachelor's, and then I was in my master's program to become a therapist.
And I became acquainted with the work of Dr.
John Sarno. And in understanding Sarno's theories, all it was at that moment was an opportunity to replace my fear with curiosity.
I had no idea if I was indeed going to be helped by the theories of mind -body medicine.
What Dr. Sarno posited was that your pain is real, nothing is in your head, but there is brain science that involves the nervous system in sustained fight or flight that leads to pain signals being sent mistakenly and confusedly as a form of protection.
Because pain in any form is protective.
You know, if in the dawn of early humanity, if you were to cut yourself and if it didn't hurt, you could become septic and die from a small cut.
We have pain because human beings need pain as information for us to know that it's time to take care of ourselves.
And what's also interesting about the brain science is that the nervous system can give it, but it also can take it away.
If you are running from a predator and you step in a hole and break your ankle, you will run without pain on that ankle until you reach safety.
So let's say, you know, you reach safety, you slam a door, you lock that door and you are able to have a moment of centering and you know that you're not in immediate danger, that ankle will explode in pain because the pain was not adaptive while you were running from the predator.
But the moment that you can take care of yourself, the ankle will explode in pain saying, alarm, signal going on.
There's something you need to attend to.
If you don't attend, this could be a threat to your survival.
So essentially, I started understanding that.
And I just did a science experiment on myself.
You know, Dr. Sarno posited that when people are full of repressed emotions, the number one thing that he was calling out was rage and they could not come to a place where they could understand that big feeling if they couldn't extrapolate it and excavate it.
that the nervous system mistakenly would see that huge, big feeling as a predator and pain signals would be sent to certain muscle groups or bodily systems, inflammation, muscle constriction, spasm, neuropathy, was sent mistakenly, was sent as a form of protection that you don't need.
Because although predators for early humanity were obvious, you know, saber -toothed tiger, predators in modern day society are constant and are confusing because the predators are your children or your parents or your self -talk or your money situation or your boss and those predators are not easy to
escape from as we all know and so essentially I understood it and in the by and by as I did the work that was explained through the lens of mind body medicine, I eliminated my back pain completely.
And when I say completely, I mean completely.
I'm 52 years old. I exercise till the day all three of my children were born.
I have never had a surgery, nor have I had an injection.
Now the story, I mean, I think you probably know if you know my work, the story is much more complex than that.
But the truth of the matter is there is a mind body connection that I understood and then have spent the rest of my career teaching that underlies everything that we feel.
And it does not take away from the real suffering, but it gives so many incredible possibilities for healing that people might not have understood before learning about it.
Yeah. I mean, it's so interesting also because you're in, I would imagine I'd put you in your early to mid -20s when you stumble upon Sarno's work.
And so at that point, it sounds like you've got a battery of doctors and people in the medical field who've been like, this is the way it is.
Right? You're young.
What do I know? These are the experts.
Let me believe what they have to say.
We've got clear imaging.
They can point to a thing on a scan that says this is what's happening.
And then you stumble upon Sarno's work.
And Sarno back then in the early days, very controversial.
It wasn't just sort of like everyone's like, oh, yes, this is an incredible awakening.
Everyone's on board.
So it's fascinating to me that you've had the internal openness to say, maybe all these people who are incredible experts in what they're doing, maybe they don't actually entirely know.
Maybe everything that they've said isn't entirely right.
And at a young age, you're like, let me just experiment.
Use the word curiosity, which is something you speak about often, like reframing this and saying, okay, I'm not necessarily saying everyone's wrong, but what if I just start asking questions and not buy into what everybody tells me?
It's a powerful way to be early in life.
You know, it's funny.
Whenever anybody says something along the lines with the energy of what you just said, I actually start getting a little teary because it's so amazing to me, those moments, those inflection points in a life, in a human life where you have an opportunity to do something wild, to do something full of wonder
that could change the trajectory of everything you thought was for certain.
And those moments are precious to me because, you know, what are we here for?
Right. In my estimation, we are here to feel big.
We are here to connect and to love and to celebrate.
But the flip side of that is there's suffering and there is pain and there are moments where we are driven to our knees in order to awaken to what is next.
And that was what that was for me.
And I don't know why I got it so young.
I mean, if you're a spiritual person, you might say, well, I was being tapped to carry this message and to help many people change their lives.
And maybe that's true.
Who's to say? but I will tell you that there was a certainty in me that I didn't know everything there was to know.
When you start to explore sort of like Sarno's work, and it starts to make a real difference for you, and then you're sort of like emerging into the world of therapy at this point and saying like, I need to be of service in some meaningful way.
It sounds like this becomes like an increasing part of the work that you're actually doing, not just on yourself, but with clients, with patients.
You have said, and I've heard you say a number of times you write this, that the pain, and you actually said a version of this earlier in our conversation, the pain is not in your head, but the solution is not in your body.
Deconstruct this for me.
Okay. So I'll tell you a little bit of the story of Sarno.
So when I first kind of hit upon the gold nugget of figuring out how to bring my repressed emotional world, which was causing my nervous system to go into sustained fight or flight and mistakenly send these pain signals, I understood the theory when I started figuring out a way to excavate my personal
stuff which is one of the things I teach quite a bit I called Dr.
Sarno and I said you're never going to believe this and of course that's always such a delightful conversation in my line of work because he's like try me and I said my MRI is exactly the same nothing has changed in my body and I have done this work and I'm completely out of pain.
And I was really young and I was just newly a practicing therapist.
I was like 30. And he said, why don't you come into the city and lecture with me on some of these alumni panels at NYU because you have a very good way of explaining it, young, fresh, whatever.
So I was doing that on a regular basis and establishing my private practice.
And he was then referring into my practice.
So I was really building my understanding of everything and how I could explain it.
And as I moved through it, I started to understand this wasn't just about back pain.
This was about migraines.
This was about fibromyalgia.
This was about irritable bowel.
This was about skin disorders.
And then as I grew in my practice, what became really prevalent was pelvic pain, pelvic disorders, and many other things, neuropathy of all kinds.
And then of course, long COVID, which we can get into.
So I started understanding that this nervous system dysregulation was behind so many different things that were considered chronic and that were considered without possibility of cure that could be managed, that there were different medications, treatments, diet changes, exercises, but no cure.
And then I started hearing all the conversation around these different symptoms and people becoming very offended.
Like, I feel like I'm being told through Sarno's theories, as you mentioned controversially, that the pain is in my head.
So I started thinking, how can I boil this down to a way that people with a ton of compassion and empathy from me understand that's not what I'm saying.
So I began by using my personal story because as soon as I tell people, I needed to be carried to the bathroom.
I screamed in pain when I turned over in bed.
I know that the pain is real.
But because I've watched people first in my private practice for 18 years, and as soon as I shuttered that in 2018, because I was spending so much time on the podcast and writing and teaching, then I started being open, especially through COVID to the global community and hearing from thousands and thousands
of people around the world.
And I knew that all of these symptoms and all of these different diagnoses were coming from the same place, this dysregulated nervous system and these pain signals, I was like, I have to find a way to explain it.
And so that's when I kind of got into the pain is not in your head, but the solution is not in your body.
And the reason the solution is not in your body is because of something called the symptom imperative.
So if you are in this place where your nervous system is up to here and it's dysregulated and it's sending all these different pain signals because it thinks you need to slow down the way you would if you had a broken ankle and care for yourself.
If you follow the traditional Western model, what you will do is you will attend to the part of the body that is hurting.
So if you are having stomach issues, you're going to go to a gastroenterologist or a functional medicine doctor.
If you are having headaches, you're going to go to a migraine specialist.
If you're having back pain, you're going to go to an orthopedist.
and I was watching people spend years of their lives chasing these different symptoms and not getting relief.
And even if they got temporary relief from one of the symptoms, I was hearing from people, well, I had a hip surgery and my right hip, it's feeling a little bit better.
I'm gonna tell you something so wild, Nicole, my left hip is hurting now.
And so there's always a medical explanation for things.
Oh, well, now you're putting a lot more emphasis on the left.
And, you know, and I know, I mean, I have people who I've worked with that have had four or five surgeries before they say, okay, I give up.
Why is this pain continuing in my body?
And then they're able to come over to where I am, which is there's brain science behind why we feel everything.
And, you know, Jonathan, one thing I'll say about human beings, things are a lot easier for us to swallow when we can relate it to something that we already believe.
And so oftentimes I say to people Slow down with all of that crazy thinking that all that stuff that's keeping you stuck and just sit here with me for a moment Let's just have a moment I'm telling you something you already believe I could be lecturing to a hall of a thousand people and I could say raise
your hand if you've ever had A stressful day and gotten a headache Every hand in the room goes up.
I don't know one person in life who's never had been stressed out and gotten a headache And then I say, OK, keep your hands up if you ran to the ER that night for a CT scan of your brain.
So everybody laughs and everybody's hand goes down.
And I said, I'm teaching you something you already believe.
An emotional stimulus can cause a physical reaction.
Stress can cause a headache.
Panic can cause hives.
Having bad news or getting broken up with by your boyfriend, girlfriend, partner can cause you to lose your appetite.
Emotional stimulus, physical response.
But when things become chronic, people throw that out the window because chronic pain is fueled by fear and meaning.
And when we think we can't be at that work meeting or be at my son's baseball game or my daughter's recital or what have you and we start to project, well, that fear and that cyclical thinking sends more signal to the nervous system that we're in danger.
The fight or flight stays up here.
the pain signals are strengthened, and we become in this loop of a society in chronic pain and illness.
And so when people start getting it, they become willing.
And once I have you willing, then I can introduce you to the work that you can do to heal yourself.
Yeah. It's sort of like just that opening move.
It's like what you're describing is you don't have to actually buy a hundred percent what I'm saying, but just if you just, if you crack the door open a little bit, so you're just curious about like, well, is there a downside to exploring this?
Not really. So many people have probably spent so many years and invested so much money and so much time and resources and so many other solutions.
And if they're coming to you at this point, it hasn't worked.
I want to be clear though, because there'll be people sort of like joining this and saying, okay, so I have clear as day diagnostic testing, imaging, blood work, whatever it may be, that points to something that is an absolute clear aberration.
In your case, it was like a point in your spine.
So many people have something similar.
And the research says that this can cause the exact symptoms that I have been having.
Because I have to imagine those people come to you on a regular basis and say, here's my imaging.
How can you tell me that this is not the source of my pain?
How do you walk them through dissociating that?
And by the way, we're also not saying don't go and do all that other work.
We're not like get the imaging, talk to the experts, do all the things because it may be, and we're not saying don't explore those interventions also.
I think what you're saying is get curious about something else at the same time.
Yes. So the first thing I'll say about that is picture the moment that somebody said, the earth is round, it's not flat.
Picture, like bring yourself back to that, how wild that moment must have been.
What are you talking about?
Look around. The earth is flat.
I just drove from X to Y or drove.
Probably no one was driving at that point.
My horse just brought me from X to Y.
it's flat it's flat it's flat as far as i can see it's flat forever i look at the ocean and it's flat too and i kind of feel like that kind of a moment of curiosity it doesn't need to be applied here but if you really want to wake up if you really want to change your life in a way that i promise you
is possible it's worthwhile thinking about that moment in history because I hear you when you say research supports the fact that this could cause this, but I'm going to disagree.
And I'm going to say that the newest research that's coming out, and it's coming out really impressive places.
The most recent study I know of came out of Harvard.
There is no statistical significance between findings on MRI around bulging discs, spondylolisthesis, even arthritis in a lot of cases where they can find a statistical link to pain.
And when they do these randomized studies and they pull people and people have the exact same experience of pain statistically, if they have no findings or they can have findings with no pain.
And the reason I'm saying this is because it doesn't mean you shouldn't get the test.
You have to get the test because there could be a tumor on your spine.
You know what I mean?
I know people who had back pain and they found out they had lung cancer.
Like I don't ever want somebody to not get checked out.
But there are a certain subset of findings that many people come to me with where I look at them immediately and I say, no, bulging discs.
It's like so scary to say it out loud, but I know it's true.
Bulging discs inherently do not cause pain.
They make a pathway for the nervous system into a place that is like the path of least resistance in order for these pain signals to go.
So I'll explain it a little bit more.
If indeed you are a person living in this long -term fight or flight, which is most of us, this is not an untenable situation, nor is it unusual, nor is it a bad news.
I mean, here we are, you know, God knows everybody has a computer in their hand that can stress them out at any moment of the day or night.
You know, we're all constantly on call and available.
Of course, The human nervous system is going to have to adapt to that level of input.
So it's not a problem that we're like this, but we have to be in concert with our bodies.
We have to understand what might happen to the brain and the nervous system, which are still primitive systems.
I mean, huge advances in evolution have happened that we are these incredibly brilliant thinkers.
But the primary purpose of your brain and your nervous system before you get to any of the rest of the stuff is to keep you alive.
And so the way you pull your hand off a hot stove, that's a reflex.
Your systems are not asking your permission or your opinion before they protect you with reflexive things.
And unfortunately, when we are up to here with that level of dysregulation, it's the same reflex.
But if you want to be curious about something that lives in the incredible space of, I don't know, the incredible space of maybe, then I offer a solution.
And we'll be right back after a word from our sponsors.
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and affiliates potential savings will vary not available in all states you know it's interesting you describe um you know when sar and i remember first reading Sarno's book, you know, like way back when, and he was, he's focused on rage as the primary emotion underlying so much of what we experience
as physical pain and chronic pain.
I first learned about it like a million years ago when I was in New York listening to Stern on regular radio and him saying how he actually became a patient of Sarno's and he literally was in such severe back pain that he would literally have to lie on the floor in the studio, he couldn't sit anymore
And somehow like it all got released.
And then, so you start out with this thing saying, okay, so rage is the thing that, that I remember being talked about the most, but this is now an expansive set of emotions and experiences, persistent stressors that can actually be the underlying driver here.
What do you say to the person who shows up and says, I get this and I kind of buy it, you know, like I'm open to this, like this, okay, maybe.
But if I look at my life, like I had a great childhood.
I have a great marriage.
I love my kids, great family.
My job is really good.
My life is objectively good, but I'm still experiencing all this chronic pain.
How could this be a part of what's happening for me?
Absolutely. Well, first thing I'll tell you is, I know you're aware I have a podcast.
The reason I started the podcast in 2018 was because I knew that my voice couldn't be the only voice in the space.
I wanted hundreds of people with all different symptoms and all different walks of life to tell their stories from their point of view.
And so the reason I'm bringing that up is when someone comes to me and they say I had a wonderful life, I say, I know I can show you a place where X number of people had a wonderful life in their own definition.
I can also show you a place where X number of people had capital T trauma and little t trauma and everything in between.
And they find themselves at the same place because there is no cure for the human condition.
There's a cure for chronic pain because chronic pain is an epidemic of fear and meaning and this confusion between the dance between the brain and the nervous system and the body.
But the human condition is one of huge feelings.
So, you know, in the world of nature versus nurture, I'm a big believer in nature and nurture.
It is not a either or, it is a both.
Anybody who has more than one child knows there is nature involved.
I have three children who could not be more different than each other, and they've been raised by the same parents and in the same situation.
And so we have sensitive natures.
We have natures that are quick to anger.
We have natures that are quick to be offended.
we are all, we are multifaceted, we contain multitudes.
And so you're coming to this world with whatever your nature is, and then you're raised in a family.
And sometimes, even in the most loving and idyllic situations, you are an energetic mismatch to your life.
You know, maybe you are raised, you're born painfully shy, and you're raised into this very gregarious outgoing family where everybody needs to scream to be heard.
And maybe you can even be that, but there's something inside of you that always needs to repress and repress a little bit of who you are.
Or you had a generally happy family, but maybe they had situations that were beyond their control.
Sickness. I definitely have people oftentimes say I had a disabled sibling that got all the attention.
Or my parents moved.
I was a military brat.
I had to change schools a lot.
Whatever it is, here we are, soft and chewy centered human beings that have to live in a world that is requires a ton of an of emotional input nobody can sustain it all rage deep shame grief that lasts longer than you know the prescribed time of grief societally which is pretty short um resentment you
know all that acid that bubbles in every single human being Here is the rub.
When that natural human input reaches maximum capacity and threatens to spill over and inform our conscious minds, the ones that we need to get through the day with, the ones that we need to love our parents with, the ones that we need to be successful with, of how scared and stuck and enraged and full
of sadness we are, because we all are at some level, that is considered a threat to your life by the nervous system.
It is a problem that the human brain cannot solve for.
And the brain loves predictability and it loves familiarity.
And it will always go toward what is familiar and predictable.
And so the natural reflex is to repress that stuff, to push it back down.
And when the alarm bell goes off because it's getting too big, that's when the pain signals fire.
And oddly, that puts you in a position of power.
Because if you're calling doctors and getting second opinions and doing Dr.
Google on the internet till three in the morning, those are action items that the brain feels very comfortable with because we are doing something.
Whereas this problem of the emotions feels like it's impossible to solve for.
So that is the reason that even no matter how you define your life, this is a human problem.
And I actually, when I first created my podcast, the cure for chronic pain, I really didn't want to call it that.
I didn't want chronic pain in the title because this is human pain.
This is everyone. This applies to everyone.
But, you know, sometimes you have to make a hard choice because the people that I'm helping that are the most suffering are people that do identify as chronic pain.
But I mean, I can't tell you over the years how this has evolved.
People have said to me, I just had no energy for life.
I wasn't having enough joy and I've done your work.
And now I'm so free and I'm exploring new options.
So it's really for everyone.
So it doesn't necessarily mean you had to have lived with serious trauma.
Yeah. I mean, it is so interesting as you're describing that.
I'm wondering to myself, I feel like there are so many folks walking through life, especially once you get further into life and you sort of say, I have responsibilities or certain trade -offs I'd have to make in the way that it would my life.
And if you like, objectively, again, I'm living a good life.
I have checked all the boxes and I feel pretty good walking through the day.
but for this one thing, which is the chronic pain that dogs me.
But at the same time, that person is in some way, how do I describe this?
Stifling their identity, stifling who they know themselves to be in order to perform the role of whatever they think is the appropriate way to be in the world, in relationship, in their work and stuff like this.
So they don't objectively feel like there's this bad thing happening, but underneath it, there's a hiding.
There's a weight of hiding that takes place.
I wonder if you see that as a potential genesis in the work that you do at all.
Not only do I see that as a potential genesis, I see that as maybe the number one genesis, the biggest, most profound thing.
And so I'm going to explain to you why.
There's an example in one of Dr.
Sarno's books that I remember reading about a man whose back went out so severely when his wife had a baby.
Now, of course, objectively, having a baby, be a healthy baby.
