The Neuroscience of Pain

Meet Dr. Matt McClanahan:

On this episode we welcome Dr. Matt McClanahan. Dr. McClanahan is an osteopathic physician (D.O.) specializing in holistic approaches to the diagnosis and treatment of chronic pain, functional syndromes, and medically unexplained symptoms. He has a practice in Chattanooga, TN called The Center for Insight Medicine.

Some Points We Discuss:

  • How did Dr. McClanahan get into the study of chronic pain and how to deal with it? (3:29)
  • How does pain actually happen? (8:19)
  • What is tension myoneural syndrome? (14:54)
  • How would Dr. McClanahan approach a patient that comes to see him with chronic pain? (18:10)

Some Key Takeaways From This Episode:

  • All pain comes from the brain. (8:19)
  • Once we have some chronic pain, we have to rule out that there isn't a brokenness to our system of some sort. (20:09)
  • It can seem counterintuitive to think that your back pain is caused by your emotions and not a structural issue. (26:14)
  • Emotions are designed to protect us. (30:03)

Brian Strickland  00:32

You're listening to the Nutrition World podcast, a show about navigating the intricacies of holistic wellness. We're a natural health food store located in Chattanooga, Tennessee, and we believe that optimal health and peak performance should be accessible to everyone, everyone. I'm Brian Strickland. I'm the producer of the show. And today we have a really great guest with us in the studio. Dr. Matt McClanahan. Matt is an osteopathic physician. He's the founder for center for insight medicine. And Matt has a really unique perspective when it comes to pain in what happens in our body and how to overcome that pain. Ed sits down with Matt today just to talk about what it is exactly that he does, and how neuroscience can actually help us overcome pain. So with that being said, we have a ton to cover today. Let's hop into this conversation with Ed and Matt.

Ed Jones  01:25

Hello, Matt. Welcome to Nutrition World's podcast. And today. I'm just thrilled to have you here with me because your gentlemen Dr. Matt McClanahan, I've known you for many, many years, I would say 10 years, probably, and you are going to speak on a topic that is very, very close to my heart at this moment has been for many years, which is chronic pain. And there's going to be a a lot of information that people simply are not aware of, and in fact, personal story. I was in had a great friend in New York and about the year 2014 2015. And also remember, I have been having some chronic pain, pelvic chronic pain. And that is pretty frustrating because it's not hard to it's very hard to treat. It doesn't seem to go away very easily. There's a very, very sensitive and it creates a lot of multiple disturbances in your life, not just the chronic pain. And this friend of mine said, Have you ever heard of Dr. John Sarno? And she was quite familiar because she lived in New York. I think that's where he was. And I had not heard of him even though I tried to be very well read about all this well. I'm a seeker. So as soon as I got home, I ordered the book, didn't have Kindle at that time. So I ordered his book on back pain. It was lights went off in me like almost no book is ever done in regard to this makes sense. No wonder I'm having pain and no wonder I can't get rid of it. And it was a whole turn. For me in regard to my perception of pain. I personally have been in and out of pain. Like some humans as we get older, it just is part sometimes part of living, not always. And if it wasn't for Serrano's principles, I'm not sure where I would be. And when I got talking to you years ago, it just blew my mind that you were a student of that philosophy of this whole new way of approaching chronic pain. So I'm going to be quiet a minute and you tell the listeners kind of what your history how you get started. And, and then we'll go into this, this very helpful information of what everyone can utilize to help their chronic pain because and I'll say one last thing. The light going off with this new philosophy helped me at least 50% From nothing else, except realizing that I was mistaken about chronic pain and the real truth of chronic pain. When I read it in his book, it immediately made my pain go down and many times completely went away. It was the strangest thing, but now I've dealt with it for so long. I have total trust in it. So welcome Dr. McClanahan. Tell us a little bit about you.

Dr. McClanahan  04:12

Yeah. Well, I'm really honored to be here. And yeah, I value our relationship as well. So happy to talk about this. It's really near and dear to my heart. Professionally, personally, as well. I've got my own story of working with chronic symptoms. So yeah, it's odd how reading a book can change your physical experience of pain. Right. And what is that and that's, that's something I really became interested in maybe early, early 2010s. last decade, during my residency, I've struggled with a number of different symptoms. They didn't really seem like a big deal to me at the time. I mean, I was getting manual medicine treatments and taking supplements and doing some physical therapy and I tried some mindfulness and those are all like moderately successful, you know, kind of helped ease the symptoms. But yeah, and I was actually as a as an osteopathic physician took an extra year of fellowship and training for manual medicine, sort of sort of like chiropractic and most people's common understanding, and so diagnosing and treating with my hands. And that was combined with a family medicine residency. And so seeing all kinds of different things using manual medicine to treat a lot of chronic symptoms, pain being by far the most common. And even in my manipulation only clinic, I had a day or two a week of doing that. People wanted to know whether it was back pain or neck pain or chronic headaches, or even some digestive issues, these sorts of things, I was treating those with my hands, and it was moderately successful, but it was only temporarily 2-4 days, sometimes a week, sometimes people will get better after one treatment, that was great. But it was the people that had persistent symptoms, you know, much longer three, six months or two, three years, you know, or sometimes a decade of variable symptoms. And these are the people that wouldn't really get better with manual treatments and they wouldn't get better with physical therapy and they weren't doing really well with even short courses of medications and or acupuncture or supplementation and really frustrating for them in me as a practitioner. And it was it at that time and partway in there that I encountered a fellow Howard Huebner physician in Detroit. And he'd actually studied under John Sarno. And so my my introduction to this kind of world it's really a paradigm shift was through Dr. Huebner and not through Dr. Sarno. But shortly, you know, a lot of roads Lita, Lita, Dr. Sarno, at some point, he's been so influential on a number of people and really tapping into some things we've known in the body and in the nervous system for a long time. But, boy, he really put a lot of meat on the bones and made it very concrete for people. And so his book healing back pain, which is I think what you probably read was his first major book. And maybe that came out in like, 1990, very early 90s. In the 80s, he was really starting to do this work. And yeah, I mean, we can get into it, but that through Dr. Schubener, in his own book, and applying that to my own suffering and my own patient care, it's actually patient care. First, I started to teach people about this about how their fibromyalgia or their chronic migraine headaches or, their chronic fatigue symptoms were related to these like sensitized, like neural plastic pathways in their nervous system. And, and yet, I had chronic back pain and tension headaches and insomnia, hip and ankle and shoulder pain. My back would go out three, four times a year, I didn't think it applied to me. And it did. It was a couple years later, it's probably 2015 16 When I really thought, hey, wait a minute, this actually applies to me, after teaching people about it, you know, doctor, heal thyself, we kind of joke about but yeah, I needed my own medicine. And once I really understood that in the same way that you did it, I mean, it shifted, it opened things in my life that I never thought possible.

Ed Jones  08:10

See if you can bullet point, what the powerful shift? What words make that powerful shift? Because it has to do with emotions, right?

Dr. McClanahan  08:19

Yes. And first, though it has to do with just neuroscience. All pain comes from the brain, whether your hands in a fire, or you've got fibromyalgia or you have phantom limb sensations, or phantom limb pain, all of that is being produced by the brain. And this is where neuroscience in some ways, has really caught up to what John Sarno was saying, back in the 80s. But the idea is that pain is a decision the brain makes, and it's an output. It's not an input, we have no pain receptors in the body. That's kind of a tricky one, right? We've got stretch receptors and thermal receptors, and McCanna receptors and these things, but based upon the input of the brain, or excuse me, the input of the body, our perception, and then our experiences, what we've been told what we've experienced in our past, these sorts of things start to make our brain more sensitized to say, Yeah, we should have pain right now. And if you've hit your thumb with a hammer, it's probably a good idea to have pain that will protect your thumb from further damage. If you've fallen down a flight of stairs and done some damage or a car crash, right, you've probably done tissue damage. However, in the long term, these acute tissue damage processes heal, I don't know to 6-12 weeks, and after that time, like their neurological injuries can go a little bit longer at times, but really, in the short period, certainly three months and certainly six months. An injury whether it's an old high school injury, or a car crash, really severe car crash, these things can really heal up and the nervous system in the brain desensitizes and we don't need so much protection because the tissue become strong again. And yet so many people develop chronic symptoms, whether it's after an injury, or some people wake up with it one day or it just kind of creeps in there with no injury identifiable in the past and, and then it's there and it's there for months and it's there for years.

Ed Jones  10:06

And the purpose of the brain to do this is a protection purposes, right?

Dr. McClanahan  10:10

Pain is a danger signal right from the brain to protect you when it's concluded that, you know, danger in the body to the tissues is greater than safety. Now, here's the thing, though there's numerous parts of our lives, right? Anything that can can lead to this kind of threat response inside of us, whether that's a global pandemic, or that's not being able to make your mortgage payment, or that's a manipulative, spouse or parent early in life, like a past, present, and personality is a way that some of us talk about how these external and sometimes internal threats, you know, as it comes to like a perfectionist and really hard driven personality, people pleasing kind of poor boundaries, these calls an internal kind of smoldering threat, that we can't stand up for ourselves and assert our boundaries or that we need to be all things to all people all the time, or I certainly have all of these, it served me very well in medical school and residency, but that served is actually an internal form of pressure. Right? Sometimes these threats come in the present with kids, and whether it's sick kids or having vaccine debates or, you know, watching the news, you know, there's there's a lot of things, but especially the stuff that within our families, whether it's family of origin, or current family that really starts to stress us out, this is where stress comes into this. And certainly some people have been through some very stressful experiences in their past. Some people not as much there's there's abuse, and there's neglect and some certain things, but it's considered a major childhood trauma for your parents to have been divorced, or for one of your parents to have had a mental illness like just simple depression, that affects how your your whole protection system views how it's safe. So past, present, and personality often are these ways to sensitize the system. And when we get sensitized, we're getting sensitized to threats in our life, our nervous system kind of turns up the volume, our vigilance, we start to worry about more things, we start to pressure ourselves to be a little bit warmer, a little bit more critical, settle less for, you know, average work, which is nothing wrong with that. But sometimes we're always moving the goalposts in our life. And other times, we really have this self doubt, you know, about ourselves or about our vocation, in life or about our decisions. All of this creates this internal threat response. And as the threat goes up, we need danger signals to protect us, we have this fight flight and freeze part of our autonomic nervous system, you've heard about I know, you've talked about you and I have before. And this is what really starts to sensitize the system. And it can actually amplify or perpetuate, or even it's sometimes cause physical pain, because pain is always from the brain, doesn't mean it's imagined doesn't mean you're making it up or being dramatic. Okay, all pain comes, your hunger comes from the brain fatigue comes from the brain, right? Joy comes from the brain, and anger and all these emotions, physical feelings, and emotional feelings all comes from the brain, and they're designed to protect us. But sometimes they can get sort of Alik out of calibration. Or sometimes they can just get amplified to the point where all we start to feel is even physical pain. But that physical pain is not being caused by tissue damage as much anymore. And that's the thing in all of medicine we're looking for cause we can treat symptoms with opiates, how's that worked out for us, right? Or you can treat symptoms with a whole host of supplements. The I'm sure you have people that are in a bucket of supplements, and what they actually need is to understand it's no, it's this and this, and you need these two supplements to really help. You don't need 20 Because you read 20 different articles that said 20 different things, we really need to drill down to the cause of this. And that's why I think you're such a good clinician, and why doctors who really focus on causes of these things get to the cause of chronic pain which is often not just the body.

Ed Jones  13:56

And this is a as people would guess a very rare conversation that a person could even have with a health care practitioner professional because they're not exposed to this so they have no idea but can I say and you tell me if this is correct. So chronic pain because I have I've had and I'm dealing with it right now I have some one is it moves around one thing that Dr. Sarno says is if it moves around, it's obviously not a broken body. And so part of the reason that it keeps creating pain in me is because there's a level of emotions, that's probably or is more painful for me to look at or deal with. Then my hip hurting, right so this hip hurting is diffusing or redirecting me into something other than my truth journey spiritually in life would be to look down in the dark well, but that's so scary that it's creating my hip pain. Now one thing that I know from reading his book, The back book is when he said pain moves, mine always has moved. I mean, yesterday my right hip hurt today my left hip hurts and the day before my right buttock hurt, well, it's just classic. It's called TMS isn't what he named that what's that stand for?

Dr. McClanahan  15:13

Tension myoneural syndrome, that essentially tension in the mind and in the emotions in the heart and the soul, right? Have a reflection through this, the muscles and the nerves and the other systems of the body, again, through this autonomic nervous system, which balances and protects us, right? Yes, fight or flight, but it also is what runs your digestive system and it runs your hormonal system. It's very implicated in your immune system. So it has little tentacles, neural tentacles, basically, that help regulate your blood pressure and how much your eyes are dilated or constricted if you're sweating or not. Right, but it also goes deeply down into this perception right of threat, which is often run by neuro chemicals, cortisol, adrenaline, these sorts of things are here to protect us, but they can get they can get turned on. And we're not built to be in stress all the time stress as a tear down process, mobilize blood sugar and fat rich fat reserves, let's crank up the juice with adrenaline and cortisol. And all of this stuff like really starts to process in our nervous system as in a way that we can't always be tearing down we have to move back to this rest, digest prepare, right fight flight freeze rest, digest repair, but certain personality types, etc etc. This makes for this persistent threat.

Ed Jones  16:27

Because if we're constantly vigilant something negative is going to happen because we're not meant to be living on the the scary place 24 hours a day that a tiger or a snake or something or bankruptcy is right on our shoulders. And so the body does in its intuitive wisdom is actually trying to help us in its own way. But if it's creating this chronic chronic pain and we keep looking for answers, we keep thinking we're kind of a victim and we're looking for someone to fix us that's a dead end road to me because the body's not broken. We have this mind activity going on that we have to maybe look in a different place then what we have been looking in it's odd with me because this this chronic pain I know is emotionally triggered maybe it's mostly caused but I know it's also emotionally has to be dealt with for me to really get better because I can get very good even and just because I know Sarno's principles and new and all the things that we believe in it doesn't mean that it takes all your pain away but what it's done for me is it gives me peace of mind I also now know how to manage it quite well and I'm in those days is not too good but I'm far better than I was and the other thing is pain medication does not help me. I don't care if it's prescription pain meds that's another sign that it's more from the brain because it's it's there's nothing wrong with my hip I've had it looked at it's fine but it's telling me that there's work that needs to be done yeah and and you know the his documentary called all the rage if you type in a YouTube John Sarno all the rages four minute five minute little documentary he very well explains about when he's talking to patients what what we're talking about. What so you see patients in regard to chronic pain. You have a clinic here in town, you've been doing it three years. And here actually at Nutrition World. So how does that go for you? What? What's a protocol with a patient?

Dr. McClanahan  18:25

Yeah, I will clarify one thing. So all the rage is actually a an hour and a half documentary. There's a trailer, you can rent it through YouTube. I did. You can also go on Amazon Prime and streaming. I mean, oh, 4.99 or something like that. But fantastic. The trailer is good enough on its own. But yeah, so the question is actually like, if we treat the cause, I mean, there are people that get cured of this, you know, there are some that have been able to manage their pain in a new way. But like Cure is possible sometimes, especially if this is just TMS. Another way of talking about is calling PPD psycho physiologic disorders, or mind body syndromes, NBS. These are all different names for the same thing. Okay. Some people call these central sensitization syndromes, that's probably the most academic term. And that's getting a diagnosis really important. Right? I'll often say to new consults. You know, if you had eight out of 10 pain right in your abdomen, for example, and you were convinced it was gas, or you weren't sure it was pancreatic cancer, right, which one's worse? Well, technically, the experience of them is that they're the same. They're both eight out of 10. But one certainly has much more ominous, you know, meaning to you and you're not sure and you're kind of like oh shoot and maybe I need to get to the gastroenterologist and get the MRI and get the biopsy. And if you just need to, like go find some bean-o. That's a whole different thing is out of 10 but I know exactly what it is and I can take care of this. That's safe. Those are safe thoughts. This is like I know what this is. I can do this. Versus Dyer and doom and uncertainty activates all that threatened machinery that we have.

Ed Jones  20:02

And I want to interject, I know and I know that you will say probably the same thing. Yeah, I could completely agree, once we have some chronic pain, we got to rule out that there isn't a broken ness to our system of some sort. The issue is, and I've dealt with this too, because I can I know I've always been, tend to be a hypochondriac a modest, not terrible. Because I deal with so many sick people. And you know, I know all the stories of medical school people, you know, you end up having every disease in the book once they start studying it at first. Well, I certainly had every disease in the book to temporarily. But when you when when you have a chronic pain, and you keep going to different practitioners, they're actually going to reaffirm the fact that you do have some problems because you go to a chiropractor, your spine is out of alignment, you go to the physical therapist, you need to do some physical work. Yes, your core is weak. Yeah, of course, weak. I mean, I've been through about eight different people, and they all have their special ideas, and they're good people with caring hearts. But I, if you totally believe in and intake, all that information, you tend to go back to that broken body. Yes, philosophy. So then you keep looking for the fix. And that does distract you from physical care, the physical fix that keeps you from doing the real fix, which is Dr. Sarno's principles of TMS and Dr. McClanahan. So does that sound like Right?

Dr. McClanahan  21:22

Oh, that sounds right, in part of a new patient consultation is really reviewing the lab work, we want to rule out tissue damage, like fractures and, you know, acute compressive issues, whether that's nerves or bones or muscles, or whatever, infections, cancers, right auto immunity, these things can really do active and ongoing tissue damage. That's the tricky part is well, that's maybe not that tricky that we rule that out with labs and imaging. And this is what the medical system is, is really designed well for the Western medical system that looks for problems and addresses them. Now when people don't get better. That's that's another thing altogether, and that's where we're getting to, but when people just start to see some degenerative change on an x ray, or an MRI and their spine, or their knees or their shoulders or hips, right, that's normal, age related change, I've got some I'm 41. And I've got some grays in my beard, you've got a few more in your hair, I don't have as much hair as you like, these are normal age related changes. And but this is what we're told by numerous different practitioners, surgeons at times, or doctors who just don't understand 40% Excuse me, 50% of 40 year olds with no back pain, have disc bulges, yes, and no pain. So just bulges without pain. It's something like 68% of 40 year olds with no back pain have degenerative changes at one or more levels of the spine. In this, this just marches right on up from 20 to whatever 100 Like the levels go up and up and up of degenerative changes of disc bulges of compressions of herniations. This sort of thing, we see the facet joint narrowing for the nerve spaces. And this is just sort of gray hair of the spine. 

Ed Jones  22:59

Now I love that. 

Dr. McClanahan  23:00

Right? And so it's not the cause of chronic pain, I can tell you that. Now, if you've got a lot of arthritis, and you've got an it's mainly right sided back pain, but you've also got right sided foot drop, right, and that can get gets confirmed on on a nerve conduction study. That's a different issue. Right? So we've got some tissue damage, and we've got a compressive lesion on maybe the L five nerve root on the right, and that causes this foot drop, okay, well, we need to go get that addressed. Surgery is great for that. But actually, there's something like a 25% success rate for low back surgeries, even these decompressive surgeries and fusions for just the indication of chronic pain, along with degenerative change. It's really awful. And so, in surgery in and of itself can lead to complications, people can rarely die on the table or have anesthesia reactions that can cause in some cases, some post like fusion low back syndromes in and of themselves. And so surgery and just a structural approach is never the only solution. We always want to look 360 degrees, we want to consider like yeah, this is a danger signal coming from your brain this pain signal. That doesn't mean you don't need tissues address but like once you can start to say well actually only I really have this degenerative changes. And you know, I've got five different diagnoses from my PT to my acupuncturist, to my nutritionist to my you know, Pilates instructor and my pain moves. Well, structural pain doesn't move, right? If you've got a bad knee and your bone on bone, which sometimes that can cause a pain experience and people it's pretty, it's pretty routine and it's pretty predictable. And it's it's usually always there a broken bone hurts like every step until it's healed. It doesn't move to the left, right? It doesn't vary with the time of day or your period, for example, or just like something non unrelated like dairy or gluten intake. I'm not saying dairy and gluten are unimportant sometimes, but when we start to have pain that is some becomes like on the right but then it becomes symmetrical. Or now it involves the entire right side of the body or It kind of gets better on the weekends, but it's worse at work, right? Or it gets better on vacation. Or it's just worse on the holidays, or sometimes anniversaries, anniversaries, birthdays, death days, these sorts of things. Or when your mother in law comes to town, I have a great mother in law, but like, you know, there are times when these sorts of things start to act as triggers, or they're just inconsistent from the standpoint of what a structural lesion would do. Or they get coupled with other things. I've got low back pain, but I've also got anxiety. And I've got I get migraine headaches, or I've got fibromyalgia and I also don't sleep. And maybe I said that already. And I have depression, and I'm on depression meds, or it's, you know, I've got irritable bowel syndrome and, and this kind of variable, hip pain.

Ed Jones  25:49

People appreciate what you're just saying, for their own body in life. It's a big sign and signal that it's time to look somewhere else. 

Dr. McClanahan  25:57

Exactly. 

Ed Jones  25:58

And so what and I know, we're going to want to run out of time here, what is what would be your advice for their next step? One is people who are here want to come see you? Yeah, possible two what would the person who can't do that is what would be your next step?

Dr. McClanahan  26:13

First step is if you have doubt about this being a structural thing, and you have not done due diligence, you know, you might still need that MRI, to really help you to understand I mean, it to take this approach is one that is somewhat counterintuitive, like, it doesn't feel like my back pain is this neuroplastic pathway. Right? It doesn't feel like that there are stressing emotions in my back. It feels like my structures hurt when somebody presses on the muscles, it hurts, but it also feels better after a while, you know, it's it's feels structural, none of this, I have a patient say no, this isn't that that mind stuff, Doc, this is real pain. There's no such thing as real or fake pain, right? Is it structurally caused? Or is it caused by the nervous system? Well, that's a different question. Right, I might be hungry. And whether I need calories, or I'm stress eating, right, or I saw a commercial while I was watching the football game, and I'm just kind of mindlessly doing this thing. Those are all real sensations of hunger is just one is more equally, you know, closely calibrated to this need for calories. And the other one is a need for comfort, which we're good. You know, we're good for comfort food in the south. So part of this is really getting drilling down towards the cause, ruling out these things if you need an autoimmune panel done. I don't think most people need these huge batteries of toxin tests and, and ruling out all kinds of you know, mold overgrowth, or testing every last little thing about your sensitivities. These can be helpful sometimes, but in my experience, the sensitive part is the nervous system, not just the gut, or not just the overgrowth of this or that thing or too much cadmium in your hair. I'm not saying those aren't helpful for some people, but like, most people when they've exhausted a few options, exhausted the PT route and exhausted some medications, and they're on a pretty reasonable supplement regimen and start considering this. But also just like you said, Do your symptoms vary? Do they move around? Are they are they triggered by certain things? Whether that's food or weather fronts? Or you know, times of the day or month? Did they get like are they not leading to like weight loss and night sweats right? If you're having blood coming out of your in your urine or your stool, let's that's not actually an organic change, right? Versus this chronic abdominal pain. Somebody told you it's no big deal but you still have blood in your stool. You need to get that evaluated right. But when we can start looking at this other stuff like oh, by the way, I did have this like these migraines or chronic abdominal pain as a kid and no one ever figured out what was going on. Or yeah, but there was this time in my 20s where I had horrible anxiety and panic attacks for a time and now you have whatever chronic low back pain or neck pain or thoracic back pain we're starting to put this together these things run in packs irritable bowel syndrome, chronic fatigue interstitial cystitis, these chronic pain syndromes, fibromyalgia, like I said, chronic pelvic pain is one can be pain with intercourse or really awful periods for women, it can be prostatitis, it can be diagnosis, prostatitis for men, difficulty sitting. These sorts of things like run in packs together, and then we can also look and say, Man, did you have was it stressful in your life when these symptoms started? You know, is there's anything going on? Or was it stressful in your past? Right? Did you have a pretty chaotic childhood you moved a lot or dad was an alcoholic or mom had really high and low highs and lows tempers are depressed episodes and it really caused you as a kid to start on a neurological level detecting threat kind of everywhere.

Ed Jones  26:57

And building your protection for from that threat. Yeah. And the you know, I know with my history, actually my pain went away within one day of reading the book The healing back pain by Dr. Sarno. Now, did it stay gone forever? No, it didn't. But I know for a fact that my shoving the emotions down instead of dealing with them is what created creates the recurrence of my pain. A==

Dr. McClanahan  30:03

So are emotions for? To protect us. And when you shove your protection down, what are you doing, you're sort of like one invalidating your system on one hand, but like, you're reducing the brain's capacity to alert you to danger. So we'll amplify something else. Right in. So it sort of amplifies all these physical symptoms, and you get fixated on these physical symptoms. And other things. This, the psychology of this is really fascinating, and how it connects to the neurology and the immunology and the endocrinology, all of this is related through this autonomic part of the nervous system. In your you're right on with this, and this is in a consultation, I mean, we're really looking for is this structurally caused these symptoms, whether it's fatigue, or pain, or, you know, anxiety? Or is there a neuroplastic part of the brain that is kind of amplified and once we start down that route, we really want to start to identify what are the inputs to fear to the system. If you think every time you move that your discs are going to flip out between your spine like a totally wink, like that's going to make it very hard for you to like want to move to feel confident in your body, you know, that's, that's a danger signal. It moves the system over towards danger, every time you move, and every every morning, you wake up dreading getting out of bed, and till you get in that first 10 minute hot shower for your body to get moving. This is often a neuroplastic process, okay? And when you put all the facts together, not exactly a tissue thing, and this variable and triggered and man, yeah, I did have a pretty stressful childhood, or I can't you know, I'm a real perfectionist, or I've got all kinds of self doubt, these personality, past, present and personality, start to point towards stress, you start to put this together and we can start to desensitize then the nervous system, we decrease the inputs of fear, worry and pressure and doubt, right. And we can also increase the inputs of safety, mindfulness, awareness, self compassion, right? Gentle graded exercise, a growth mindset, these sorts of things add all kinds of like, knowledge is safe knowledge is power, we say, powerlessness versus power, right. And so as we start to develop power, in different kinds of connection to ourselves and others, and a meaning, we make meaning out of this pain, like, oh, wait, I can see why this is happening. There you go, right, that this is not a matter of like blind faith, it's a matter of understanding the literature. Two studies came out within the last three weeks that like approve of this, one of them is in JAMA psychiatry. It's on what's called pain reprocessing therapy. And it has to do with like, understanding a little bit of the neuroscience of pain, you don't have to be some nerdy neuroscientist to do this. But to understand that, like these signals coming in from the body, are no longer dangerous, or we can read, we can change our pervasive perception of this.

Ed Jones  32:42

Well, what unbelievable points and I know for myself, and I'm always constantly reading and on YouTube with people like yourself, who helped me to be further educated on these principles. Dr. Sarno says he's got, I think, a list of 12 kind of recommendations for life, one of those is, go back to exercise, don't think that you're broken and you can't do things? Well, to do that you have to have, you have to move into the place or I have that I say to things to myself, I am not broken, and I am safe. And I have to keep telling myself that when the pain goes up, because the lack of safety always makes me have more pain, and then not feeling secure and feeling that I am broken, keeps me from doing anything, which then feeds the pain more or feeds the fear more.

Dr. McClanahan  33:31

It feeds the fear. 

Ed Jones  33:32

Yes. And that just gets me in this spiraling cycle. That is it's a doom and gloom cycle. There's no doubt I have learned so much from chronic pain. And I try to look at life's challenges as teachers. And this has been a wonderful teacher is one reason you're on here because I want to help people to know there's hope. There's hope more than opiates, there's hope more than just hanging on to the side of your bed every morning and barely moving because you might break more. And again, ruling out the medical stuff first is important. But then you kind almost have to quit going to those people because you're going to keep getting diagnosis that you're broken. That's not what we need, because then we won't feel safe again. So we have to do some self work and for you. So you see patients here in Chattanooga. Yeah. What's the name of the clinic?

Dr. McClanahan  34:17

My practice is called the Center for Insight medicine. You can go to centerforinsightmedicine.com. I just redid my website. It's got links to like all kinds of videos, books on the subject. I've got healing back pain link right into Amazon there. There are a few like national groups that do this. One is called the PPD Association psychophysiological disorders. We're actually having a conference later this week online if you really get into this. I don't know if this will be released in time for that but PPD Association dot o RG has all kinds of links a questionnaire it's got links to practitioners in different states. Oh good. So you can look through nationally to see if your state's on there and then where these practitioners that unruly, understand and how the brain works. And it's not just this fragility, tissue damage model only, right? We really need to incorporate this bigger neurological and psychological connection. Another one is called TMS. That's what you said tension my own neural syndrome TMS wiki, like Wikipedia, TMSwiki.org, has all kinds of other videos, links to self directed programs to take yourself through to really understand one, why do I hurt? What is this TMS thing? And then what do I do about it? And then as you progress through that, again, there's another practitioner directory, links to books. There are coaches and psychologists and PTs and physicians all over the country and even the world now doing this. It's not a majority of us for sure, unfortunately. But yeah, TMS wiki.org PPD, association.org. Centerfo insightmedicine.com is my website. These will all be really invaluable to people just to go explore right? Read a John Sarno book healing back pain is on Audible. I listen to a lot of books these days. His best book, in my opinion is called the divided mind. Yes, it is.

Ed Jones  36:05

I love that book.

Dr. McClanahan  36:06

There's a book called out when the body says no by a guy named Gabor Ma Tei. Who is on there and a brand new book that just came out called the way out by Alan Gordon, this this is actually based off that research in JAMA psychiatry that I mentioned, it came from a study out at University of Colorado Boulder working on pain reprocessing therapy. It's just a new way of talking about TMS work in a sense, but it really is fundamentally changing our relationship to fear. 

Ed Jones  36:34

I love that you know Dr. McClanahan, and this. I mean, this is life saving stuff. And that's one reason we work so hard to empower people through these podcasts and through information. Because the normal traditional pathways are, they kind of have medical inertia going on, that what they've done in the past is what they're going to do in the future. They're not going to break out of this mold very easily. You've just empowered people with all of your website information. Because again, knowledge and reading is the key to this, you can't expect someone else to do the work for you. But it's not that difficult. I went through years of no pain for the first time I read his book, but life is life and you know, went through a divorce and I went through this and I got relationship issues and and and and we all do, it's not just me. But being able to learn better how to process the emotional stress that comes with that which will happen if we're breathing human beings is the key to me controlling my chronic pain. And so, you know, I know it's watching I think the documentary you talked about was Sarno I think I saw him with a couple patients. And at the end of his visit, he would all tell always tell people are his patients. Now go live your life. And I love that now go live your life. And I have to remind myself sometimes of that, hey, it's time to go live my life. There isn't a finish line there that I want to get to. It's every day is my life. This is all I have. And this chronic pain, Hey, it's okay. It's okay to not be okay. Sometimes if it's disabling then I have to work harder. But so I'm just thrilled you're here in Chattanooga, thrilled that you are here to to expose people to this. Your credibility is just the top of the game. So thank you for joining us on Nutrition World's podcast.

Dr. McClanahan  38:16

Thanks for having me. And I appreciate everything you're doing with Nutrition World, but the things you said today are just right on and your own experience I know as informing that and so if anybody would, if I would leave everybody with something, it's just you're probably not as fragile as you feel like they are right. And just be curious, like curiosity and fear or you can't really have both at the same time, like one is, is more dominant in the more curious we can be about our symptoms, curiosity that might direct you to a website or a book, curiosity that might just help you to question your symptoms, right? Move from that pancreatic cancer to gas like we would if this was gas. It can change everything. It can change your nervous system to start to a more safe place. And that can change everything. So stay curious.

Ed Jones  39:05

All right. Thank you so much for your wisdom. Dr. McClanahan. Thank everyone for listening to Nutrition World's podcast. Now go live your life. 

Dr. McClanahan  39:12

Go live your life. I love it.

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