Tag Archives: anxiety

The Mind/Body Connection in Chronic Symptoms

neck pain

Pain and other chronic symptoms—like IBS, vertigo, tinnitus or bladder issues—can take over our lives. Physical symptoms naturally create fear, and symptoms and fear together can become the center of our attention, pushing everything else into the background.

When pain or symptom keep us from doing the things we enjoy, it’s common to feel anxious or depressed. In fact, most people who struggle with chronic pain also experience anxiety or depression. It’s not always clear which came first, because they are closely connected. Many people with chronic symptoms have experienced childhood adversity, and are likely to be perfectionists or people-pleasers—traits that can increase stress and make us more vulnerable to both physical and emotional symptoms.

While chronic pain and other physical symptoms appear to be based in the body, research shows that trauma, emotions and stress play a powerful role—even sometimes when pain seems to have a clear physical cause.

I experienced this firsthand. Years ago, I developed chronic wrist tendinitis that was attributed to  typing too much. My pain was real and constant, and I tried everything—chiropractic, physical therapy, massage, acupuncture, Alexander Technique, and Feldenkrais classes. Nothing helped for long. I had to stop doing many things I loved. I wore wrist splints, used voice-recognition software, and avoided cooking, gardening, and knitting. Despite all these precautions, I was in pain for more than two years.

Then I found Dr. John Sarno’s book Healing Back Pain. He discovered that many people who had  physical findings that might cause pain—like herniated discs or arthritis—had completely different pain experiences. Some had severe pain, while others with the same imaging results felt none at all. One large study of over 3,000 people found that spine changes seen on MRIs are usually a normal part of aging and don’t necessarily cause pain. His work with his patients demonstrated that emotional stress and repressed anger can create very real physical pain. He helped many thousands of people recover from chronic pain with his medical practice and his books. I was one of them. 

It’s important to note that pain or other symptoms are not “all in your head.” Chronic symptoms are  absolutely real. But all our experiences are mediated by the brain, and our brains interpret pain based on not only sensations sent from the body, but also based on expectation, and the perception of danger. If we’re afraid that something is wrong with our bodies, or of conflict, negative emotions, or anything else we experience, pain and other symptoms can begin or intensify. On the other hand, if we feel safe and confident in our body’s strength, and in our ability to handle our emotions and our relationships, they can fade—even when nothing physical has changed. This is why treatments that reduce fear and increase a sense of safety can be so effective. The fact that changes in in how we interpret the world impact our symptoms is why we call these symptoms “neuroplastic.”

Over the past several years, there has been increasing evidence supporting Dr. Sarno’s theory, and new treatments have begun to be proven to help patients overcome neuroplastic symptoms. In 2020, I completed training with the Pain Psychology Center to work with clients using Pain Reprocessing Therapy (PRT). A study at the University of Colorado found that people with long-term back pain experienced major or complete recovery after just four weeks of PRT.

PRT helps retrain the brain to interpret pain signals differently. It uses mindfulness, cognitive, and behavioral techniques to reduce fear, calm the nervous system, and build a sense of safety in the body. As fear decreases, pain often does too—sometimes permanently.

Chronic symptoms, as miserable as they can be, often serve hidden purposes. They may give us permission to slow down, rest, or seek care from others. They may distract us from emotions we’d rather not face. Understanding these patterns can help us reclaim our energy and our lives.

When we start to truly trust that our bodies are strong and resilient, and that we can handle our emotions and the stresses in our lives, we can stop letting pain dictate our choices. With the right tools and mindset, recovery is possible—and life can feel full and joyful again.

 

Take a test to see if your chronic pain or symptoms are likely treatable using a mind-body approach

References:

  1. Sarno, M.D., John E. Healing Back Pain: The Mind-Body Connection. New York, NY: Warner Books, 1991.
  2. Sarno, M.D., John E. The Mindbody Prescription: Healing the Body, Healing the Pain. New York, NY: Warner Books, 1998.
  3. AJNR Am J Neuroradiol. 2015 Apr; 36(4): 811–816.

    Published online 2014 Nov 27. doi: 10.3174/ajnr.A4173

 

Antidepressant Medication in Pregnancy

Pregnant Belly

The debate over the safety of psychotropic medications during pregnancy continues to spark strong opinions. Critics of antidepressants often cite numerous articles and isolated studies highlighting potential risks or questioning their effectiveness. What we’re seeing, in many cases, is a form of “splitting”—the tendency to categorize something as entirely good or entirely bad. When it comes to psychiatric medication, people often fall into one camp or the other and accept only the evidence that supports their viewpoint.

The reality is more nuanced. Yes, some psychiatrists make mistakes, and psychiatric medications can be overprescribed or misprescribed. Some people do not respond well to them. But many others experience profound relief, and for some, these medications are lifesaving. This is why clear, balanced, and evidence-based information about the use of psychotropic medications during pregnancy and breastfeeding is so critically important.

Many who oppose antidepressants advocate for natural or holistic approaches to treating depression and anxiety. These approaches can absolutely be helpful for some people. I’ve personally tried acupuncture, chiropractic care, homeopathy, craniosacral therapy, and herbal treatments, and at times found them beneficial. But, just as we rely on modern medicine for conditions like Type 1 diabetes, there are situations in which holistic measures simply aren’t enough.

In my own experience many years ago, no amount of holistic treatment or psychotherapy touched my severe postpartum anxiety and depression. I was eventually hospitalized when I no longer wanted to live. Six weeks after starting an antidepressant, I was able to function again and finally benefit from therapy. I know that medication saved my life, and I’ve heard countless similar stories from other birthing people.

Perinatal mental health disorders have both biological and psychological components. Hormonal shifts, physical recovery from childbirth or cesarean, and chronic sleep deprivation can all play significant roles. In my work with birthing people, I’ve seen again and again that those with severe perinatal depression, anxiety, or OCD often do best with a combination of approaches—psychotherapy, self-care, social support, nutrition, sunlight, and moderate exercise, and medication when needed.

Some parents choose not to take medication, and many do recover with therapy, support, and lifestyle changes. But some later wish they had considered medication sooner, regretting the weeks or months lost with their baby while they struggled to bond or function due to overwhelming symptoms.

Untreated depression and anxiety during pregnancy and the postpartum period carry real risks. They can affect birth outcomes and have lasting effects on the parent, the baby, and the entire family system.

The truth is that some new parents simply do not have the energy, motivation, or clarity to benefit fully from therapy or self-care until their symptoms are stabilized. In my experience, most of these individuals improve significantly once they receive the right medication. That practical reality matters far more than abstract debates about whether medication is “good” or “bad.”

New parents deserve balanced, compassionate information—not scare tactics, shame, or political agendas. Their health, their babies’ well-being, and their family’s future depend on access to accurate guidance and the full spectrum of effective treatment options.

Coping with Anxiety Using Mindfulness

anxiety

You know the feeling when it starts: an unpleasant burning in your chest or abdomen, a feeling of cold on the back of your neck, tingling in your arms, or tightness in the back of your throat. Anxiety is a physical phenomenon.

Many of us are unaware of the specific physical sensations associated with our anxiety, but it sends a signal to our brain that we are in danger. On its own, anxiety tends to pass quickly and without much ado. It is the way we attribute meaning to the sensations in our body that causes anxiety to feel unbearable and to stick around. We interpret our anxiety as being “out of control.” We look to our environment or our thoughts for signals that we really are in danger, either physically or emotionally. And we beat ourselves up for feeling anxious, telling ourselves “What is wrong with me?” “Why can’t I feel calm?” And even worse, “I can’t tolerate feeling this way.”

But in reality, we can tolerate anxiety. By tolerating it and observing, without fear, and without judgment, its physical manifestations, we rob it of its power over us. And over time, anxiety will diminish if we refuse to escalate it by letting it take over our thoughts and our decisions. The quickest path to diminishing anxiety is to accept it and not to catastrophize about it or let it make our lives smaller.

Mindfulness is one of the most powerful tools for coping with and transforming anxiety. While it may feel like WE ARE anxious, bringing awareness to our body and choosing to focus on the specific physical sensations we are experiencing allows us to see that we are the observer of anxiety, not its victim. We can choose to halt self-defeating thoughts by returning awareness to our body and reminding ourselves “Anxiety cannot hurt me. It is only a feeling, and it is temporary. I am in control of myself. I can choose to be aware of the anxiety without letting it take over my thoughts.”

Practice doing mindfulness exercises such as this one when you are not feeling particularly anxious, as a way of being ready for anxiety when it comes. Learning to focus your full attention on your body rather than your thoughts takes some practice, but only five minutes a day can make a huge difference in reducing anxiety and helping you cope with it when it comes.

Anxiety is often associated with depression, even if the depression is not severe. Taking steps to address negative patterns of thinking, grieving losses, and learning to take better care of ourselves physically and emotionally is another important step in dealing with anxiety. If you need help to learn to identify and challenge negative thoughts, work through with past trauma or loss, or learn to improve your self-care and relationships, finding a therapist you trust is a great place to start.

Why Parents Should Nurture the Child Within, Too

Young woman on swing
Young woman on swing

Becoming a parent brings out so many new qualities in each of us. We learn to nurture selflessly. We learn patience and empathy. We learn to read the cues of our new baby, and how to meet their needs as best we can. It is an opportunity for growth like no other in our lifetime.

However, as we learn to give love and care to our child, many of us also begin to face the reality that we were not nurtured in certain ways in our own childhood. As we provide a loving mirror to our child, reflecting back a positive and validating image, we may become aware that we were not mirrored in a loving way ourselves. Perhaps we were shamed for certain qualities, or silenced when we voiced our truth, or in other ways shown that we were “not OK” the way we were.

Many of us have internalized shaming and dismissive attitudes directed at us as young children. We may not even realize that we continue the pattern by shaming or silencing ourselves. The child part within each of us, which is our source of joy, passion and creativity, is often stifled by our own inner shame. Our need for validation, love and nurturing are easily dismissed as “selfish” or “needy,” as we tell ourselves that we “shouldn’t” need the things the child inside us craves. The things we most enjoy and that give us pleasure are easily lost as we focus our attention on practical realities and the needs of others, especially our children and our partner.

This pattern of self-neglect fosters depression and chronic pain or physical symptoms. The child inside us loses hope that he or she will ever experience joy and fulfillment, contributing to depression. Or the child gets angry at being neglected and acts out, causing us to be resentful, irritable, or develop chronic symptoms (anxiety or somatic complaints) that tell us that all is not well in our inner world.  

This is how I understand my own struggle with anxiety and chronic symptoms as a mother raising my children. When I lost touch with the child inside me, as it is so easy to do while raising children, my anxiety mounted. If I continued to be what I believed a “good mother” was (e.g. selfless, endlessly patient and focused on the needs of others), the result was depression, painful physical symptoms, overeating, and other self-destructive patterns. What I came to discover was that by focusing my attention inward, and creating a loving dialog between my inner parent self and my inner child, I was able to heal those childhood wounds and feel a sense of balance and wholeness. 

Some clients of mine find that they can identify a clear inner parent and inner child voice. But for those who find it more difficult, the following exercise can be useful. You can communicate in the voice of your inner parent by writing with your dominant hand, and can reply as your inner child by writing with the non-dominant hand. It is amazing how easy it is for many people to access the child part of themselves when struggling to write with their non-dominant hand! If you have difficulty “hearing” your inner child voice, put your hand on your belly — that can help you access this vulnerable part.

You can start a dialog by asking “how are you doing?” or “how can I take care of you today?” or “what are you needing from me?” Some will find that the child inside them is quite angry and distrustful of the inner parent at first, for having neglected them for so long. But you can overcome this distrust by responding consistently in a loving parental voice, and reassuring the child inside you that you are there for them, that you will not leave them alone again, and that you love them just the way they are. You may not always be able to give your inner child what it wants in that moment, but just as we do with our children, we can learn to validate their needs and make sure that we create a life in which our inner child’s needs have some level of priority as well.

Here’s an example of an inner child dialog, that was initiated when the client found herself feeling very heavy and having back pain:

Parent: What are you needing from me today, Sweetie?

Child: I’m sad and I want to play with my friends, but I always have to work and take care of people.

Parent: I’m so sorry you’re sad. Working so much is really hard. We don’t have time to go play today, but I will make sure we have a couple of hours this weekend to go do something fun. You’re feelings matter to me, and I’m really glad you told me how you feel. Would asking [partner] for a hug help make this day easier?

Child: Yes, I like hugs. But I’m still sad.

Parent: I know, and it’s OK to be sad. Your feelings matter to me. Do you think a nice bath before bed would feel good?

Child: Yes, that’s good. Can I have bubbles and music?

Parent: Absolutely! I’m so proud of you for asking for what you need and I love you very much.

This exercise will allow you to begin a conversation that can allow you to experience a corrective emotional experience of being cared for and attended to, which can heal your heart in a very deep way. You can also learn how to create a balance between the needs of others and the needs of this tender part of yourself, which will allow you to live a more authentic, joyful life.

Perinatal Mental Health and Perfectionism

canstockphoto10868712

You’ve read the books. You’ve prepared the nursery. You’ve heard about Postpartum Depression—even if you may not see yourself as someone who’s likely to experience it. The commonly known risk factors for Perinatal Depression and other perinatal mental health disorders include:

  • A previous episode of depression or anxiety (especially during pregnancy)

  • A recent loss or major stressor, such as financial or health challenges

  • Lack of social support or relationship difficulties

  • A complicated pregnancy or birth, or breastfeeding challenges

Many of the clients I work with can check several of these boxes, and having one or two doesn’t guarantee you’ll struggle emotionally after birth. But there’s another risk factor that’s harder to measure—one that isn’t about what has happened to you, but about how you relate to yourself and the world.

Research shows that perfectionism and related personality traits can significantly increase the risk of postpartum depression. In particular, new parents who struggle the most with making mistakes are about four times more likely to experience postpartum emotional challenges. Also at higher risk are those who naturally prefer order, clarity, and control. This makes intuitive sense. Becoming a parent is the ultimate beginner’s role—messy, unpredictable, and often undertaken on very little sleep. If uncertainty or imperfection has always been hard for you, new parenthood can feel especially overwhelming.

In my practice, many of the new parents who struggle most aren’t just perfectionistic—they’re also used to taking responsibility for everyone else’s feelings and needs. That may work—barely—before a baby arrives. But a newborn instantly multiplies the emotional load. Babies cry. They will cry no matter how devoted, attentive, or skillful you are. And the more pressure you put on yourself to be a flawless parent, the more strained your energy and relationships can become. It’s a setup for stress, anxiety, and depression.

This is why learning to let go of perfection—in small, practical ways—can be powerful preparation for parenthood. Let the dishes wait a few hours. Run out of clean socks once in a while. Burn the rice because you got lost in a great article. Notice what’s going well instead of what could be better. Enjoy the sunshine in your half-landscaped yard. Allow people to be disappointed on occasion—after all, they disappoint you sometimes too. Practicing being good enough is not just healthy; it’s the foundation of sustainable, compassionate parenting.

If the idea of leaving a dish in the sink feels impossible, consider trying mindfulness practices or guided exercises. Mindfulness can help you accept what’s happening in the moment instead of feeling responsible for fixing everything. And you might benefit from support with a warm, understanding therapist (bonus points if their desk is a little messy). Learning to release some of the pressure you’ve carried for years is an investment in your well-being—and in the emotional health of your growing family.

People-Pleasing Moms: At Risk

Sad new mom holding baby - people-pleasing momsOne of the common themes I come across when working with mothers experiencing depression and anxiety is perfectionism and people-pleasing. Moms get worn out when they are trying to make everyone happy all the time.

There are often good reasons for a tendency to be over-responsible for the feelings of others. Many of us come from families where there was an unspoken expectation that a child must be “good,” because one or both parents were unable to tolerate the challenge of even normal childhood misbehavior. Or sometimes, children develop an unconscious habit of caretaking for others as a way to get their own needs met.

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Take a test to see if you have Prenatal or Postpartum Depression