Tag Archives: back pain

Somatic Complaints During the Perinatal Period

Pregnancy and the postpartum period are very vulnerable times. Our bodies change in ways that can feel scary and uncomfortable. It’s also a time when a lot of birthing people experience somatic complaints. Symptoms often include morning sickness and the typical aches and pains of pregnancy and new parenthood. But they can also include sciatica, vertigo, migraine, heartburn, wrist pain, back and neck pain, and even Hyperemesis Gravidarum (severe nausea and vomiting during pregnancy). These symptoms can be scary, and they can make us believe that there is something seriously wrong with our bodies.

When we are experiencing symptoms that scare us, that fear turns up the dial on our perception of those sensations. And those of us who tend to experience these symptoms the most during pregnancy and the postpartum period are folks who “somatize” our stress and emotions — often those of us who’ve experienced childhood adversity and who are also susceptible to depression and anxiety.

I am one of those people. I’ve struggled with chronic symptoms since childhood, including asthma, IBS, TMJ pain, wrist pain, bladder symptoms, etc. But after the birth of my second child, my physical symptoms were the worst I had ever faced. My postpartum anxiety presented as somatic symptoms—constant, overwhelming dizziness and nausea that made it difficult caused me to be unable to care for my children. At the time, I didn’t connect these symptoms to stress or self-neglect, but in hindsight, they were clear signs that I needed better boundaries and self-care. With therapy and support, I learned to prioritize my own well-being, and slowly recovered.

I now know how common it is for new and expecting parents to experience both psychological and physical symptoms during the perinatal period. It’s an incredibly vulnerable time, and stress commonly shows up in the body. The good news is that these symptoms—whether depression, anxiety, vertigo, or pain conditions like headaches, dizziness, wrist tendinitis, neck pain or sciatica—are highly treatable.

As a therapist specializing in perinatal mental health and neuroplastic symptom recovery, I help clients heal both physically and emotionally, so they can return to the full, balanced life they deserve. How we engage with our physical symptoms can either exacerbate or heal them. Pain Reprocessing Therapy teaches us how to view physical sensations from a lens of safety, so sensations are not amplified. And Emotional Awareness and Expression Therapy helps us release strong emotions that can contribute to tension and symptoms in the body.

Psychotherapy can also support birthing people in learning to prioritize our own well-being as we are learning to care for our babies. Not abandoning ourselves while caring for our family helps us become healthy parents in body, mind, and spirit.

Take this Quiz to help you determine if your chronic symptoms are likely neuroplastic.

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

 

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.