Why am I still in pain? It's one of the most searched health questions on the internet. Millions of people live with chronic pain, fibromyalgia, back pain, neck pain, migraines, pelvic pain, IBS, anxiety, and unexplained symptoms despite seeing specialists, trying medications, physical therapy, injections, surgery, and countless other treatments.
In this episode of the Crackin' Backs Podcast, chronic pain educator and bestselling author Nicole Sachs explores a different question: What if your symptoms aren't simply something to eliminate—but something to understand?
Rather than debating whether pain is "all in your head," this conversation dives into the fascinating relationship between the nervous system, emotional stress, chronic pain, and the body's remarkable ability to communicate through symptoms. Nicole shares why so many people become trapped in cycles of pain, perfectionism, people-pleasing, fear, and nervous system dysregulation—and how learning to listen differently can become part of the healing process.
In This Episode
✔ Why chronic pain often persists even after tissues have healed
✔ How the nervous system influences pain, stress, and recovery
✔ Why your body may be sending signals instead of simply "breaking down"
✔ The surprising connection between emotional stress and physical symptoms
✔ Why people-pleasing and perfectionism frequently accompany chronic illness
✔ What to do when you've "tried everything" and nothing has worked
✔ How Nicole Sachs approaches healing alongside—not instead of—conventional medical care
✔ What gives hope to people living with chronic pain today
Whether you're living with chronic back pain, neck pain, fibromyalgia, migraines, pelvic pain, long-term stress, anxiety, unexplained symptoms, or you're a healthcare professional looking to better understand persistent pain, this episode offers an evidence-informed, compassionate perspective on one of healthcare's most challenging problems.
Nicole Sachs, LCSW, is a psychotherapist, chronic pain educator, speaker, and bestselling author known internationally for helping people better understand the relationship between the brain, the nervous system, emotional processing, and chronic symptoms. Her work has helped thousands of people explore new approaches to healing while complementing appropriate medical care.
If this episode helps you better understand chronic pain, the nervous system, or mind-body health, subscribe to the Crackin' Backs Podcast for weekly conversations with world-leading experts in pain science, sports medicine, longevity, neuroscience, rehabilitation, nutrition, and human performance.
We are two sports chiropractors, seeking knowledge from some of the best resources in the world of health. From our perspective, health is more than just “Crackin Backs” but a deep dive into physical, mental, and nutritional well-being philosophies.
Join us as we talk to some of the greatest minds and discover some of the most incredible gems you can use to maintain a higher level of health. Crackin Backs Podcast
Follow on Twitter for health tips! http://twitter.com/DrTerryW
SPEAKER_03
Well, millions of people spend years searching for the right doctor, diagnosis, or treatment. But what if your body isn't working against you? What if it's desperately trying to tell you something? Today we're exploring that hidden conversation between the mind, the nervous system, and the body with chronic pain coach Nicole Sachs. Welcome to the show.
SPEAKER_00Thank you. Thank you for having me.
SPEAKER_03Oh, you're welcome. You're welcome. This is going to be fun because it's always fascinating what goes on in people's minds. But you know, many people know your story, but let's start with what you were a young woman living with debilitating pain until this discovering uh Dr. John Sarno's work, which we've heard about before. But that experience, we understand, has changed your life and ultimately led you to help thousands of others navigate this whole spectrum of chronic pain and emotional suffering. Please start by sharing that story.
SPEAKER_00Yes, happy to. So when I was 19, I was at college and my back went out. So anybody who has had any sort of back pain, it was pretty typical. You know, I don't even think I was doing anything too extreme. I reached for something or I, you know, went to pick something up, and my back went out so completely I couldn't stand back up. And so, of course, this is really terrifying. And my parents took me home from school and I went to, you know, the MRIs, X-rays, orthopedic surgery consults. And I know you guys will be familiar with my diagnosis. I was diagnosed with spondylolysthesis and apparently a very severe case. You know, I was 19, so I didn't really have much to go on. But they basically said, um, the only, now we're in, you have to remember this was 1990, but they said the only surgery that we can recommend is spinal fusion surgery. And that would be, you know, a really long recovery, and it would limit my mobility for life. And so they said, like, don't worry about it now. The only thing, the only thing you have to do is no more exercise, no more travel, very specific sleeping positions, no more lifting anything over 10 pounds, and the likelihood that I would have a biological child was slim to none. So just that.
SPEAKER_03Good Lord. My gosh. You know, it's amazing how medicine, the concepts in medicine have changed so much over the last 30, 40, 20, even 20 years, and even now escalating even more so. So your work has evolved tremendously, but today it's it's you know much more than about pain. It's about understanding why the body speaks in the first place. And so looking back at your younger self in the middle of that whole suffering experience, what did what was your body telling you that your mind simply could?
SPEAKER_00Well, you know, I think a lot of people, when they first hear about my work, get very confused because they think that, first of all, I'm saying the pain is in their head, or in some way they're making it up, or they're overly sensitive, they're hysterical. And I'm really, I'm really sensitive to this because for over 25 years, I've been in practice and I work with many, many women, and they say when I got to the doctor, I was dismissed, or you know, I wasn't heard or I wasn't listened to. And so that's really, really important for me to start with is that there's no perception of pain. You're in pain. I work with people who have everything from like structural stuff, back, neck, shoulder, knee, hip, elbow, wrist, whatever, to IBS, to chronic migraine, to pelvic, different pelvic diagnoses and pain, skin disorders, autoimmune disease. So I've I work with things across the gamut, and I will tell you that the pain is never in anyone's head, they're never making it up, and they're never over, like overly sensitive or dramatic. What people, what I teach first and foremost, is the brain science, the brain science behind why we feel literally anything, why we feel positive or negative sensations. And I help people understand that people think, for example, they see with their eyes, but you don't actually see with your eyes. You see with your brain, just like you don't really feel with your skin, you feel with your brain. And so when people start understanding that yes, they are in real pain, they're able to get curious about where the pain is actually being generated from. And that's when we can get into the more um complicated conversation of emotional experience, emotional repression. You know, people are very familiar with Gabor Mate, I mean not Gabor Mate, um, Bessel Vanderkoult's uh When the Bot the Body Keeps the Score. Uh Gabor Mate wrote When the Body Says No. It's very similar theories. So what I what I'm really teaching is I'm not quite saying that the body keeps the score. I'm saying the brain and the nervous system keep the score and the body expresses the score. And so that is sort of the basis of where I start. So nobody feels dismissed because my story, although it began really dark and I wasn't going to have children, and you know, I did find the work of Dr. John Sarno, and I did understand, I learned about the brain science and mind-body medicine. And through doing that work for myself, I have not had back pain in 25 plus years. I have three children. I exercise till the day they were born, and my film looks exactly the same. So I still have the same very terrifying looking, according to doctors, spondylola's thesis, but it has never been the reason for my pain. It was an incidental finding, and it is real. It is the shape of me, but it was not the reason for my pain.
SPEAKER_02Wow.
SPEAKER_03So there's two types of I well, I believe there's two types of patients, but please clarify that. There's the ones that come in that they're in pain, they've been in chronic pain, and it there's always this psychological overlay that you have to deal with that that becomes negative and energy draining and not sleeping and so on. So and then there's the ones that come in that have maybe IBS or you know, or other, you know, uh digestive complaints, um you know, poor bowel movements, things like that, because of their emotional state, that it's more neurogenic. And how do you is there a difference really with those two types of patients, or and how do you how would you typically deal with that?
SPEAKER_00Difference between the patients in terms of the where their pain is coming from, the difference is how much it's going to take to get them to move into rest and repair enough to do the work to move themselves out of this cycle that the brain and the nervous system are in. So, for example, you know, I work with people sometimes that have never heard of mind body medicine at all. They listen to a podcast, maybe a couple of you guys are out there today, they hear of something they never heard of before, and there is this amazing aha moment for them, kind of like it was for me, where they're like, I understand this speaks to me. Those kind of people recover very quickly because they don't have the trauma of like trying a lot of things and feeling like they've failed because human beings are so complex. But if you look at this through the lens of evolutionary biology, we are always got our antennas up for what hurt us, because then we are going to supposedly not walk into those situations again. And so that's what's complicated when you the first kind of person you identified, which is like they've been through so much, you know, they've had chronic pain and now it's affecting their sleep and it's affecting their relationships and maybe they're on disability. Those people are absolutely able to be helped. But it can be a kind of a heavier lift than people who kind of come into this and they're like, oh my God, you know, aha moment. I understand what's going on with me. I have a ton of emotional repression, I have a ton of stored trauma. We all do, by the way. This is nothing to do with like exclusively if you had some, you know, abuse, neglect, like that. It's not just that at all. But people who come in and are less um resistant, let's say, that can be a much more easy recovery for them. But having said that, those two patients are the same. I have dealt with people who are on disability, let's call it for 10 years, um, bedbound, who are now living absolutely full productive lives with no chronic pain. I mean, it is absolutely astonishing what happens to the human body when the brain is no longer in fight, flight, or freeze in a chronic state, constantly trying to protect you.
SPEAKER_03Many years ago, uh in fact, I was just telling the mentioning this case to uh one of my uh interns yesterday, and it was about a female that came in with low back pain that she had chronic, it was going on, it was it was not very complicated whatsoever, but after two weeks I had to ask her, well, you know, you you start to listen really closely to the patient, and I'm wondering what where you can manage now with all the specialization in in health care. You know, you got you can go to an orthopedic surgeon because he's a specialist at an index finger, you know, things like that. But at what point were she you I listened so closely to her, she started talking about how she didn't like her husband and didn't want to have sex and things like that. I mean, I'm I'm I'm making it, you know, the I'm giving you the answer, but we had to listen, I had to listen really closely to it. At what point do you go, I think you need a marriage counselor? Or how how deep would you handle that one?
SPEAKER_00Yeah, so this is the question. First of all, good for you for being willing to listen. You know, I mean, it really we people are in such a vulnerable state when they show up at any medical professional and like just being willing to pause, especially in today's medical environment, and to be like, like, what's going on with you? I mean, it's just a kindness that I really appreciate. So thank you for doing that for people. Um, but what I will say is this I used to lecture, so so the the the way my story goes is I found Dr. Sarno's work. I um ended up meeting with him as a patient. I did all, I used all of his theories. I completely eliminated not only my chronic back pain. Never, never, by the way, never have I had my back go out again, but I um eliminated chronic migraines, different stomach issues. You know, I didn't have any other diagnoses, but like these were things that were really annoying. I always got these terrible headaches, or I get these stomach aches. And so I I have not had any sort of chronic symptoms or issues in, I mean, over 20 years. Having said that, there is no cure for human pain and there's no cure for the human condition. So I will get a headache, I will get a stomach ache, I will have a day where my body just feels like exhausted and it shouldn't be. That's that's acute. That is a result of whatever's going on. But because I am no longer confused about the way my mind body system works and I'm no longer frightened, nothing can become chronic. Chronic pain is not an epidemic of pain and symptoms. It's an epidemic of fear and meaning. Because once we start attributing meaning, dread, you know, anything that we are terrified that we won't be able to do, right? I have to get to work. I have to keep up with this relationship. My partner's gonna leave me. I'm gonna, if I don't show up for my kids, they're gonna be all screwed up. Like whatever it is that we do to ourselves, that is what elevates the nervous system more and more and keeps the symptoms firing. So when I first met Dr. Sarno, I did all the work. And then soon after that, and I was completely free of chronic pain, and I called him and I said, How can I be of service? And we started lecturing together at NYU for several years on something that he called his alumni panel. So he would bring patients that had had these really amazing recoveries who were articulate about it, and we we would share with this very large audience and then they would ask us questions. And so at that time, I was already totally credentialed as a psychotherapist, but I had just had my third child and I was just getting ready to go back to work. And he was like, let me start referring into your practice. So at that point, he became my colleague and we were evolving this stuff together. The only reason I'm telling you that is the number one question that people asked when we were doing these big symposiums at um NYU was, um, I hate my boss. I go in there every day and I feel like I'm being abused, but I'm making a salary I can never make anywhere else. So how can I feel better? I can't quit my job, or my kids are this, I can't put them up for adoption, or my parents are this, I can't murder them. You know, like the people, I obviously say this to be funny, but that like that's the kind of question. And it kind of speaks to what you just said. So you just said, at what point do you refer people to a couples therapist? And like I was in private practice for 18 years. I close my practice because I, you know, do podcasts and I write books and I travel the world and I teach because my whole point is I want to teach anyone who, you know, can hear me what's going on here. But in the years that I was in private practice, the biggest message that I would give people, and the message Dr. Sarno gave on the stage on those days is you don't have to change anything in your life to release this these chronic symptoms. You just have to understand how you feel about them. Because what the nervous system is actually resisting is the rise of all of these repressed emotions threatening to inform us consciously of how stuck and sad and grieving and enraged we are. And that feels like a threat to our lives. The brain and the nervous system perceive our repressed emotional world and our unresolved conflicts as a greater threat to our lives than a little pesky back pain or migraine, something that keeps us small and in bed and away from the dangers of the big, bad world, right? So it's very logical once you really understand what I'm saying. So, sure, you might need a marriage counselor. That's not my business. Like if you, if you, if you ask for a referral, I'll give you one. But that all I was there to say we have this joke in my circle that um my work has a 100% misery back guarantee. Like anytime you want to go back into the way you were doing things, it is available to you. But if you can understand yourself in this way and be willing to do this work, you who knows what what might transform in your marriage.
SPEAKER_01Who knows what, you know, who knows?
SPEAKER_03You know, we're we're we're more health conscious we got than ever before, but yet people are much more sick um or chronically ill. This is why, by the way. What's that?
SPEAKER_00This is why what we're discussing is the reason why at the height of technology and at the height of medical advancement, we have a society of more and more sick and suffering people, specifically what we're talking about here the dance between the brain, the nervous system, and the human body.
SPEAKER_03Is it because we're not as adept at social skills uh with others or ourselves because we're so dependent on, you know, whatever we see online? Is that what you mean?
SPEAKER_00That's certainly a factor, but that's not what I mean. What I mean is there is a very seminal thing going on in the human animal that people do not know, that doctors are not educated about in medical schools, that very few helping professionals know the intricacies of it, which is, you know, like basically my life's work to get it out there. So I'll explain it in just the most basic way. Because the brain and the nervous system perceive this unconscious, largely emotional reservoir. So I want you to picture like a clear science beaker between your belly and your chest. And every day there's like a cup dumped into it. And here's what's from, you know, uh triggers from childhood, meaning you were super bullied and it was terrible in eighth grade, and now you're 42 and you walk into your job and somebody is just, you know, railing on you, but it's inappropriate to say something to them, but it is touching into a place of such rage and such shame and such sadness, you don't feel most of it. Most of a human being's emotional experience is like that little tip of the iceberg. We know that that like is super annoying. We don't know that we're enraged. We don't know that we're devastated. That stays under the surface. As that rises, what happens is the brain perceives a predator. Just like if you were like the herd of antelope, right? And they're at the watering hole. The lion walks through the savannah, the whole herd is gonna like tense up and everybody's deciding, are we gonna run? Now let's say the lion just continues walking into the tall grass. The herd is gonna shake it off, but they're not gonna run. They're gonna stay at the watering hole. However, the human animal is the only animal that is able to make what's going on in between our two ears as more real than what is directly in front of us. So, what I mean is that perception of danger starts to brew. And we are giving meaning to it. And then there's the panic. Like I said, this guy's abusing me, but if I quit this job, I'm making $200,000. I'll never make that again. My wife will leave me. My kid is, you know, this is all going on. Then we go in and we have to take that abuse again. That kind of thing becomes a non-livable situation for a confused nervous system where you have not opened this reservoir to vent it. And then you get your first migraine. Okay, well, you're home in bed or you're throwing up or whatever's happening to you. Who could blame you for not going in there? It's not your fault. You're not making a decision. I like to call that safe in the unsafest way because now your nervous system has protected you by putting you in the cocoon of your smaller life, and that is where people end up coming to me. They're stuck there. That's what I mean.
SPEAKER_02Fascinating. Fascinating.
SPEAKER_03So what I do understand though, also, which may or may be connected in such a way, is that they did MRIs on on those folks that have had or have chronic pain. Now, when I say had, they're they're over the pain, but areas of the brain still light up that are associated with that same condition because it's manifested in their their their map, their mind map, and that it requires they've had it for so long that they like if I um like if you were limping for you know three months, you know, suddenly you feel better, but you still have that tendency to want to limp. So how how would you take that typical person uh or a patient, what what would you start out by saying or asking them?
SPEAKER_00Um my work is uh what I like to say if you want to envision like a stool with three legs, three legs of the stool. And as we all know, with a three-legged stool, if one of the legs is not there, the stool can't stand. So there are these three pillars of my work. The first is, and just I use I picked like simple words underneath which are complicated um concepts, but the first word is believe. Okay, so under the column of believe, it's essentially my prescription is knowledge. Learn. You know, I mean, I wrote, I wrote a book recently, it came out last year called Mind Your Body. It is like 20 years of best practices. I have a podcast, I'm sure you guys have heard about all my stuff, the cure for chronic pain, hundreds and hundreds of episodes. I've been doing it weekly since 2018. So all of that, there's so much content out there. Educate yourself because as soon as human beings understand what's going on, we are very reasonable. Like if you're like, aha, I see this is what's happening, people are very willing to open their minds. So that's the pillar of believe. The second pillar is do the work. And that essentially is we're here, we have this reservoir, it's overflowing, causing the nervous system to stay in fight or flight, the symptoms are fired. That is literally capital T true, what's going on because it's like I've I've worked with people for like thousands of people over the years. It always works the same way. You need to put a ladle in the reservoir and get it down. So I teach this expressive writing tool called journal speak. It is not regular journaling. And oftentimes when I'm interviewed, people are always thinking, journaling, you know, and I always say, like, oh, if 20 years ago when I created this, I was thought more thoughtful, I probably wouldn't have put journal in the title of it because it's so confusing. But essentially, it is a very specific, curated, expressive writing technique that allows you to be off the charts, like unpolitically correct, inner child, winning every argument, you know, like really honoring those like really inappropriate, unspeakable feelings. So that's do the work. And then the third pillar that I think most people ignore, and I certainly ignored it for a large part of my life, is patience and kindness for yourself. We are so awful to ourselves. We talk completely opposite to ourselves the way we would talk to the people we love the most. And I often tell people doing this work without some sort of an understanding of a self compassionate voice is like bailing out a boat with a hole in the bottom. Like, who wants To waste their time. It's so like annoying. I wouldn't. So those three pillars, no matter who the patient is, I lay this out. You know, we have many different ways. I don't work one-on-one with people anymore, but we have, you know, a whole team of coaches who I supervise and we have memberships and courses. You go through it. And what is amazing, and this is what used to happen to Dr. Sarno, people call him up and be like, Dr. Sarno, you're never going to believe it. And he used to be like, try me, try me. So I'm exactly the same. People who have had chronic conditions for years and years and years start doing this, start understanding the three pillars and doing the work. And they're like, they're like, you're never going to believe it. And I say, try me, and they're like, I don't understand. And I said, a nervous system in rest and repair does not send pain signals. It just doesn't happen. And there are many scientific studies that are really codifying this. And so it's being easier for me. Like I have a friend, Dr. Michael Danino, out of Harvard, who is now on his third or fourth study specifically about this. And so it's so great to be able to point people to hardcore science with randomized controlled trials because I don't have to just live in the anecdotal anymore.
SPEAKER_03Very interesting. I like that. Go ahead, Terry. Were you going to have something?
SPEAKER_04Yeah. You know, I I love stories and good God, your passion is fantastic. You know, in all the thousands of people, what are the conditions that are the patterns you see over and over that are still surprising you? What's some what's some stories you got on that?
SPEAKER_00I mean, I had so many stories. Um, I could tell you any number of stories. I will say nothing surprises me. I just can't be anything but honest. Um, I have seen it all. I have seen everything from the most typical, right? Like my back went out, or this is my bad knee because I blew it out in eighth grade. And I'm like, you're 63, you know, like, but that's your bad knee. Or like, you know, um, or like I have migraines, but my mother had migraines, and so did my grandmother. So, you know, obviously it was coming for me. And I'm like, brain conditioning, predictive coding, like, you know, so it's a lot of things going on. Never, ever to dismiss, never to make it less uh a person's suffering is their suffering, and I have been that person. So never to dismiss, but just to help them understand this makes sense. I have had all of those typical things down to the most bizarre. Like a woman who had itching on a quarter-sized part of the back of her leg that made her so insane that it kept her up all night, but there was no rash and there was nothing to indicate that anything was wrong with her. That's a little surprising. But for the most part, um, you know, I will tell you there's this documentary that I love to help people like when people are trying to understand my work. It was several years ago, maybe seven, ten years ago. It's a documentary short, and it's called Life Overtakes Me. And it is about, it's it, it's you can get it on Netflix, and it is about these children that were refugees in Sweden from war-torn countries and for real serious capital T trauma going on. And their families were um given temporary asylum in Sweden, and a whole community of children started slipping into comas. And one after another, it's amazing, it's amazing documentary. One after another, sometimes two siblings in the same family are getting more tired and more tired. Nothing is physically wrong with them. They're checked out by doctors, nothing is wrong with them. They become completely comatose and they follow this one child where she is the this the scene opens where she's they put an ice pack on her exposed belly and she doesn't even flinch. She's in a full coma for 18 months, feeding tube, but nothing else is wrong with her. The family gets a letter that they are going to have permanent asylum in Sweden. And within 24 hours, she starts waking up. And within like a month, you watch her, she's on the playground. She was in an 18-month coma. She has no memory. And what I explain to people is the human brain and nervous system are capable of shutting the body down that hard if it is perceived. These children were like, what if we have to go back there? And that uncertainty alone was enough to truly put them in a state of such abject terror that they went down to the point where they didn't actually have consciousness. And I have patients who were in bed for 10 years who truly chronic fatigue, POTS, um, long COVID. Don't get me started on long COVID. If I hear one more article about long COVID, we're like, we have no idea what's wrong. People are killing themselves. Oh my goodness, there's no cure. I'm screaming at the TV. Like, please, I do know many op-eds I've written that don't get published. I I one day people are going to believe that there's another way to look at long COVID, and I will celebrate on that day. But I have I have people who I've worked with who had long COVID who are truly unable to walk, unable to bathe themselves, who are now one is a travel journalist. All of them are on my podcast, and many of them are written about in my book. So this is not like secret. You know, you can find it in a lot of places.
SPEAKER_04All right, right there, uh, Spencer. So let's talk about long COVID because we we we still get them. I mean, obviously you're passionate about that. You know, what do you think happened that's causing this chronic pain system? Let it out, sister.
SPEAKER_00Israel, once again, you will never ever hear me diminish anyone's diagnosis. So I'm never, I'm not laughing at it. What I'm saying is long COVID is a subset of symptoms that I've been treating for since the beginning of my career. Things like brain fog, headaches, um, chest chest um constriction. So it feels like you can't breathe. And by the way, I love doctors. Let's get this straight. I love antibiotics, I love medical advancements, I have my children checked out for everything. Nobody should stop going to the doctor. However, once you're at the doctor and they say either we can't find anything wrong with you, so it's a mystery why you're so sick, or well, you did have COVID. Like who didn't have COVID? We've all had COVID, and these symptoms follow the pattern of long COVID. Okay. Long COVID in all its glory, and I'm telling you, I have researched it very, very deeply in terms of all of the symptoms set, and there are many that are under this umbrella that somebody could be diagnosed with long COVID. Every one of them I've been treating successfully for years. So you ask, why is this particular symptom set created and called long COVID? First thing I will say is if you had COVID and you have heart damage or lung damage, that's not who I'm talking about. Most people who have the most severe long COVID had a rather uneventful COVID infection. Um, they are just, you know, they they they they had COVID, you know, or whatever. And what happens in the human body is when there is a disruption. So they had a virus that they'd never had before. Totally understandable.
SPEAKER_01How can I say this?
SPEAKER_00It's like there's an opening. So let's pretend I re I really do personify the brain and the nervous system a lot, as if they're like these guys that hang out in my in my body. But let's pretend the brain and the nervous system are concerned about you. You know what? You've been burning the candle at both ends, and you know, your mother, Jesus Christ, like if it's not one thing, it's your mother. And so, like, you are expected to show up at family dinner and she's just so critical. And then, like, your kid is starting to have an issue, and you know your mother's gonna blame you for it, work, money, love, blah, blah, blah. Okay, all this is going on in your life. The brain and the nervous system are sensing this. And what they're sensing is a predator, they're sensing a lion on the savannah, and they start to look for where they can protect you. Where can we put you in a place where you're not in danger anymore? When you have had long, when you've had COVID or when you have, I mean, I really mean this with all respect. It's not that people are making it up, but if you're reading a lot about long COVID or if your best friend had long COVID and that fear starts to come into you, the brain and the nervous system see an opening. Because if they're gonna save your life at all costs, they're gonna find somewhere that's gonna work, which is a lot of times why many, many researchers and scientists who study my work and my stuff say that I have a structural abnormality. I have spondylalysthesis. It's gnarly. Like I can feel where my spine is misshapen with my hands. And so obviously, that was the first pain syndrome I had because I would believe it. Your brain and your nervous system are brilliant beyond anything that any scientist yet can explain about the workings of the human brain. And so that is the place it is channeled. Certain people are more susceptible to fear-driven projections, and those people tend to be more susceptible to long COVID, but it is absolutely curable. I cannot say, I don't even care how far the line down the line you've gone. I don't care if you are on full disability, I don't care if you're using a bedpan. I'm I've worked with people. I worked with an athlete. I can't even say what competitive, he did my work and I interviewed him on my podcast because so many people just do my online stuff or whatever. He was an 18, 19-year-old competitive skier, crazy, like flips and jumps, and he was on the circuit. He had a he had a minor COVID infection. Now in the retrospective nose, he felt really pressured. He felt really stressed about like performing, you know, all the things that a young athlete might feel. Got a little bit, he got a little bit. This guy who was capable of doing these crazy jumps and races on skis was in his bed. The parents bought a wheelchair in order to take him from the bed to the bathroom and back. He was 24 hours a day in the dark and he couldn't form sentences properly. He ended up connecting. It's there's too many stories. I feel like I don't even have enough time, but he ended up connecting with someone who did my work who was public about it, and they he helped him, which was just like the loveliest story of like common humanity. And he is now competitively skiing again. So I just want people to understand that your brain, just like these kids in life overtakes me, it will protect you at all costs. And the reason why is because we as human beings are idiots and we will walk right into danger. And your brain is the only thing, your your cat-like reflexes, right? You don't put your hand on a hot stove and think, is it hot? But is it really hot? No, you pull it off. The same exact thing is happening with chronic illness.
SPEAKER_03The interesting thing is that when we went through school, you know, the teacher would go through these symptoms, and uh without a doubt, there was always a student that'd go, I think I have that problem. I think I think I have that that condition. And they really didn't, but the power of suggestion or the thought process that matched up. And then, you know, as as we moved along and then out of school, we would get patients that do you remember? I don't know if you were i i practicing or not, but there was chronic fatigue syndrome was like the the fascinating. It's still very much a thing.
SPEAKER_00It's still very much a thing because chronic fatigue is part of long COVID as well.
SPEAKER_03Oh, gosh. And then then there was myofasci. Oh, I think I have myofascius. You know, like everybody, it it's whatever condition seems to be vogue at that moment that people identify with when they really don't have it, but it was like an excuse almost.
SPEAKER_00What's really funny? Dr. Sarno used to use that exact comment all the time, and he would say, What happened to ulcers? Everybody do you guys remember the 90s? Everybody had an ulcer. He has an ulcer, she has a bleeding ulcer. I mean, it was terrifying. And I was in college, um, 90 to 94, and I remember thinking, shit, am I gonna get an ulcer? Like, I'm just because I'm stressed. I have not heard one person tell me they have an ulcer in like 20 years. Have you?
SPEAKER_02I mean, you kind of does happen very often, huh?
SPEAKER_00But don't you remember when everybody had ulcers? I mean, it is it isn't our fault, but it is true. We're a social species.
SPEAKER_04You know, I stopped uh a couple years ago. I stopped giving diagnoses because I saw people want to come in and they want a diagnosis, and they became that they owned the diagnosis. They wanted to have that identity of having a diagnosis. And I went, do you want a diagnosis or do you want to get fixed? You know, pick one. And so I would like I stopped doing diagnosis. I don't, I don't, you know, don't take insurance, so I don't have to give a diagnosis. And I go, we're gonna focus on causes, not symptoms. But do you think a lot of patients out there have been so focused on the I need the identity of that diagnosis so I feel better, and they stop listening to their body?
SPEAKER_00This is a really interesting question. You know, there's so many different ways to look at it. So the first thing I'll say, and I'm thinking of a particular story in my book, where there's this woman named Suzanne who had so many symptoms. Oh my God. It was like one thing after the other. But she talks about how excited she was and her husband was. It's so heartbreaking when she got her diagnosis of fibromyalgia, which don't get me started with the fibromyalgia, but just be just because it creates such a fear in people, because it's like, we don't know where it's coming from, we can't see it, we know you're suffering. Oops, you're gonna have it forever. Like all that stuff is just truly like abusive, as far as I'm concerned. But what she writes about and I published is how quickly that became the what she went from excited to devastated, because it was exciting to get a diagnosis because she thought, okay, what can we do about it? Because that's why people love a diagnosis. They love a diagnosis. Like there's I I raised three children, okay? They're 23, 21, and 18 now. But when they were little, what do you think? Well, you won't know, but I'll I'll say, what do you think my favorite thing for them to have was? The answer? Strep throat. I love strep throat because we got the antibiotics in the child, and within 24 hours, they're allowed back at school, right? But other things that are viral and just have to move through you, they are not as great because they take whatever time they take. People like a diagnosis because they attach a diagnosis with a cure. So I commend you for no longer diagnosing people because you're right. Unless there is a cure, if you can say, oh my God, you're anemic, you know, like let's give you some iron supplements, or, you know, that's why I still believe fully in blood work, fully in diagnostic tests, because if there is something that you need to know, like I've heard of people, nothing, nobody I've worked with, but I've heard of people that have chronic back pain and they get an MRI and they have a tumor on their spine. Like, don't come to me until you've had yourself checked out. Having said that, though, so many diagnoses are a recipe for misery because there's nothing to be done about them.
SPEAKER_04Right. And I think that's, you know, don't don't take my not diagnosing um as, you know, I look for causes. And if it's like if the cause of pain is a tumor, you know, you know, but if you but if people focus on the symptoms, sometimes they miss the cause. Do you do you also find out I I've gone to these places and I've seen that funerals where you go to a funeral and all these pockets of people sit around and all I do is they complain about all their their issues, you know, and and they just sit around and they have these little pockets. And I went to one, I'm like, is anybody happy here? They're all just complaining. And I find those same people that they're also people pleasers. They're always trying, they're perfectionists, they're always emotional supporters, every, you know, and I and I I talk about women, I go, women don't aren't good at focusing on themselves. They're always trying to focus on the kids, the husband, the job, everybody else but themselves, and and because of that, they suffer because they're always trying to help everybody else. Um, what do you what traits do you see in these people that are all these chronic sufferers that you try and twist around? I try and tell somebody instead of focused on helping them, you focus on yourself so you can be there for them. Um what are some thoughts you have on the the people pleasers?
SPEAKER_00So there are several personality characteristics that make people very, very um susceptible to this kind of mind-body um chronic pain stuff. Perfectionism, people pleasing, what Dr. Sarner used to call goodism, which is like it's super important for you to be seen as a good person, codependency. So, like, I'm not okay if you're not okay, and I'm constantly vigilantly scanning the atmosphere to say, are you okay? Is he okay? Is he mad at me? You know, these kind of people, and I count myself among them, I mean definitely recovering people pleaser and perfectionist, um, are very susceptible, but only in such a way that if you think about the reservoir, okay, so the the core thing to think is what contributes to a reservoir? You know, like there are certain people, you see them on the news, and let's say they're like sociopaths or they're like not able to care about what other people think are the consequences of their actions, these people have very little chronic pain because it actually you have to care. You have to be a person that has access to your emotions for it to overflow the reservoir. And what's really funny, and a lot of my clients over the years have said, but like, God damn it, I'm sitting here suffering left, right, and center. And my brother, who's like such a jerk, you know, he's he he doesn't care about anything and he's fine. And like I always say, you never know the secret battle that anyone is fighting, but it is true that there are certain personality characteristics that tend to dump more in the reservoir. So when you say people pleasing, you know, I oftentimes work, I when when I do my work with the only in-person work I do now when I say in-person is I teach retreats. So um, you know, we're gonna be in Miraval Austin. We teach at the Omega Institute, we're going to Hawaii. We will move around the world and we teach in person because COVID is over and we can be in person. But I also do this thing where I teach this um membership, this virtual membership, and I work with people on Zoom twice a month. It's like really exciting. And we have this whole structure of how they move through the work. And I notice that I'm like bringing these people in, they have no boundaries. They have totally allowed their family to walk all over them. They um feel like if they say no to their children, it's mean. You know, they feel like if they're not the ones doing everything that life is going to reflect poorly on them. And these are people that get really sick, as you said, because it's too much. It's too much overflowing the reservoir all the time. So the best thing I ever do for people is I give them permission to look at life in the following way life is not good or bad, happy or sad. Okay, it is not that simple. Life is a choice always between what hurts and what hurts worse. And on the surface, people think that sounds negative, but I'm like, no, no, no. It's the greatest relief you will ever experience. Because if you understand that everything you choose, you choose, but everything you choose has a part of it that's gonna hurt. Meaning, I always say there's a gamut. Do I have that donut to do I have that child? Okay. And everything in between, there's gonna be a part that you like and there's gonna be a part that hurts, right? I like the instant gratification of the donut, and then I feel like gross because that like doesn't feel good in my body. Or I love my children beyond, but do they hurt? Oh my God. My children are excruciatingly painful because of the fact that they could be hurt by others, or like I could feel like I'm messing it up, whatever the reason. And as soon as they understand that, I can say to them, I find you here in a chronic pattern, you're so miserable, you're so scared and sad. Are you willing to draw a boundary with your husband? And they say, Oh, no, no, no, I never could. And I say, Life is a choice between what hurts or what hurts worse. You are empowered. I hand people back their agency and I say, you don't have to draw the boundary, but when you don't draw the boundary, you are choosing your pain. You are saying it hurts too much to draw the boundary, you are choosing your pain. This is not victim blaming, this is giving people power because the second that day it hurts less to draw the boundary, they will draw the boundary, and their pain will be much more susceptible to doing this work and getting the reservoir down because they won't be constantly putting more in.
SPEAKER_02Here, I got a good one for you.
SPEAKER_03I love when patients come from other doctors and they use the term arthritis and they make it seem like it's the you know, the forever death sentence. Where do you start with some first of all, I mean I go clinic I mean, I I go clinical on them, you know, but where would you start with someone that comes in and goes the that word arthritis, you know, they think it's they th i i i it's almost on the same level as having cancer, you know. For some of these people, where would you start with a patient like that?
SPEAKER_00It's it's terrifying when you ever you look at anything and there's some doctor that told that says that the phrase the rest of your life. I mean, nothing nothing's ever really fun when you hear that. Um, and so here's what I will say about arthritis and many other things that are very similar in my world, fibromyalgia is another one, um, is the best. So this is funny because my partner Lisa and I um she's she's the person I take everything out into the world with, and we're always having conversations about the current climate. And when we talk about AI and like everything that's about to happen with AI or that's already happening, we often say we always have to figure out how to help people hold on to what is human, like what is essential because we are human. And the most essential thing, and you guys said this, is story, is human story is our ability to say, I have been there, and because I've been there, I'm gonna speak with such authenticity and such passion that you're gonna open your eyes a little wider and you're gonna go, wow, they have been there. I would like to hear what they have to say. So the reason I started the podcast in 2018 and I've never stopped is because I have story after story after story. So if you come to me with arthritis, I'm gonna say, listen to episode 212, listen to episode 318. You know, like listen to a person who was stuck in a horrible chronic pain pattern, bone on bone, blah, blah, blah, all these things. And now they're hiking up Mount Everest. My only question to you is, how do you feel today? Like that's the only thing that matters. I love that I have spondylolisthesis. I love I have the gnarliest MRI I've ever seen because I hold it up and I say, I have no pain. Does it matter that I have this finding?
SPEAKER_01It's a normal.
SPEAKER_00Like it was never the reason for my pain. I thought it was until I understood. So I'll give you an example of a very, very difficult diagnosis, which is rheumatoid arthritis. And I recently had a woman contact me, and she had very physical symptoms. Her joints were super swelled, her feet and her hands. She had terrible pain, numbness, tingling. She was panic. This is a young woman with four children, and she was just absolutely spinning out. And, you know, she had come to me after she tried all the conventional stuff, which is great because then I, you know, they're ready for me. And I did all this explaining and all the work. She started doing the work. She called me. You're never gonna believe it. Her her swelling started to go down. But here's what's amazing, guys. And she we actually just did um, I did an appearance on a TV show with her because she's on a TV show. So that's a spoiler. In the fall, I I'm gonna be on The Real Housewives of New York, so you'll see me. But the point is, because she's a cast member, but the point is when she started doing this work, when she brought herself from fight or flight to rest and repair, where she didn't believe this was a lifetime diagnosis, when she said, Wow, what if? That's all I need is what if, what if if this isn't what I thought it was? Not only is her swelling completely gone, her blood markers changed. Her blood markers for RA, her inflammation markers in her blood went from way, way high to completely normal. Her doctors almost fell over just from this. So I need people to understand there's so much more than meets the eye about the human body that you have yet to learn. But this is your life. This is your life. Like, what's it worth?
SPEAKER_01Do you are are you willing to be curious?
SPEAKER_03Nicole, that's a that that's a beautiful, that's a perfect, beautiful, fantastic story about that, like as a as a as an example for all these other conditions that people come to us with. What gives you hope about where healthcare is headed and and what still worries you?
SPEAKER_00It gives me a lot of hope is that people are willing to question long-held beliefs, and all I want is for them to replace their skepticism with curiosity. Like, I don't want anyone to believe me. I'm not interested in convincing anybody of anything. I'm saying if you're willing to be curious and say what if, then I can help you. And I do feel like you guys, you guys make me hopeful. Okay, you guys are chiropractors, right?
SPEAKER_01Yes, that is your dispatch. Yes, so like Yes, yes, yes.
SPEAKER_02Yep.
SPEAKER_00Chiropractors for years who were like, straight up, this, you know, you need this physical, you know, treatment or you need to be adjusted or whatever. More and more people, just like you, never met you before today, say to me or ask me the kind of questions where I'm like, yes, people are asking the right questions. People are getting it. People come to me all the time and they're like, I heard about you from my GP, my physical therapist, my chiropractor. Like, people are starting to say, we don't want to do surgery on you necessarily. Let's get curious about what else is going on. So that does give me great hope. Um, what scares me, quite frankly, is global societal universal groupthink. Like the reason that the long COVID um, you know, epidemic has become what it is. And also media, like the way media feels the need, and I guess this is since the beginning of time, to stir the pot in the most like hysterical, negative, fear-driven way. You know, like that's why I say like every time a new article comes out and it's like the cover of the Times, or it's like the cover of Newsweek, and it's like chronic pain, you know, the devastation of our time, and like there's no solution and like long COVID, you know, it's it's it's a mystery beyond. Will we ever figure it out? You know, and like I'll tell you something timely that's happening right now. Are you guys familiar with Brian Johnson, that guy who wants to live forever? He's like a biohacker. Okay. Yeah. So he announced in with huge fanfare, like two or three days ago, that he's been diagnosed with an autoimmune condition of the gut. And like he's so so dramatic. He's like, my gut is eating itself. So, what has he done? He is starting a worldwide campaign to get to the bottom of it, and he's going to spend millions of dollars and he's gonna biohack this. And I'm promising you, it's not gonna work. Not only is it not gonna work, but if he even can have enough of a placebo effect for it to affect his gut, he's gonna get something else. His back's gonna go out, he's gonna have something because all of this is coming from the same place. But people are listening to this guy. And like I saw him on Instagram today being like starting to film my documentary about like getting rid of my autoimmune disease. And like, if people continue barking up the wrong tree, they affect other people. Now, granted, that is the way of the world. You know, I can't get too hysterical about it, but like that is what upsets me. What upsets me is there is so much information now, more and more, that like if you can look into the mind-body connection, so many things can be resolved, and I want more attention to be given to that.
SPEAKER_03Thank you for mentioning about the uh effect that uh us being chiropractors, we get patients all the time that come in as a well, many years ago they would come in as a last ditch effort. Now there it's a primary approach. But they would come in and they were told they had needed surgery or prosthetics or you know, whatever it might be significant amount of medication, and and because we operate at a different level, and we've been doing this for long enough that we are able to share a different perspective, and suddenly the patient starts believing that there is an alternate way of healing. So it's really uh you're you're absolutely right. And what you're doing from a mind-body experience or body-mind is is enormous.
SPEAKER_04It's also what it's also why we named the podcast Cracking Backs. It would just to break the whole paradigm. You know, everything's of you know, Garbages is backcrackers, and we've actually had some pushback on the name, and I think it's hilarious because it gets people one, they think about it, and two, they're like, oh, wait, you're you're not cracking backs? No, those are entertainers. We're actually real doctors. Yeah. So uh you know, I I have to think about that.
SPEAKER_00I want to say something about that because I really want to I I my biggest objective always is to forgive people for being themselves because we all are the same way, which is we are desperate to give away our power. Desperate. Give me a pill, give me a surgery, crack my back, adjust me, fix me, and I forgive you and I forgive myself because we don't want the solution to live inside of us. It's too scary, it's too daunting, it it pushes at the buttons of our self-esteem, our self-worth, our ability to change. And so, and it's much more hairy to deal with like the relationship you have with your mother or your body image or your fear of money, then just do the surgery. I'll do the PT, I'll recover. And if it worked, this is what I say to people all the time: if the pill worked, I I'm happy to be out of a job. Give me the pill. It doesn't work. If these things work, so I have empathy for people who walk into a chiropractor's office and say, Yes, can you guys please fix me? I want you to fix me too, but I know that doesn't work. And because I know that doesn't work, I have to offer the solution. But it's it's definitely a very human, natural, there should be no shame about like we do want other people to impose something upon us and fix us. And when you realize that that sometimes it can work, but most of the time, honestly, it can't.
SPEAKER_01And then, you know, thank God there's something you can do to help yourself.
SPEAKER_03Nicole, we're nearing the end of the program. We wanted to go into our rapid fire questions. There's five of them. And it's gonna require you to answer them briefly. So I wish you luck on that.
SPEAKER_02Are you ready for question number one? Uh okay, yeah. Yeah. Number one, what's the biggest myth about chronic pain?
SPEAKER_01There's nothing you can do about it physically yourself.
SPEAKER_02Very good. Hey, you're doing good so far.
SPEAKER_03All right, question question number two. Now, we know music can be a strong healer, but what is your go-to feel-good music?
SPEAKER_00God, okay. I just know I have to put my brain in a okay. Lately, I have been back listening to music from the 80s and 90s, so that's high school and college, and I have been loving it, loving it. So that that's my go-to these days.
SPEAKER_02Okay, can we give her what's it what's the song that will pump you up?
SPEAKER_01This morning I was listening to Fleetwood Mac, Don't Stop Believing.
SPEAKER_02Oh, perfect. There you go.
SPEAKER_03Question number three. What's the greatest lesson about healing, presence, or being human that has ever taught you?
SPEAKER_01The lesson that taught me. Empathy. Empathy.
SPEAKER_00It is so easy to judge other people because you don't think that you would do something that way. And what ad adversity and needing to be healing healed has taught me is that I can be an empathetic empathetic top.
SPEAKER_03Very good. Empathy see the word empathy seems to keep coming up in our conversations lately with uh other podcast guests. This is obviously a needed subject. All right, question number four. Now, this is kind of funny. You admit to suck at relaxing. What's your go-to way to play? And how do you teach other workaholics to do the same?
SPEAKER_00Life is a choice between what hurts and what hurts worse. If you do not figure out what brings you joy, you choose your suffering.
SPEAKER_02Very good. And last question number five. What's one question you wish people asked you more often?
SPEAKER_01Do you want to have a TED talk?
SPEAKER_00Do you want to come on Joe Rogan? Do you want to do another major? I want to share this message. I want people to ask me to speak.
SPEAKER_01That's what I want.
SPEAKER_03Well, you have been absolutely wonderful in this engaging conversation about how the mind plays such a significant role in pain. Thank you for being on our show and expressing your deep emotion about it.
SPEAKER_00Thank you for having me.