The Mind-Body Couple

Understanding and Overcoming the Symptom Imperative: Why the Brain Triggers New Pain or Symptoms While Healing

• Tanner Murtagh and Anne Hampson • Episode 84

Share episode

In this episode we dive into discussing symptom imperative, a fascinating phenomenon where new symptoms arise as one heals from chronic pain/symptoms through a neuroplastic approach.

We guide you through effective strategies for overcoming the symptom imperative, emphasizing the need to recognize symptoms without an obsessive urge to fix them. Beware of the trap of consulting "Dr. Google," and instead, consider gentle brain retraining practices, somatic tracking, and challenging your limiting beliefs as constructive alternatives. Understand the emotional messages or unresolved traumas that might be linked to these symptoms, but avoid becoming consumed by the search for meaning. Through sharing our personal experiences, we highlight the importance of identifying patterns and managing the focus on symptoms to keep them from becoming overwhelming. Join us as we explore these techniques to help navigate the often perplexing terrain of healing and transformation.

Tanner Murtagh and Anne Hampson are therapists who treat neuroplastic pain and mind-body symptoms. They are also married! In his 20s, Tanner overcame chronic pain and a fibromyalgia diagnosis by learning his symptoms were occurring due to learned brain pathways and nervous system dysregulation. Post-healing, Tanner and Anne have dedicated their lives to developing effective treatment and education for neuroplastic pain and symptoms. Listen and learn how to assess your own chronic pain and symptoms, gain tools to retrain the brain and nervous system, and make gradual changes in your life and health!


The Mind-Body Couple podcast is owned by Pain Psychotherapy Canada Inc. This podcast is produced by Alex Klassen, who is one of the wonderful therapists at our agency in Calgary, Alberta. https://www.painpsychotherapy.ca/


Tanner, Anne, and Alex also run the MBody Community, which is an in-depth online course that provides step-by-step guidance for assessing, treating, and resolving mind-body pain and symptoms. https://www.mbodycommunity.com


Also check out Tanner's YouTube channel for more free education and practices: https://www.youtube.com/channel/UC-Fl6WaFHnh4ponuexaMbFQ


And follow us for daily education posts on Instagram: @painpsychotherapy


Discl...

Speaker 1:

Welcome to the MindBodyCouple podcast.

Speaker 2:

I'm Tanner Murtaugh and I'm Anne Hampson. This podcast is dedicated to helping you unlearn chronic pain and symptoms. If you need support with your healing, you can book in for a consultation with one of our therapists at painpsychotherapyca or purchase our online course at embodycommunitycom to access in-depth education, somatic practices, recovery tools and an interactive community focused on healing. Links in the description of each episode.

Speaker 1:

Hi everybody, welcome back to our podcast today.

Speaker 2:

Hi everyone we are back.

Speaker 1:

We are back and we are filming and recording this the day after Halloween, ooh Halloween. This the day after halloween, whoo halloween. Yes, halloween, I think, can be a big night for a lot of people and for us it can be a heavy time with kids. Yes, kids yes, it was.

Speaker 2:

It was pretty smooth, like it wasn't like you know, like we've had some halloweens, we're like that was rough you know, but yeah with young kids.

Speaker 1:

I had a good time at least yeah, I saw you having a good time.

Speaker 2:

I feel like I was laughing a lot. We were with and sisters, family at their place. Yeah and yeah. Like usually as I've shared on this podcast, these events, yeah, these social gatherings In the past, I would just be like in fight or flight just not having a good time or just like disconnected, shut off, but I really leaned into the playfulness.

Speaker 1:

And one thing I want to say that this has been like a work in progress for you to get to a point of feeling a bit safer or more comfortable in or leaning into playfulness in these situations yeah, and I and I killed it. I was on top, yeah it was pretty good and it did go pretty smoothly till we got home to our dog. Then it was less smooth. So we have a dog as many people probably know the german shepherd cross yes, and she's like a little over one.

Speaker 1:

She can be a bit nervous sometimes and we left her alone for halloween yeah, and darla.

Speaker 2:

We realize, darla is a very friendly dog she's very sweet outside of her house, great. But like if someone new comes into her house, like she's like taking it upon herself to be the guard dog yeah, so we didn't realize how she would be impacted by all the people coming to the door and like poor dar dar trick or treat, so she was a bit traumatized, yeah dar dar didn't have a good time there was goblins and ghouls yeah, coming up to the door all night in costume.

Speaker 2:

We just left some candy on the doorstep yeah, she like when we came home. We just left some candy on the doorstep, but she like when we came home.

Speaker 1:

She was like— oh yeah. So we came home and we entered and, like it was dark, the lights were off and our kids were also dressed up with like witch and wizard hats and she was guarding us a little from the house she was a bit freaked out by us Once the lights turned on.

Speaker 2:

she like smelled us. She was fine, but she just probably thought there was intruders.

Speaker 1:

Oh, yeah, so think of like fight or flight. Poor Darla was in that state for a while.

Speaker 2:

We really did not think that. Lesson learned Next, next year. She's in her crate. She's going to be in her crate In her safe space. Yes, yeah, it was a rough time for Darla. So, yeah, it was a rough time for Darla.

Speaker 1:

So Tanner did quite well and Darla, on the other hand, had a hard time.

Speaker 2:

I gave Darla my fight or flight energy. Feel bad.

Speaker 1:

Yeah, unintentionally, you really should feel bad.

Speaker 2:

In other news, I've heard from multiple people on YouTube comments, instagram clients just being like I love Ann. Is it real this?

Speaker 1:

like really warms my heart.

Speaker 2:

I know.

Speaker 1:

I'm glad they do it's nice to get that feedback they're like Ann has wisdom which is also nice to know that people feel that way. So, thank you. All of you that are kind of sharing this with Tanner, and, yeah, it's nice to know that you know. All of you that are kind of sharing this with Tanner, and, yeah, it's nice to know that you know we are a partnership here with this podcast and also like maybe I am the like the wind beneath your wings, tanner, yeah, that's what you're trying to say.

Speaker 1:

You know, like I am like like the driving force, here you guys, there you go.

Speaker 2:

Okay, well, let's dive into the topic today.

Speaker 1:

See, you just dismissed that comment I did not.

Speaker 2:

I let you go for a while, but now we're moving on, fine, okay. Okay. The topic today, the symptom, imperative.

Speaker 1:

So this is a good one, and actually this has been coming up in a lot of conversations with people and I think this is something people commonly experience. Can you define what this means, Tanner?

Speaker 2:

Well, first off, I'll just explain what happens to people typically here, because we're going to talk about the symptom imperative and also how to overcome it. We want to give some tips throughout this episode, but here's a common scenario Perhaps you have had chronic lower back pain for five years. Okay. Okay, and luckily for you, you realize your symptoms are neuroplastic and you begin to utilize a brain and nervous system approach to heal. Yes, and guess what? You start to heal. Yes, you're getting better, it starts to work, your pain's reducing and then all of a sudden, you get a headache for a few days, followed by some fatigue symptoms and finally your elbow starts to hurt.

Speaker 1:

Which might be maybe a new sensation, or symptom.

Speaker 2:

Things that have never happened before, too, yes, and most people are not having a good time with this.

Speaker 1:

No so, and it's super common to start fixating on this new sensation going on.

Speaker 2:

Yes. So what's happened here? You are likely experiencing, experiencing what dr sarno coined, the symptom imperative, which is when one symptom reduces and, in his theory, that symptom is no longer distracting you from your emotional state and so a new symptom replaces it to distract you. Now I want to be clear. The new symptom could be another pain symptom, could be fatigue, dizziness, tinnitus, like a lot of chronic symptoms, but it could also I see this happen with people it can be conditions besides pain or physical symptoms.

Speaker 1:

So what's like the most common one Anxiety, yeah.

Speaker 2:

Like all of a sudden people's pain or fatigue starts to reduce and they just have like chronic anxiety, yes, or chronic depression, yes. Insomnia is another really common one Obsessive thinking. So it can be things besides just the physical symptoms.

Speaker 1:

And I think like the telling point for this is if, like, okay, this symptom's lowering, but then this other thing is increasing and they kind of correlate together.

Speaker 2:

Yeah, and in my own experience I don't know Like, I definitely experienced this while healing. This is a really normal thing, but what occurs for most people that don't understand the symptom imperative is they panic.

Speaker 1:

Right, which makes sense. Oh yeah, oh my gosh, what's happening here, yeah?

Speaker 2:

And they respond with like fight, flight, freeze, shut down energy to that new symptom and perhaps they even start to get obsessed with it. They spend all their time trying to fix it, figure it out.

Speaker 1:

Maybe they even move off a mind-body approach and start treating things physically, which also again I want to validate why our instincts would do that, especially with something that might be not the norm of like, oh, what's this? Or thinking it's separate.

Speaker 2:

Yeah in fact, when I'm first having a first session with like a therapy client, I mentioned this like I tell people, I tell people one of the risks wise yeah, wise wisdom.

Speaker 1:

I'll take some of that wisdom.

Speaker 2:

We can share the wisdom. This is. We're too goofy, this is after halloween, this is not good. I don't remember what I was saying now? Oh, what I was telling clients. So when I first meet with a therapy client, I tell them one of the potential risks to starting to treat your symptom in this way is that your symptoms might start acting oddly or bizarrely, or new symptoms start to take place. And I tell people that's a good sign.

Speaker 1:

Yes. And so why is that a good sign? Because I think often when I talk to people about this, like when they're in the midst of experiencing this, it can be really troubling, yeah, and obviously fear inducing, and so I try to say it's a good sign too, but sometimes it can be hard to get that message clear. So what message do you like to give?

Speaker 2:

Well, I like to tell people you're in the process of rewiring your brain and nervous system. Yeah, and weird stuff happens when this takes place, and part of this is a good sign that you're starting to feel safer, calmer, more at ease with your initial symptom. Yes, and I'm going to explain in our lens why the symptom imperative occurs. Yeah, but it's a good sign that you're on the right track.

Speaker 1:

I like that and I like the idea of like weird stuff happens. It doesn't make it like we're not making light of it, but also we want to really kind of say let's not be so afraid of what's happening here. It's that curious lens of like okay, what is shifting and changing?

Speaker 2:

yeah so let's talk about why does the symptom imperative occur? Okay, I want to be clear here. People have different opinions about this. I'm going to share you know, our lens, how we view it from a nervous system lens, yeah, but I think however you view this, that's okay like it's. There's no right or wrong. Like there's a lot of theories out there why the symptom imperative occurs. Um, you know sarno talked about like distraction of emotions. Alan gordon's version of this from pain reprocessing therapy talks about extinction bursts, right, like brain's become wired a certain way. So I think there's a lot of opinions and it's okay to have a variety of views here. There's no right or wrong.

Speaker 2:

But in our view, when your nervous system becomes chronically dysregulated, fight, flight, freeze, fall and shutdown energy is taking place constantly. Over time, what occurs is your nervous systems become sensitized. When it becomes sensitized, it starts to produce chronic pain or chronic symptoms. Yes, but as you start to change things, your emotional and nervous system responds to your main symptoms using like brain retraining techniques and you start to feel safer with them. That symptom is going to reduce, but unfortunately your nervous system may still be chronically dysregulated. You might have unprocessed trauma that you have moved through before. You might have a lot of difficult emotions stored in your body that haven't been released. For you might have a lot of difficult emotions stored in your body that haven't been released, and so, even though you feel safer with the old symptom, your nervous system is still sensitized, so it's causing a new symptom to then arise and replace it.

Speaker 2:

So it's almost like a message of like hey, there's still more work to do, still something that we need to look at here exactly, and so the part of this episode everyone really wants to know is what do I do if I'm experiencing the symptom imperative?

Speaker 1:

well, and I think, kind of like what we've outlined a big start and we always say a big start is having awareness that, okay, maybe this is what's going on.

Speaker 2:

And so you kind of took the wind up my sails.

Speaker 1:

I was just about to say that Well, I like how you wrote it here, though.

Speaker 2:

So you can say that Okay, fine. I'll just keep going. We wrote down three steps, three well, not really in any specific order, but three things you can do to essentially overcome the symptom. Imperative, as Anne just said. Number one recognize and don't buy in.

Speaker 1:

Don't buy in is key, so what would a not buy in look like?

Speaker 2:

Well, the first thing is just you got to recognize that this is happening. That's why we're sharing this podcast. That's why I tell every client at the beginning of treatment yes, which I think I'll start doing now.

Speaker 1:

Like I said, I can take that it's useful.

Speaker 2:

It's useful because they start to recognize oh like, my body's not damaged, it's not turned against me. This is normal in using a mind-body approach, yes, and we don't want to buy in by starting to fix it or figure it out mentally, so that would mean maybe staying away from Dr Google with the new sensation. Dr Google is not your friend. No, and I think that's a common go-to of like this is happening now.

Speaker 1:

I'm going to learn about it and intensely look into it.

Speaker 2:

And I'm clear, like I don't want people intensely fixing or figuring it out in either direction whether it's more physically, because I've seen people do that where they just go down the rabbit hole of trying to fix the new thing physically, okay, and it just prolongs everything. I'm not saying like, if you have a new symptom, be responsible for your health. Like, get checked. Of course I do that as well, yeah, but be careful how far down that road you go.

Speaker 1:

Well, I'm looking for like similar patterns. So if you're used to operating a swim away with your typical symptom, notice am I doing that same pattern here?

Speaker 2:

Yeah, the same goes for using brain and nervous system techniques. So because then people start to intensely do exactly what they did last time to get their symptom to go away. Ah yes, and it's not that you can't use some of that, but like just watch how intense the fixing or figuring out becomes. Right For myself, the one thing that has sunk me every single time a new symptom comes up and it's rare, but usually a couple times a year I'm human, I'll get a symptom. Usually it doesn't last very long times a year. I'm human, I'll get a symptom, usually doesn't last very long. The one thing that will cause it to last significantly longer is if I start to try and fix it, I start to try and figure it out, or I start to try and control it and avoid all these things that could be causing it uh, so even though you know all this, what happens in your mind?

Speaker 1:

that you kind of go back into that pattern?

Speaker 2:

Tanner, I think it's. It's just that same old story that my brain gravitates towards of something's really wrong with my body. Yeah, something's fundamentally wrong. And that belief, even though I've done a lot of work over the years and it's pretty minimal now, like if I get a symptom, usually it's less than a day, like it's really cold, like yeah, but especially early on, like I've shared.

Speaker 2:

Like my biggest relapse that I had I think it was a few years after I recovered was about six weeks. What happened there is I started to try and fix it. I was on Dr Google, I was trying to figure it out. I started to avoid certain movements or positions, like it just took off. Luckily I was able to pull it back after that time. But I just warn people like we got to recognize this is symptom imperative. Yes, and just not buy in or follow that path too far down. Yeah, that's fair. Number two and we talked about brain retraining In the last couple of episodes. We want to start using the brain retraining in the last couple of episodes.

Speaker 2:

We want to start using the brain retraining practices with the new symptom totally, but, as we just mentioned, without intensity without intensity, without and you might have to do it a little bit different this time people always think, like I got better doing this, so they just like, take that template and try to apply. But they make sense, yeah, but they have a completely different attitude this time of like I need this to go away now. Yes, so yeah, you could use somatic tracking to change the emotional response. You can start to challenge and change your beliefs and thinking, which we talked about last episode, and use some of those messages of safety. Episode 69 of our podcast. I always mention this because it's such a silly name, but it's a useful skill. We want to reduce focus and obsessiveness and so that don't L-C-T-T, instead shift skill, I got to make a new name Say what that is again.

Speaker 2:

Don't look, check, think or talk. Instead, we're shifting to safety in different ways. Yes, because that's what happens. Is people now become obsessed about the new symptom? Yes, and it's a really upward battle to heal if you're just thinking about it 80% of the day.

Speaker 1:

Yeah, and so like intervening kind of quickly can be helpful, Because I think the more we go down the spiral, the easier it is to keep rolling in that direction.

Speaker 2:

Yes, it just yeah. It's that snowball that keeps building and building. Yeah. And number three understand the meaningful message within the symptom. Imperative. Now I'm cautious here, Don't become obsessed, but I do think it's useful. As we said a lot of times, the symptom of impairment is occurring because you have a lot of difficult emotions you haven't processed, or trauma, or you're still dysregulated. So understanding like okay, what's underneath all of this?

Speaker 1:

Right.

Speaker 2:

Because you're getting the symptom, but that's not necessarily where we want to focus all our time, like what's the meaningful message underneath? For you and like your example of the six week flare. Was there a message under there? Oh yeah, that was when our daughter was in the NICU, which was a really hard time.

Speaker 1:

Yeah.

Speaker 2:

There was a lot of difficult emotions.

Speaker 1:

Yes.

Speaker 2:

And to give context, I had been having like some troubles with anxiety right before for a number of months, and so I was very dysregulated and I had a lot of difficult emotions and I was just trying to ignore, push through, put this pressure on to be like a good dad, and our life was chaotic.

Speaker 2:

It just was all these factors, and so that's what I want people to think about, because your meaningful message within the symptom imperative could be that there's difficult emotions you need to process somatically Totally, and I have lots of free content on YouTube that people can check out in the link of this episode. Next is do you need to focus on nervous system regulation? Okay, and again, on YouTube, I have lots of things that people can go and practice for free, but typically, like if you're constantly dysregulated, what I mean by this is just prolonged states of fight, flight free, shut down. That needs to shift so that it's not the next symptom and the next symptom and the next symptom, like you need to have some type of regulation on board to make sure you're not just having these serial symptoms over and over again.

Speaker 1:

Yeah, for sure.

Speaker 2:

And it could be deeper trauma. I've worked with many people where they do the courageous work of processing trauma and it makes a significant leap forward in their healing from their symptoms, for sure. And the last thing I want to talk about, because we talk about in our approach talk about social safety. And is there a sense of social danger around you? This could be work, school, family, friends, community, um, certain hobbies and the way you're interacting with them, like is. Is there a sense of social danger? That's not an easy thing to fix. We'll do a whole episode on social safety in the future, but sometimes there is hard changes we need to make to make sure we're not just having this symptom imperative. Continue on.

Speaker 1:

Well, and sometimes it is that greater world that we're living in. We are able to make changes there that we need to take a hard look at. Okay, is this just perpetuating symptoms and making them kind of continue on?

Speaker 2:

Yeah, and so these are the three elements, the three steps you can do to overcome the symptom imperative. What do we got? Number number one recognize and don't buy in. Number two use brain retraining practices with the new symptom.

Speaker 1:

And number three understand the meaningful message within the symptom imperative yeah, and I think the theme with all of those is okay, let's not react with fear, let's respond with and also a little bit of that like indifference approach in terms of like, okay, this is going on, but I have my skills and my solution that I'm using, and now I'm going to use it over here too.

Speaker 2:

Yes, so if you're having a symptom imperative right now, I empathize with you. I've been there, without a doubt. Practice some of this. It can be overcome.

Speaker 1:

Yeah, totally, and it's very common. So it's a very common part of recovery and healing. It doesn't mean you're not healing and not recovering.

Speaker 2:

Yes, so thank you everyone for listening. Thanks for listening. I'm going gonna go walk dar dar oh, darling, don't make her happy.

Speaker 1:

She needs a little soothing. She might be having a symptom imperative herself right now, probably you know, yeah, we're just failing. You weren't the greatest dog parents yesterday lesson learned, though yeah yeah, yeah okay, right, we'll talk to you next week.

Speaker 2:

Talk to you next week.

Speaker 1:

Thanks for listening. For more free content, check out the links for our YouTube channel, instagram and Facebook accounts in the episode description.

Speaker 2:

We wish you all healing.