Heal with Grace

55. Trauma & Chronic pain through pain reprocessing therapy with Vanessa & Olivia

• Grace Secker / Vanessa and Olivia • Episode 55

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In this episode of the Heal with Grace podcast, Vanessa Blackstone, MSW and Olivia Salisbury Sinaiko, LPC specialists in pain reprocessing therapy, share their experiences and insights about their newly released workbook. They discuss their backgrounds, the journey to developing the workbook, and the importance of addressing trauma in pain therapy. Highlighting the need for tools that make therapy accessible and engaging, they cover the significance of non-linear progress, overcoming urgency, and the value of personalising therapeutic practices. With a warm and playful approach, their workbook aims to be a companion for those seeking to manage chronic pain and transform their relationship with it. The conversation also touches on practical steps, like avoiding aggressive messaging of safety and being mindful of outcome dependence. The episode concludes with personal anecdotes and the joys of gardening, reflecting the authors' down-to-earth and relatable nature. Overall, this talk provides a thorough understanding of the principles and applications of pain reprocessing therapy.

Episode Resources
Pain Reprocessing Therapy Workbook

Episode: 34

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[00:00:00] Grace: Hello, Vanessa and Olivia. Thank you so much for coming on to heal with grace podcast. I'm really excited to dive in to more about pain, reprocessing therapy and the workbook that you both came out with. So without further ado, please just tell us who a little bit more about who you are and how you came to specialize in this work.

and especially how you came to write this book together. I know that's about three questions. So there you go. 

[00:00:26] Vanessa: Yeah, we're so excited. I, I loved our last episode that we did together and I just remember thinking that like it would be so great to have the both of us on here when the workbook came out.

So I'm just really grateful that you invited us. 

[00:00:40] Grace: Yeah, everyone act. Absolutely. That's one of the most download episodes, which I'll leave below too. so yeah, it was great. So I'm hoping this will will 

[00:00:49] Vanessa: be as well. Absolutely. Yeah, I can start by just sharing a little bit about or reminding folks how I came in to this work a little bit and and then we can go from there.

I, I got into this work. oh, my gosh, I don't even know what date. I just remember that things were awful. I, Was dealing with so many different symptoms, head pain, neck pain, pelvic floor pain, hives, and a lot of other like sensory symptoms, a lot of like vertigo and vestibular symptoms and chronic fatigue from all the head pain and neck pain and everything else.

And, I was in grad school at this time. I had been having a lot of these symptoms for years. The migraine started when I was like, 11, and then they just got increasingly worse and spread into other things. And then IBS got really intense during grad school. I was going a million miles a minute and deferred from a PhD program because of how bad things were, with encouragement of some family members being like, this is not how you can go into a program.

You need to take care of yourself. And in that pause, it was much needed, but really, really hard to do. it was the first time I had a panic attack when I had deferred. cause it was like my world was too quiet that I didn't know how to sit with it all. And in kind of talking to some mentors, I learned of, pain, reprocessing therapy through a previous supervisor who went to a conference that Alan Gordon was at,the person who created pain, reprocessing therapy and the practice that I run pain psychology center.

And this. Person told me that, you know, Alan said at the conference he was hiring, but they were also telling me a little bit about pain reprocessing therapy. And I think they wanted me to get treated more so than work here. But I took it as a work opportunity, of course, and so, you know, interview, reach out, interviewed, got the job.

And then the more that I started to learn it professionally, the more I realized that it fit for me. So I was kind of doing the work personally and professionally at the same time. And it, it just grew the research came out, Alan's book came out, the work continued to grow. I got put in the position as executive director and it's just really flourished since then.

And then this book came out and in that process, we were doing clinical training through the training center and I was leading all the consultation groups. And that is where I met. Olivia. 

[00:03:07] Olivia: Yeah. And I have like my own version of, of that story, which is I'd had migraines my whole life, really as long as I could remember.

they have been a feature of my experience since very early childhood. And, I had at different points, they sort of interfered more and less with my life. And, I was a pretty new therapist and, in a mode of Increased openness for whatever reason to psychological interventions. I had flirted with them before.

I just found them like completely confusing and frustrating and unhelpful. but somehow through, like, the magic of the Internet, I connected with Alan Gordon's podcast. Tell me about your pain and like the first episode I heard it and I was like, oh, yeah. Nope. That's Absolutely part of what's going on here for me and I connected with the interventions just started to practice them on myself Immediately started to find relief and was like, whoa, okay I, I don't just want to do this for myself.

I want to do this for others too.and so I shifted and sort of gradually my practice shifted more and more towards working with pain. And I was really lucky to, be in Vanessa's consultation group, through the training center and we, Totally hit it off and, really saw sort of kindred spirits in one another and, especially with regard to the way that we approach this work.

and 1 thing led to another and here we are 

[00:04:34] Grace: cool. And when did you both decide to write this workbook? How did that come about? 

[00:04:42] Vanessa: That's a really good question. Can you remind me? 

[00:04:46] Olivia: I mean, I know that I felt like there was a need and I just assumed I just assumed Alan must be writing because there was.

Such a clearly there were a way more people who need this work than there are PRT therapists and it's the kind of work that is, you know, just like me getting into it from the podcast. It's the kind of work that not all nervous systems, but many nervous systems can engage with. In a self guided way. and so I, at some point, Vanessa and I talked about it and we were like, let's do this together.

Yeah, for sure. Yeah, exactly how that unfolded is like lost a time, I think, but we, we had so much, we just had so much to share with the world and a ton of energy around it and a lot of enthusiasm for, Co creating something, 

[00:05:38] Vanessa: and it happened so fast. Like when Olivia is determined to do something, she hammers it out and it's kind of amazing.

And I think it all just happened so quickly and and we, we submitted our work and they already kind of knew what pain reprocessing therapy was and, the publisher and had an interest in this modality already, so it was just exciting to realize like, oh, we met you at the perfect time and it just, yeah, it happened.

I think it all happened within a week submitting it, hearing back, finalizing things. It's just it. It was very fast and very exciting. 

[00:06:18] Olivia: Yeah, it was really and it's kind of wild looking back. I'm sure everyone who writes a book feels like this. In some ways, but it's like the way that happened, like, we really did that because it was so much work along the way for what's ultimately a pretty slim book, but it's just like, yeah, it happened and now it's here and it's a hard copy.

And I'm still sort of in disbelief. 

[00:06:41] Vanessa: Definitely. Yeah. 

[00:06:44] Grace: So, you're right when you said Olivia, you know, we just, you just kind of assumed it was going to be written because it seems like it was needed. you know, for anyone listening, if you're familiar or not, there are a couple of books that, have been out for a while around pain, reprocessing therapy or unlearning your pain.

You know, there's a couple of ones that are, yeah. Very helpful and just really get to understand. Okay. What is this? And really switch your mindset around pain and symptoms. And there's a lot of people that will read that and then they'll end up coming into therapy and they're like, this is, you know, I, I believe it, I think, and I understand it, but okay.

So what do I do with that? Right. And so, yeah, exactly. There's a, there's a need for sure to understand. Okay. What are the actual applications of this? We can understand it psychologically that our mind and our body are connected and that chronic pain and symptoms have a psychological component, but all right, cool.

Then what do we do with it? So, yeah, I could totally see that. it was very much so needed. 

[00:07:45] Olivia: Yeah. So then what we hope to offer. Oh, sorry. Go ahead. Oh, no, no, no. Go for it. Oh, what we hope to offer is like a real step by step. I think the feedback that I've often gotten from folks who have read the way out is like, Oh my gosh, yes, this is amazing.

It's exactly what's going on. I'm sure this is me. But like, wait, how do you do this? How do you operationalize this? And that's just not what Alan's trying to do with that book. He's like, He's not giving you, like, a really step by step. He's giving you, like, the big interventions and a big sense of what they are.

But there was this gap around. How do I actually implement this? And especially for a nervous system that is overprotective, that is in that upregulated state a lot of the time, sometimes creativity. Can be in short supply, and there is a fair. We're trying to fill those gaps for people so that they don't need to interpret.

We're just telling them this is exactly this is the step you take. And this is the step you take and really building gradually from 1 exercise to the next so that it does feel more accessible. 

[00:08:51] Grace: So, then what is it what's special about the way that you both approach this workbook instead of it? I'm guessing because I know, I know more of how Vanessa works, but you said you work pretty similarly that it has to have a little bit more than just like, okay, do steps 1, 2 and 3.

Right? So, can you speak a little bit more to what's so special about this workbook? 

[00:09:11] Olivia: Do you want to take a hack at it? 

[00:09:13] Vanessa: Yeah, I think 1 of my bit more. A few of my favorite things I have so many favorite things about this workbook, but a few of my favorite things is that 1st and foremost, it's very personal.

Like, we put so much of ourselves into the workbook to make people feel like I look. I may not know what it's like to be in your body, but I, I get it. I get it to some degree from my own experience, like, I have been there and this is what works for us and the things that we encourage people to do. We have tried them ourselves.

So we're not just saying them because. We, we think that, you know, that this is. The best way to do it without personally understanding. I don't know if that makes sense, but, like, we really put things in there that we would use for ourselves that we would use for loved ones, and that we would use for our clients that we put a lot of time and care into making sure that they get the best possible in order to optimize their healing and recovery.

So it feels very personal. so that's probably my most favorite thing about this workbook. And the other part of it is how playful. It is. I think that was something that was really important to us is wanting to make sure that this felt very warm and playful. Yes, we are on a journey and this journey can feel so serious.

Of course, not being in pain and getting better and getting back to your life and the urgency to, like, make up for a lost time. That all makes a lot of sense, but we wanted it to also feel real. Really playful, something that you could engage in that you could actually enjoy felt insightful. No matter no matter how many different methods you have tried.

We hope that there's something in here that feels new and exciting and enjoyable to engage in. And then additionally, is making sure that it feels interactive, like, it's not you just reading text and writing things down, but I'm happy to explain more about how you can actually listen to things that follow along and be able to.

See graphics that allow you to engage with the material a little bit more so that you have a visual of what this all looks like. 

[00:11:20] Olivia: Yeah, yeah, I agree with everything that Vanessa said. one thing that I'll add is, I think that we take a particular, we're particularly attuned to trauma and the relationship between trauma and pain and pain like symptoms.

and so that comes forth, I think, in the book a little bit more explicitly, because it's Vanessa and myself who wrote it and. Really understanding and turning towards, the parts of ourselves that are holding trauma, whether those are wounded parts or, you know, more protective parts, but the parts that are working so hard to keep us safe.

With curiosity, with acceptance, with compassion, not to try to persuade them out of what they're doing, not to get into an argument or a really, you know, outcome dependent sort of like, stop, we don't want to arm wrestle with these parts that are working so hard to protect us. We really want to understand them and make space for them.

To feel understood and accepted, which is the only way, at least in my experience that they're going to let go of the rates. so that's a really big piece. And that comes up a lot with, with nervous systems that have experienced trauma, whether that's big trauma or a little trauma. So we, we make that more explicit and then how to care for those pieces when they, when those parts of ourselves, when they do come up.

In the work, because they will, they absolutely will. It might be as in the simple form of just I want my pain to go down any sort of outcome dependence, but they can also come up and in all sorts of other ways, whether it's some dissociation or really, you know, panic, severe dysregulation, frustration, really anything these, these parts of ourselves that are trying to protect us can show up and do show up in the work.

And so we need to be really attuned to how to care for them when they do. 

[00:13:16] Grace: That is a really important piece that I don't, I don't always think is included initially in, my body work with, with pain. I think probably there's a reason there's layers, right? And then we eventually end up getting to that.

But it's good to know. That's a, that's a big part. cause that's, that's the inner, I mean, I keep saying part that is a big part of the work because working with our parts, right? and so, You mentioned to Vanessa that there were, you put a lot of personal things in there, to make it warm to make those stories stand out, which to me, when I hear that, it makes me want to go look at it and work with it a little bit more in my mind.

Sometimes the workbook feels dry and I'm like, I. I'm bored. I don't want to do it. You know, that's why I would assume I would assume knowing you, that's not how it's going to be. So, it's good to understand that because I don't think I'm the only one, you know, it can be very like rigid working through something.

and so we also learn through story and metaphors. You know, and I'm assuming that's a big part of it as well. 

[00:14:18] Vanessa: yeah, yeah, I, you know, I had a really sweet interaction with a client. I think yesterday or the day before, where this client that I've been working with for for some time expressed their pride and knowing that this book was out, but then immediately.

started started crying and it made me cry too and we were in session together and this person was like, you know, you're I sent an email out to all of my clients, letting them know, like, they were a big part of this workbook being written because I wouldn't have all of these things to share if they didn't allow me to work with them.

and trust me and, and, you know, open themselves up to me. And so I sent out this email to clients and this client was just sharing their gratitude and their pride. And we both started crying and they were saying, like, that, that felt so good to hear. And I was like, no, no, no, I don't think you understand.

Like you, you are in this workbook, the things that we wrote, we made sure. Would I apply this to so and so like, would I do this with this person with this kind of story? And we would always be reworking exercises. Cause I'm like, well, I wouldn't say this word though, to that person, because it would feel really invalidating.

And we like consistently did that and made sure that everything felt like it makes space for everyone. And I know I can say this and I'm sure Olivia can too, like the hardest part about Reading and diving into all of this work as well intentioned as it always is. It's really hard to make it universal without having someone feel a little left out without having someone feel like I don't fit in that box.

And even though we're saying like, hey, you don't have to fit in a box. Sometimes when we're reading this material or listening to it, it can feel like you have to and we. Made it so intentional to make sure that if somebody is dealing with some other layer, we have to find a way to include that so that it feels so welcoming to everyone.

And there's even this 1 little section that I'm really proud of where, after we talk about a somatic tracking exercise and have an interactive piece around it as well, we have a section after it that talks about if you are dealing with headaches or migraines, keep these things in mind. When you are practicing these kinds of things, because it might look different for you or feel different for you.

And these are some ways in which you can tweak it to be unique for you, where it will still work, but knowing you may might not fit in this box of applying it in this way. And that's okay. 

[00:16:47] Olivia: Yeah. I think just to piggyback on that, I mean, the headache, the migraine, the special for migraine infection in particular, that came like straight out of our own experience with our own headaches.

and so much of the book, it was. Tested on our own nervous systems first, and it's developed out of our own healing and our own recoveries. And, it is really like, deeply personal. I don't I think it's pretty sure it's not going to feel dry 

[00:17:13] Vanessa: fingers crossed. 

[00:17:14] Olivia: Yeah, I definitely would. We're really in there for better or worse.

We're really in there.

To the extent that, like, we, we do share aspects of our own recoveries and what has been helpful for us and challenges that we experienced to, because we understand that a lot of these things are common, whether they're experiencing pelvic pain or migraines or dizziness, you know, this, you can experience any symptom, but the commonalities are just, you know.

Profound from one overproductive nervous system to the next. So, 

[00:17:49] Grace: yeah, I'm glad you said that. I, I actually just had a client this week asked me a newer client and we're working through some of this and semantic tracking. And she's like, but how do I semantically track for for my brain fog? Right, my headaches or my fatigue, right?

So we had to go through that because there's some nuance to it. So, yeah, it is really important. I think some people. When they. First, come to this work on their own and they don't have as much of the physical, maybe like joint muscle back pain, neck pain. They have other symptoms. They don't really understand how they fit in there, but they very much.

So do and we know that for sure. Yeah. 

[00:18:28] Olivia: And so connecting those dots when it comes to the psycho ed piece, and then also trying to point towards modifications that people can use for, for different symptoms that maybe don't fit as neatly into the pain box. Yeah. 

[00:18:42] Grace: Yeah. Yeah. 

[00:18:43] Olivia: Awareness is awareness is awareness.

And that is ultimately kind of what it comes down to 

[00:18:48] Grace: pressure with that. Where do you see people getting stuck in this process? what is maybe it's underlying for all symptoms, right? Like, what is that place with this mind body, like pain cycle where people tend to get stuck that you've highlighted in the workbook?

[00:19:08] Olivia: A good one. I have a spot, something that came up, came to mind right away. And I, Don't necessarily think we speak, we darn word counts. We would have spoken to it probably more directly if we could have, but word counts, we have word counts.yeah, we, I think one place that I see people getting stuck a lot when they're like midway.

So they've kind of started the work. They're totally persuaded that what they've got is neuroplastic. Some aspect of their pain is, or their symptoms are neuroplastic is this I'm safe. I'm safe. I'm safe. I'm safe. I'm safe. I'm safe. I'm safe. I'm safe. I'm safe. I'm safe. I'm safe. I'm safe. You know, it's like incredibly aggressive messaging of safety that does the opposite.

and although I don't know that we speak to that specifically, certainly we never ask you to, like jackhammer that message into your brain. Some brains are going to be really soothed by that and many brains won't, and there's not a one size fits all approach to. Offering safety to your nervous system.

and so one of the things that we really encourage is like, if those words don't work for you, if these messages don't work for you, here's a lot of other different ways that you can do it. Explore, find what helps your nervous system feel safe in this moment. Right now, and even safety might not be the right word, like.

Okay, ish. What helps your system feel okay ish right now. So being much more exploratory, more creative, and sometimes it's going to be a cognitive message, but often it's going to be something that's more somatic, whether that's putting an ice pack on your chest or nothing with your dog, getting a hug.

I'm watching a silly show. 

[00:21:04] Vanessa: Yeah, I think, I think there is a kind of work around way that we do highlight this a little bit and it's addressing the urgency and the intensity in which we do things with. So, we do try to highlight that. In a small way in the workbook, not as much as we would really like to, but I could do a whole chapter on this quite frankly, but I also think that this is sometimes the hardest thing to say to people.

Hey, like, you want to get out of pain, but don't do an urgently or intensely. It can feel really offensive.I have found myself, like, trying to message people on social media back with that message or comment it or say it in a session even and it. doesn't always land well, and it's because it's a hard thing to say, and I, and I, and I get it.

I get you really want. To get better, I want to be right and I want to be the 1 that helped you get you better. Like, even though I say, it's not on me, it's it's you, but I also want to be that person along the journey with you. Like, I, I feel it too as a provider and I have to check my own urgency and intensity and not psych myself out when I'm like, am I.

Am I not doing enough? Am I not doing this the right way? Why aren't they getting better? Like, this is such a theme in our work as a provider and as the client. But it is something that we all get stuck on. It's something that a therapist will get stuck on when they feel like they're not doing this, the quote unquote, right way.

And that's why this workbook is also for therapists and providers and coaches to use with their Take care. Clients and patients, if they need a guide, it's also for the client to help them be more aware of a variety of these things so that they have specific practices. But this is the thing that people get stuck on the most.

I watch therapists get stuck. Coaches get stuck and clients get stuck urgency and intensity and the way that we treat this work. And this is why it's so nice. To have someone guide you along the way, you can definitely do this work on your own, but it's hard to call yourself out. It's a little bit easier when somebody else is doing it for you and can and somebody that you trust.

And that, you know, gets you and gets this work can say, but you're, you're, you're doing it again. Do you notice where you feel like trying to solve that question right now? Do you notice where you feel that in your body? Because as much as I want to even answer it for you, it's coming up internally. And if I can feel it in my own body, I cannot imagine what it feels like in yours.

And sometimes it's just so nice to have somebody say that to you. And now we introduced this lightly in the workbook. There is going to be somebody. That still gets stuck even when they do our workbook and I just hope that like that message comes across in a validating way and I hope that that can lead them to finding their individual help because there will someone be someone that gets many people that get stuck even in this workbook.

And it's typically those 2 things intensity and urgency. 

[00:24:03] Grace: Very well said because it's. Comes in so much, right? We want to get it right. Even like you were saying, Olivia, before trying to establish safety in our bodies, we're like, I'm safe. I'm going to do it. I'm going to do it. I'm safe. I'm okay. You know, like make myself safe.

and it just stresses us out and creates more of that cycle. Can you, we understand this, right? But can you give a few examples of how maybe that urgency or intensity will show up for a client and then also actually for a clinician? Cause I think that's very helpful. There's a lot of therapists that listen to this so that we can get a good idea.

[00:24:37] Vanessa: Yeah, I, I can definitely highlight, I watch a lot of our clinicians and coaches struggle with this and it's something that is probably my favorite thing to do is I guide them into reducing their own urgency and intensity so that they can guide others and I, I watch this in, in a few different ways. I have, like, I could give you some catchphrases so that you know what this sounds like.

1 is, can I work with that symptom? Is there any neuroplasticity there? Is there, is that outside of my scope of practice? Do I know how to approach that as if, like, tinnitus has a different part of our nervous system than all the other symptoms do? Right, so it's always interesting watching somebody be like, well, but what about this symptom?

Can I even talk about that? Or can I even right? So that's a 1 trying to pick apart and think that maybe 1 symptom operates from a different part of our brain than the rest to, The other one is, I don't think I'm helping or I don't think I'm doing enough or like, maybe I'm not practicing this the right way with them.

And that's why they're not getting better when a client comes to session and they feel really frustrated and they're like, but I'm not better this week. So what else can we do? And the therapist is like, burning through their resource list and they're like, I don't, I don't, I don't know. Right. Or what should I be doing or how much?

And the therapist feels the anxiety in their own body where they start getting a little warm and, Flustered and they're trying to answer that question the right way, right? Anytime a client comes to you with any kind of question of what next and what should I be doing and how much should I be doing and what do you have for me?

That is different for what somebody else offered my favorite approach. Is always using that as an opportunity to come back to the body and I have even told clients, like, I really. I have this urgency in my body to answer your question right now, but I'm realizing it. But if I answer your question, I'm actually just feeding into the urgency.

So I'm going to take a 2nd and step back and just take a few breaths. And if you want to join me in that, you can. I think this is a really good opportunity for us to take a step back from having to answer that or plan this the right way. So, figuring out which symptom is which and how I need to approach it and then trying to always answer the next question of this isn't working.

What should I be doing? How are you going to give me something different than somebody else that I've seen in the past? 

[00:27:00] Grace: I will actually highlight that 1st part. Actually, both of them were clients, right? Because I get. Messages usually on Instagram, or even, you know, clients will keep coming back and saying, well, what about this symptom?

Can the symptom be helped? Right? Can the symptom be helped? and it's the same thing of like, yes, but right? Yes. But what what really can be helped? Can you actually help me in this symptom? Because I have all these I have a whole list of them all. Right? Which 1 is. Physical or which ones are plastic and which ones not, and there's so much anxiety understandably around that.

Right? I mean, they're fearful. Just want to be helped, but also have probably been through who knows treatments practitioners, you know, the whole thing and it hasn't worked. So, as you were talking, I was like, yes, therapists and clients, obviously, it's both, Where we have this question of what can be worked with what can't, but it comes from that sense of, like, anxiety and fear and urgency.

[00:27:59] Vanessa: Yeah, 

[00:28:00] Olivia: I think 1 of the places that it comes up the most for both clients and practitioners is in somatic tracking. Actually, so you hear, you know, you've heard. Alan, do these amazing, you know, 5 minutes of interventions where someone goes from like pain. They felt like all day, every day for decades to like, no pain.

And you're just like, what amazing. That's what somatic tracking is. That's not what somatic tracking is. And of course, Alan tells you a million times, that's not what somatic tracking is. but still nervous systems will create expectations really understandably based on what they've seen. And so for both clients and practitioners.

That idea that when you do somatic tracking or when you engage in any experiential intervention that your pain is supposed to go down and that somatic tracking or whatever intervention you're using. When it goes down, that means it works. That's a real stumbling block for folks. And you can understand that intellectually and still have the parts of you that are very understandably, so understandably, more understandably than anything else in the world, want the pain to go down at the wheel.

And so that's true for the client side, and it's also true for the practitioner. Why do we get into this work? Because we want to help people recover from their pain. But that's different than wanting someone's pain here and now in this moment to disappear or to decrease. And so when those parts, whether they're client parts or practitioner parts inevitably arise, those parts that want the pain to decrease and are doing this, using this tool in order to make the pain decrease, turning towards that part, recognizing that that part's here.

Oh, hey, hi, that makes sense. Totally makes sense. You want the pain to go down. Absolutely. Can you give me a little bit of space so that we can just just take a step back or two and watch what happens. Can you be curious and that's true for client side. It's also true for practitioner side. So if you're a practitioner and you're leading someone through somatic tracking or any other dimension and you find yourself wanting their pain to go down.

It's time for you to take care of yourself because your outcome dependence is going to get in the way. Big time, almost for sure. So take care of your own parts. Those parts aren't bad. Those parts make total sense. But acknowledge notice them understand them friend them and then shift. 

[00:30:38] Grace: Yeah, it's easy to get caught up and wanting it to go away.

Of course. Right. Of course we want it to from both sides. and again, I think it's. Really helpful to be reminded over and over and over again that when we get caught and wanting to make a go away, we bypass we skip actually what is important and what is important is attuning to those parts, attuning to ourself, taking a breath, taking a step back, to be able to actually sink in to ourselves instead of avoid and bypass and push past the pain or try to make it go away or whatever it is, which.

Even as I say it out loud is very true, and I can understand someone coming to this work and having a hard time understanding that because, well, of course, they want it to go away. Why do I, why would I not? Right? 

[00:31:29] Olivia: yeah, the neural pathway. 

[00:31:31] Grace: Yeah. And can you, can you explain that? Actually, I think we, we didn't fully explain what outcome independence is for our audience.

So outcome dependence is 

[00:31:39] Olivia: doing something. With a particular outcome in mind, so I'm using this intervention to make my pain go away and the success of this intervention is dependent upon whether that outcome occurs outcome independence is doing something to do it, practicing something for the sake of practice, practicing a new way, practicing a new relationship rather than achieving a particular outcome.

So when we practice them out of tracking, for example. We're not trying to make the pain we're feeling right now go away. We're practicing a totally different relationship to the sensation and to the fear around the sensation. And when we practice, we strengthen the new neural pathway. And outcome independence is itself a neural pathway that we want to strengthen.

So we want to practice and get in the habit of relating to things in this open, curious, practicing for the sake of practice approach, which is so different than that problem solver, outcome oriented habit that so many of us have.

[00:33:00] Grace: Is there anything else around where you both feel like people get stuck that would be important to highlight? Maybe what's highlighted in the workbook? It

doesn't have to be. So many. So many. Yeah. 

[00:33:16] Olivia: 

[00:33:17] Vanessa: Yeah, there's well, there's such a beautiful graphic on this in the back of the book that I'm so excited for people to see is like, how nonlinear this work is.

And I talk about this in a lot of other. In a lot of other ways, I, there's this really wonderful, audiologist, Dr Arthur, who has a great kind of set of resources for those dealing with some, dizzy and vertigo and just varying, like, vestibular symptoms and, I talk about having this really bad experience.

I think it was, like, 2 years ago now, when I went on a little quick, like, overnight trip with a friend, and I don't know what was going on. I think we were in the meat of the workbook, or I don't know, there was something happening where, I don't know, just, like, typical, you know, Like work stress to just a lot of my plate, but, you know, I like to do a lot and I like to go a 1, 000, 000 miles a minute and I sometimes I need a break and sometimes I can keep going.

I get tell clients all the time. Like, it's not about stopping this pace. It's about recognizing when you need to pull back and I am 100 percent guilty of having a hard time of recognizing that limited capacity. So, you know, Had this really bad extinction burst, really, really bad one. And it was a full blown migraine like they were back in the day.

The full like vestibular symptoms, bad vertigo, nausea, getting sick, not being able to see like every sensory thing, just like really poking at this very like vulnerable, like, You know, like unsafe nervous system. I could feel it so deeply. And I just remember after the fact, I didn't, I realized I didn't worry about a lot of what had caused it, even though I know that I was dealing with a lot.

I didn't do this run around in my head about, you know, How this was going to ruin the rest of my week or cancel plans or cancel work things that I had done in the past panickingly. I didn't I didn't worry about what caused it. I didn't once I tell myself that, maybe I can't handle all of these things that I that I'm doing.

I also had a safe person around me. My friend who's. Who's really, really good at being patient and meeting anybody where they're at. And she just kept reminding me, like, stop trying to be okay. We don't have to go run around all weekend. We can take it easy and I can read my book and I'll be fine. And so it's like having a safe person around having this work.

And when I told a colleague of mine that I. Had this happen, she asked me if it was the last four years being symptom free. That was like my win, or if it was having an experience like that and not responding in your usual way, if that felt like the win and I suddenly realized that I would take yesterday over the last four years, any day because I didn't panic a single moment.

The only reason I panicked is because I was worried about somebody ruining someone else's time. And when they said, you're fine, chill out. I was like, okay. And I did. And it was gone within a day. It was like lingering light headache the next day, like a one out of 10, but usually those take me out. I'm out for five days straight.

And I didn't once think of it being like that. And I use this example all the time with clients. And I'm so proud of the way that we depicted this in the book and such a beautiful graphic to be like, it's not, it doesn't matter how many hours a day you practice this work or talk about it. Like your body is a body and we have.

Tough days it is all about how you respond and extinction bursts understandably is an area that we can get really stuck in because who wants to have a good streak for like days on end and then all of a sudden tank nobody wants to feel that but it's how you show up for yourself and the ways that you learn how to meet yourself where you are at the way that you change.

How you respond to this that will help your brain realize that this is not the whole story of what's going on and that the more that we remind ourselves that this dip is an unfortunate part of the process, but nonetheless, something that deserves as much compassion and patience as we're trying to learn to show ourselves that it gives us the opportunity to, I don't know, just like ride that wave.

And that's what extinction bursts are, right? It's a big wave that comes through. It's a burst of the behavior that you're trying to extinct and we can get stuck there, but we're learning to respond differently. So that we remind ourselves like we still we are still here and we're still okay. Even when we're not okay.

[00:37:49] Grace: It's that honestly, I think learning how to respond differently is truly. Everything everything of this work, whether you're in the beginning of it, whether you're 5 or 10 years in and you had an extinction burst, you know, it is truly how we respond that changes. And it's I mean, I know for sure it's always a practice for me as well with my journey and my symptoms, and it'll pop up and I'll notice that that fear that spiral of, oh, my gosh, what happened?

Why is this happening? And realize, okay, hold on. Hold on. Let's just let's just be right. Let's just respond a little differently. And I think that that message needs to be shared over and over and over and over again, because it's really quick to forget when we're in our moments of symptoms and pain and fear.

[00:38:36] Vanessa: Absolutely. 

[00:38:37] Olivia: Another really granular thing where I think people get stuck and this is like, to kind of go in for a moment. Is. This very binary motive, am I in pain or not in pain?and we give some, like, really handy tools that probably for me have been, like, the ones that I use in my own life, like, more, more often than any others, which is just turning towards the sensation.

And this is so simple. Asking on a scale of 0 to 10, how unpleasant is this sensation, which is not the same as a pain rating. So lots of people are used to being like. It's a 10, it's a 10 out of 10, but we're not suggesting that you do that because that is such an, what your pain intensity is. However, you think of that is often this aggregation of all these different dimensions surrounding the sensation.

So it can be the intensity of the sensation, the unpleasantness of the sensation, and then also really importantly, tied together and completely tangled up in that the distress about the sensation, the resistance to the sensation. So pulling back from the way that we've rated pain in the past. And instead just turning towards it and asking like, okay, how actually though on a scale of 0 to 10, how unpleasant is this sensation right 

[00:39:58] Vanessa: now?

[00:40:01] Olivia: How unpleasant is it right now? And once you kind of feel like you got it, you felt that out, how much distress on a scale of 0 to 10, how much distress about the sensation or resistance towards the sensation do I feel? And where do I feel that? And can I turn towards that and take care of that? That is. A very simple intervention that people can weave into their day a million times, and it just cues this very different kind of curiosity.

And what I often find in myself is historically, Oh, I'm getting a headache. I'm getting a headache. I'm getting a headache. Okay, lots of distress really understandably headache or no headache. But now, when I have those sensations, I turn towards them and I go, Okay, yeah, 1. 5 1. 5 just A 1. 5. That is totally fine.

Or four. Four. Right now, a four in unpleasantness. And distress. Eight. And just having that curiosity. No need to persuade. Just letting all those parts of yourself see that that's where things really are. It's not this black and white. Are you in pain or out of pain? But what's really happening right now.

That's been a big game changer for me and for a lot of folks. Thanks. 

[00:41:40] Grace: Yeah, thank you for sharing that. I think these are going to be really, really helpful tips and obviously know that they're coming straight from what you all both put a lot of hard work and thought into. And with that, is there anything else around?

Well, not anything else. What do you want specifically people to walk away with, as they've used your workbook? What's important

[00:42:08] Vanessa: I think the biggest thing that I really want people to walk away with is knowing that they have a set of tools to always come back to if they ever need them. Like, they're not done and alone and have to like. You know, like, go through the trenches by themselves once they close the book that there's so many things that they feel that filled out and interacted with that are always going to be there as long as they need them.

Because I think that can feel so hard as I'm doing this alone and how isolating it can feel how hard it can feel to feel. To just recognize, okay, I, I noticed this like fear pain cycle that I really get stuck in, but like, am I going to have to just keep doing this by myself all the time and remind myself that I'm safe?

No, because I have an audio that goes along with that, or I have a reflective letter. I don't want to give away too much, but a reflective letter that I was prompted to write to myself in the event that I need to go back to a reminder about what grounds me. I think as someone myself, who's very, very hyper independent and loves doing everything by myself all the time.

And then I turned to my partner at the end of the day, I'm like, Oh, I feel awful. And he's like, yeah, because you, I, you don't let me help you. I'm like, Oh, I forgot that. That's the thing I, I, I love, like, working this stuff in with that in mind of what is this going to be like for a hyper independent person who needs to rely on something outside of themselves.

And that's what I hope people take away is that. This is you not doing it all alone and we get it because we've been there and this is why it's as interactive as it is there are qr codes with audios attached to those qr codes that if somebody can't just read through the spaceman somatic tracking that Olivia so beautifully wrote that if they can't.

Read it and get something from it that they can listen to it and then they can follow along as they listen to it and rate their experience and write their experience in their workbook and go back to it when they need it. So I think it's just having something to not feel. So on their own. Right those hyper independent people or the people that everything really is on their shoulders in life, or they have to be the 1 that always takes care of everything just to feel like they have a companion, whether they're meeting with someone individually or not.

[00:44:30] Olivia: Yeah, yeah, all that and. I mean, I mean, I think just really personally, you know, when I listened to that first podcast of Alan's, that sense of things, clicking, seeing myself in it and the sense of hopefulness, like, whoa, things can be different. Things can be different. That's what I want people to walk away with for sure, is that sense of seeing, even if it's just a sliver of their own experience, seeing it and what we've shared and what that sparks.

In terms of I love that. 

[00:45:10] Grace: Yeah, that ability. I mean, both of you just highlighted the ability to feel seen and what you're experiencing and have someone something a companion to go along with it. Right? I mean, being in chronic pain and chronic symptoms can be so isolating because a lot of times people don't get it unless they've been there.

And I mean, that's exactly why I started this podcast. I just want people to hear and understand and know and feel seen and. Get that yes, things can be different. It does not have to be this way of feeling in pain and hopeless every day because you don't know what to do. So yeah, I love that. That's a big message.

And part of it. Thank you both. I. Yeah, I could, I feel like I could talk for a long time, but, I know that we, we need to wrap it up. So 1 thing that I like to ask every guest that comes on just like a kind of a fun ending question is what are you enjoying most right now in your life? Whether it's. I don't know a new recipe or a new book or a new adventure or something

[00:46:17] Vanessa: I okay last time you asked me this question. I went on a rant book that I was reading and I have another book it's I'm, I'm looking really quick. It's called. We made a garden. Okay, and I bought it on our recent trip to Europe. I bought it from Shakespeare and Co. It's like a bookstore in Paris. It's really cool.

if, if anyone's been, you know, how special it is. And if you go over there, you have to make it a point to go to Shakespeare's bookstore. And there's no phones allowed, so you're not allowed to take pictures or anything. So that's also really nice and serene. Everyone is like, really into just looking around and picking their book.

And I felt some pressure to, like, hurry up and pick a book because my friend had already picked a book and we had to get back somewhere at a certain time. And I was just kind of scanning around and I landed on this little teeny, like, plant section of, of, if, If anybody's seen my back , you know, that I have a lot of plans.

and I was like, oh, so predictable, so basic. Of course I pick a plant book, but then I saw this one and I was like, oh, that looks like something in, the English countryside. And it was, and I grabbed the book and I looked at the bio and it's this book about this couple, I believe her husband passed away maybe in the fifties, and I think she passed away sometime in the sixties.

But it's essentially about this couple who. Bought a home in the English countryside, they work and live in London and they bought this home and they argued about it a lot because they just felt like it needed so much work. But the more that they looked for other homes, nothing landed with them. And then they finally circled back and they're like, it's still on the market.

They went back to see it again, and then they just kind of envisioned themselves there. And this whole book is just about how they made a garden in this home that they didn't want initially. And it's about their arguments and it's about how they paved certain pathways. And he wanted one kind of flower and she wanted another.

And then after his passing, when the flowers that she didn't initially want would bloom, it would like warm her heart and be like, Oh, I miss him, but he's here. Oh, it's just like. I'm in the middle of it right now, and I do this every time I don't want to finish it. So I procrastinate finishing it because I'm so afraid to be without it.

So it's called. We made a garden, her name is Marjorie fish, and it's the cutest. Frickin thing ever. 

[00:48:44] Grace: Oh, I love that. 

[00:48:48] Olivia: Yeah, that's where we did not plan this. I'm going to wait. I'm just going to be honest. I'm a little tempted to switch it up, but I'm not my thing that brings me the most joy right now is gardening and 

[00:49:06] Vanessa: sink 

[00:49:07] Olivia: just yeah, we share a plan of sessions.

We live in vastly different places, but this is in LA and I'm in Juneau, Alaska and power plants are. Cacti and beautiful indoor plants. And I've got a lot of hardy perennials outside. but yeah, just getting my hands in the dirt being, it is, it's about 34 degrees and raining out. And my plan is to go plant my bulbs today and just being out there, being okay in the discomfort, not just being, being better than okay in the discomfort, just loving it, having all of my rubber.

Clothes. and having a great time. And if you are into British gardening, I'll just plug, gardeners world. Hosted by Monty Don is it is I call it sort of Valium. It's like 

[00:49:54] Vanessa: television. 

[00:49:56] Olivia: It's just incredibly relaxing. There's a zillion seasons of it. Look it up gardeners world. It's a BBC production every week from like spring through autumn.

They come out with a new show that just profiles beautiful gardens. Mostly in the UK. I love it as well. And, it's like, it would be a nice compliment to Vanessa's book. 

[00:50:20] Vanessa: I love it. Sounds like it. 

[00:50:24] Grace: Wow. Okay, cool. You are you are both very in sync. 

[00:50:28] Vanessa: I know 

[00:50:29] Grace: it's a habit. I love it. Okay. thank you again so much for coming on and I know this will be really helpful and, cannot wait to go pick up the new book.

[00:50:40] Olivia: Thank you so much. 

[00:50:41] Grace: Thank you. You're welcome.