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Ep 21 - The Brain Science Behind Chronic Symptoms That Doctors Miss: Neuroplastic Pain Explained | Hillary Rollins

• Sandi Magder and Daniel Schuman • Episode 21

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What if your chronic pain isn’t coming from where you think it is?

If you’ve been living with chronic pain, unexplained symptoms, anxiety, or health issues that don’t fully make sense, this conversation with mind-body coach Hillary Rollins explores the brain-science of neuroplastic pain, the mind-body connection, and how the brain and nervous system can create very real physical symptoms even without ongoing structural damage.

It offers a powerful new perspective on the mind-body connection, neuroplastic pain, and the role of the brain and nervous system in physical symptoms. 

If you’ve ever felt confused, dismissed, or trapped by a diagnosis, this episode may open a door you didn’t know existed.

This conversation is especially personal to Sandi, and it gets at one of the deepest reasons The Health Hunt exists  for her, in the first place: to explore the gray areas of health that too many people are living with in silence. We talk about what mind-body work actually means, what it does not mean, and why this topic matters for the millions of people dealing with chronic illness, persistent pain, fatigue, digestive issues, dizziness, tension, and other symptoms that don’t always have clear answers.

Hillary breaks down neuroplasticity in plain English and explains how the brain is constantly learning, adapting, and creating patterns. Together, we discuss how chronic pain can become a learned pattern in the brain and nervous system, why the body can stay stuck in fight-or-flight, and how stress, fear, and threat physiology can influence physical symptoms in ways most people were never taught to understand.

We also get into the difference between acute pain and chronic pain, why pain does not always equal damage and why damage does not always equal pain, and how modern pain science has changed the conversation. Hillary explains concepts like functional MRIs, the placebo effect, and the nocebo effect

This episode is not about saying symptoms are “all in your head.” It is the opposite. It is about validating that the pain is real, the symptoms are real, and the brain-body connection is real. It is about understanding that the nervous system may be trying to protect you in a way that is no longer helpful and that for some people, that understanding alone can be the beginning of healing.

Text us your thoughts, questions, or takeaways. We read every message.

All views, opinions, and commentary expressed on The Health Hunt Podcast are solely those of the hosts. They are shared in a personal capacity and do not represent the views, policies, or positions of any current or former employer, including any organizations with which the hosts may be professionally affiliated.

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Sandi Magder

Welcome

Chronic symptoms, mind-body connection, and why this topic matters

Sandi Magder

back to the Health Hunt. A human, humble, and sometimes surprising exploration of how to better understand our health. Now, if you've ever had symptoms that just didn't make sense, if you've ever received a diagnosis of this is forever, if you've been told something is wrong, but the explanation never fully felt right, or if you've lived with chronic pain, anxiety, or health issues that just don't seem to go away, no matter what you try, and you feel helpless, hopeless, and with no light at the end of the tunnel, this episode might provide a new perspective, or at least some food for thought about the way you think about the symptoms in your body. Today we're starting part one of a three-part conversation with mind-body coach Hillary Rollins. And this is a topic that's very personal to me the connection between the brain, the nervous system, and chronic symptoms. Now we ended up going very deep on this topic, so we split it up into a three-part series. In the first episode, we focus on the science behind mind-body symptoms, what neuroplasticity means, how the brain can create very real physical pain, and why chronic conditions don't always come from structural damage, even when they feel completely physical. And this is the framework and the context part of this discussion. In part two, Hillary shares her own story of chronic pain and most importantly, recovery. And in part three, we talk about some of the tools people use in this work and how people start to break the cycle of chronic symptoms, including a discussion of mind-body coaching. This conversation is perhaps a little different than what we usually do on this show, but it's also, in my opinion, one of the most important topics that I've really wanted to share. So let's get into part one of our conversation. But first, you know what I gotta do. The Health Hunt Podcast is for informational entertainment purposes only. We are not medical professionals, and nothing shared should be considered medical advice. Always consult your healthcare provider before making changes to your health.

Why this conversation is personal & chronic pain statistics

Sandi Magder

And it's really a deep motivation for what I wanted to share when Dan and I decided to start this podcast. And what I'm talking about is the mind-body connection as it relates to chronic pain and chronic illness. And this is not just personal to me because chronic pain is really one of the most common health problems in the world. In the US alone, there's like more than 50 million adults that live with chronic pain. Millions of people have severe enough pain that it affects their daily life. And worldwide, it's estimated to be one in more than one in five adults. And it's probably even higher because not everybody actually seeks treatment. So, you know, these numbers are often skewed. When we talk about mind-body work and neuroplastic symptoms, we are not talking about something rare. We're talking about something that affects a huge number of people. Many who've been told that there's nothing wrong or that they just have to live with it. And it's exactly why this conversation matters. Now, before I introduce our guest, I just want to take a minute to explain what we mean when we talk about mind-body work because I have mentioned it a lot in this podcast in various episodes. And I realize that if you're new to this idea, it can sound confusing or even like a little bit out there. And I really haven't slowed down to explain what it actually means. For me, this work is important because through my own experience with chronic pain, I was dealing with symptoms that were very, very real and very physical. And like most people, I assume something must be structurally wrong. So I went down the normal path, doctors' tests, scans, like all the things, trying to find the thing that was broken so I could fix it. But what made it frustrating, and I've talked about this in an episode where I introduced sort of why we're doing this podcast from my perspective, was that the answers didn't always make sense or they didn't fully explain what I was feeling and they also didn't lead to any real improvement. And again, I talk about this if you look at episode three that kind of go into it on that journey. So when we talk about mind-body work, I just want to be very clear. We're not talking about symptoms being imaginary, and we're not saying that people should just think positive or ignore real medical problems. Mind-body work is based on the idea that the brain and nervous system have a powerful influence on the body. And sometimes chronic pain or other symptoms can be driven by these learned patterns in the nervous system rather than ongoing structural damage, even when there is structural damage present or when there's a diagnosis. And that's what this discussion is really about. The key point is that the symptoms are real. The pain is real, the fatigue is real, the dizziness, the tension, digestive issues, dry eyes, watery eyes, all of the weird things. It's all real. You're not imagining them, you're not making them up. Your brain is just trying to protect you in a way that's no longer helpful. It's not about blaming the mind, it's about understanding how powerful the brain-body connection really is. So today we're kind of going to slow it down and break it all apart, what neuroplasticity actually is, how it relates to chronic pain and chronic conditions, and why this work can be life-changing for people who have tried all the things but still feel stuck. And more specifically, today is about the theories, the science behind the chronic condition, and the stories of recovery. Now, our guest today is someone who really understands this work, and

Meet Hillary Rollins: chronic pain recovery coach

Sandi Magder

not just from a theoretical standpoint, but from her own personal experience, including her journey, which you're going to hear about a little bit later, and also working with people who are dealing with chronic symptoms, chronic pain, and conditions that don't always have clear answers. So now I'm finally going to shut up and introduce our wonderful guest, Hillary Rollins. She's a chronic pain recovery coach and longtime writer in theater, film, and television, which actually makes her an excellent storyteller, which you'll get to enjoy later. After recovering from chronic pain using mind body methods, she now helps others break free of the pain-fear cycle and return to full active lives. And that's a pretty cool thing. And just as some context, she's part of a mind-body community that I'm in that I've learned a lot from. We have a similar mentor who I'll share some resources about later, but her name is Nicole Sachs and she has a program called Breakawake. And like I said, we'll share more in um information about that. But without further ado, welcome Hillary, and thank you so much for being here.

Dan Schuman

Welcome Hillary.

Hillary Rollins

Hi, thanks for having me. This is exciting and scary and um it'll be fun.

Sandi Magder

All the things we try and work on, right? Right. It's gonna be all the things. It's the test of all the things. So I mentioned that we are gonna get into your story, but I really want to start with you talking nerdy to us because the neuroscience about all of this is fascinating. And I know that this is sort of a starting point for where you work with clients. So again, because uh we throw this word out here and we like big words, we joke about having them on t-shirts. We want you to really

What is neuroplasticity? Brain science explained simply

Sandi Magder

help us with what with what neuroplasticity is in plain English, like how you might explain it to a three-year-old, and obviously, especially in the context of mind-body work.

Hillary Rollins

A hundred percent. So, first of all, neuroplasticity, which is definitely a mouthful, simply means that your brain can learn things. And that is at the very basis of something we all already know about ourselves. We all learn to speak, most of us. We all learned to walk, we all learned, we all changed and grew, and our brains changed and grew with us. And what people don't understand is that that does not stop ever. The brain is a learning machine, it keeps learning till the day you die, till you take it offline. We're trying to create AI now in computers, you know, they're using all the resources, and we already have that right here in our skull. So our computer, and I like to use this metaphor a lot because it's it's current for a lot of people, you know, it's it taps into something they already should have understood. Your wiring, your brain, and your nervous system are learning machines at the basic. And they have important things that they do in your body. And one of the things they do in your body is interpret everything that your body experiences so that you can understand it. So just like a CPU in your computer takes in all these beeps and bops and ons and offs, and then tells you, you know, what you see on the screen, and that's kind of your body. Now, that's not always the way it's taught, but that's one good way into it, because it's just another metaphor for the understanding that there's never really been a separation between the mind and the body. That mind-body medicine is medicine, it's neurology, it's psychology, it's that we are one um system, and we have a nervous system that has two things that it does. One thing is it runs everything that we can't run, like our heartbeat and our breath and all the things that make us alive that are not conscious. I don't want to be the person just telling my body when to breathe. Thank God that's offline. And that's run by my brain and my nervous system. The other thing my brain and my nervous system does, and every other human being on the planet, is help keep us alive so that we can do the next thing that we need to do until we die. We live in a linear time system of a moment at a time and a, you know, feed yourself, clothe yourself, survival. They're very, very, very basic systems and they're in all human beings. So now, what does that have to do with pain science? We now understand what chronic pain is, and we didn't understand it before through this lens. So um, brain science and body science are one science, but we don't have a history in the medical, the way the medical world developed, that we see them quite together. We we make, we put things into little silos, and that has a lot of value because when you need to, you know, when you need eyeglasses, you want to go to the eye doctor, and you don't necessarily need to go to somebody who doesn't have expertise in that. So the idea of experts is not the problem. The idea is that we have did not have scientific research until really the mid-2000s that validated an entire understanding of what chronic pain is. And it's a little bit different than most people think. And it's 100% rooted in science, and it's now validated by MRIs, what what they call fMRIs, which are functional MRIs. You're not just looking for something in the body, you're looking for the activity in the brain in real time while the brain is feeling pain, while the brain is not feeling pain. You can track it. So we now have used our wonderful scientific method to understand something that is profoundly paradigm-shifting. But really important to start with, Sandy, as you said, because we we want to get it right. We don't want to use mind-body medicine uh to not help people. We want people to understand that understanding this, that the first part of this is education, because your brain is a learning brain and it has learned

Chronic pain vs structural damage, how pain patterns form

Hillary Rollins

certain patterns, and there are reasons for that, and we can work with that.

Sandi Magder

Yeah, and I think that that's a great point because I've talked about sort of a diagnosis being a blessing and a curse, right? Of course, we grew up, especially our generations, the doctor tells you something, the doctor must know something, the doctor saw something on your test, your scan, whatever. And so that must be the thing. And we can go through decades never questioning that until, and this is one of the reasons why I wanted to bring this to light is because sometimes knowing that that is maybe not the case, that there may be other reasons why you're having pain or chronic symptoms, if you've never heard that before, just that alone can be game-changing. It allows you to think differently about it and and have a different perspective and then start exploring.

Hillary Rollins

Absolutely. So it's a great starting point. But even more interestingly is that once you see that, you can't unsee that. And that's the beginning of the journey that gets the symptoms to dissipate. Because what happens is your pain is not what you think it is. You think your pain is damage in the body, and sometimes there's damage in the body, but damage in the body heals. That's another thing about plasticity. All plasticity means is change, it's changeable, right? Uh stretchable, you know. And so the body is plastic, also. They work together to heal. So when you no longer are healing from an acute damage in the body, and you continue to have chronic pain in those same places, it starts to ask, right? There's a disconnect logically between wait, what? I'm I no longer have a broken bone, but it hurts every time it rains. And then we have lots of ideas about what that means, but we don't understand what it really means, which is that all pain is in the brain, acute and chronic. The brain is taking sensations from the body and interpreting them, and it makes mistakes because it's an excellent computer, but all computers make mistakes. They learn a certain neuropathway until you correct it. And so that's all happening subconsciously. I love this because I'm looking on the camera and I've got Daniel on one side and Sandy on the other. And I know Sandy knows a lot of this, and I know that Daniel's kind of new to this, so I want to check in and say.

Dan Schuman

It's a great check-in. You read my mind. Um, so um, I'm going to couch what you just said under two words, chronic pain.

Where people go for chronic pain in traditional medicine

Dan Schuman

That seems to be kind of what you to sum up what we were talking about here. I think about it in traditional medicine. Um, people go to the doctor, go for, you know, I shouldn't see a neurologist, they ask you go see a um a gastroentologist, they go see their primary care physician, all for like the the infrastructure, the CPU, all the hardware components. Um, but the average person, and certainly even me, I don't consider myself average in the health world. Um, where do I go to address chronic pain in in traditional medicine, let alone in, you know, in any other integrated functional medicine? I don't know that people know where to go.

Hillary Rollins

That's a very good question. So there have been many, many, many years of people trying to relieve chronic pain. Um in all areas, including the Western medical model. I mean, there are pain clinics that are simply designed to s to help you deal with the pain and hopefully reduce the pain, but they grew out of the fact that it was an un it was a gnarly problem. Um mind body medicine today understands that to not be really great medicine, to be honest, because it does not purport to treat the source of the pain, it purports to give you tools to live with the pain and possibly to reduce it, but true neuroplastic pain can be healed 100%. You can be pain-free from neuroplastic pain. And that's a promise that sounds really um overblown to people who don't understand why I'm saying it. So, but to bring it back to your question, where do people go? They go to their doctors, and more and more they get what we call a nocebo effect from getting a diagnosis. The diagnosis is the doctor, I I love doctors, and I don't know too many doctors who I wanted to be a doctor. I couldn't do the math, honest to God. And my mother turned to me and said, We don't do that in our family. You know, we're I know. I'm the only Jewish girl you know whose parents wanted her to go into show business instead of medicine. But anyway, um but the the fact of it is that we they are trying to help when you go to them in chronic pain, and they don't have a great answer. So they either get opioid prescriptions or they get surgeries or they get um alternative treatments. And you know, I used to have an acting teacher who said um helped me so much when he said technique is whatever works. And here's the thing about all of these other modalities, some of them work some of the time. And if you're treating the right problem with a modality that works, you can expect a certain result. What happens in the chronic pain world with most medical providers is a lot of the time you're getting not the results you would expect. And that's the first clue that this is not what they call that that this could be primary pain, pain that is brain down, not bot body up. Because the pain is go the signals between the brain and the body are both ways. It's a two-way street, and it's the hardware is sending information, it's not yet interpreted as pain. But the brain beyond your control is protecting you. So if you put your hand on a hot stove, you don't have to decide whether to remove it or not. The nerves in your fingers send information to the brain, and the brain says, do that. Take your hand off the hot stove so you don't burn yourself. Not rationally, in a split second automatically. Same thing is happening the other way. You're getting things that the brain doesn't want to interpret as what it is, because it's trying to protect you from a perceived danger. So we can send you that same sharp pain to get you out of the way of a bus that's about to hit you. Yeah.

Sandi Magder

So that's something I want to dig into a little more to explain to people is the how and why your brain is creating, and again, I want to be careful, it's not creating as in it's

Sandi's story in the context of mind-body symptoms

Sandi Magder

making it up, but how the brain is sending pain signals to the body that become chronic. Because I can what I I'll I have my own story of my understanding of this going back to when I was young before I even knew my body was a thing. And that's why I think it always clicked for me.

Hillary Rollins

But if you can kind of explain that, like why is that happening from a, but I'd actually think uh the best way it would be for you to give me your little thumbnail of why you thought it was and how respond to it.

Sandi Magder

Okay, so I've shared with with the, you know, with our audience that I was diagnosed with rheumatoid arthritis when I was 18. And it came on hot and heavy. I mean, I couldn't get out of bed. I was on, they gave me all the drugs, all the things. And I remember going to the rheumatoid, and this is before the internet, so I couldn't Google it, I couldn't look it up, but I remember going to the rheumatologist's office, you know, week after week and seeing that everybody was decrepit and miserable. And I knew that they weren't helping anyone. And secondarily, I didn't like the explanation, your body's attacking itself, right? Like that just didn't make sense to me. I didn't know why, but it didn't make sense to me. And sort of over time, and even back then, I noticed patterns. I noticed that when I had exams, my entire the flare-ups would be significantly worse. During times of stress, it was significantly worse. And I can now go back and say, and I, you know, again, it ties into what I've learned about this work and the type of people that end up with chronic symptoms. It's perfectionists, it's something that people call goodists, like you always want to be seen as good and do a good job and all of those things. And I was a high stress kid. And I like perfectionists at the T. Again, I've talked about I spelt kindergarten wrong in the third grade and I ruined my perfect. It's I'm still like it still makes me sweaty and anxious when I talk about it. Like that's that's what we are dealing with here. So but that was the kind of kid I was. I was trying to get into Harvard, I was going through all of this stress. Every test, every exam, every like uh project was a point of failure, a point to not be perfect. And so I was in this concentration my entire life. This goes back to when I was like two years old. So I understand now, and I this is what I believe that my body, and it had been trying over the years with different illnesses, send me signals of we can't go on like this. And so the arthritis, the way it came on and the way it was so debilitating, literally forced me to stop. And that was the thing that I needed. And even more than that, it almost gave me an out, right? Like if you're sick, people kind of, especially if you're very sick, if you've been given a horrible diagnosis, people give you a pass, which allows you to give yourself a pass. And so when I think about all of that together, the neuroplasticity element and the fact that something was happening in my brain that it didn't know how to deal with, that it needed to send a signal to my body, because that would be the only thing that I would at some point notice. In the context of all that, it made sense. Again, I kind of always knew these things, but I just didn't have the language to explain it until I started doing this work. So maybe you can explain how that kind of works with the science.

Hillary Rollins

Absolutely. Wow, that was beautifully put. So the way it works with the science, and it's a little, again, I don't want to get too too nerdy. Here's how Nicole describes it. It's a metaphor, but then I can get I can get more granular with the actual biology if you get interested enough. And but at bottom, we are talking about the fact because your your emotions are created by your nervous system in order to it's called threat physiology. That's the basis for all of this. We all understand fight, flight, or freeze. We all see it all the time. We see if you we say we felt like a deer caught in headlights. We know that means we the deer goes into freeze and that's how they get killed. But it's also how it saves them if uh somebody is gonna shoot them and and is tracking their movements, and if they're not moving, they lose track of them. So it's an automatic nervous system that puts your body into fight, flight, or freeze when you're in danger. Um, and that's brain down. The thing is, we don't really have a perfectly working system about when we're in danger or not in danger. Because the part of the brain that developed to keep us alive to this point in mankind's history on the planet goes back to early, early, early times. We all we've from even people who are into brain science kind of talk about the lizard brain and then the next layer, and the and then we get to the thinking brain, the intelligent, you know, thing that separates us from the animals. Um, and in that process, we never lose that fight, flight, or freeze because it runs the whole system and we need it. So it makes symptoms in the body to do whatever needs to be done. It sends electrons that, and there's a chemical process that has now been understood, if you're interested in that. But the bottom line is emotions that feel to the nervous system like a threat to your survival will be repressed. And when they start to bubble up, as they will, when there's enough of them piled on, you will get symptoms in order to keep you safe. Now, as Nicole likes to describe it, it's safe in the unsafest way, because now you can't do your life. But from the point of view of the nervous system, fight, flight, or freeze are the choices. And if you can't run away, you can't kick the bully in the balls, excuse my.

The role of stress in chronic pain: fight-or-flight, and the nervous system connection

Hillary Rollins

But yes, in the 21st century, nobody doesn't live in constant stress. They used to call this stress illness, but the misunderstanding is that stress gets a good and a bad name. You need stress, just like you need pain in order to survive. You need stress, it's stressful to be human. It's good. We we go to the gym and stress our muscles in order to build an abus muscle. Well, in the mind-body system, which is what we live in all the time while we're alive, we have emotions bubbling up and we have physical uh experiences, and they are being mediated all the time through this fight, flight, or free system. Is it gonna keep you alive? Is it good for you or is it bad for you? Is it gonna get you to your next meal? Is it gonna get you to live long enough to make babies? All the things that we know drives nature and science and man's development. In that regard, we don't live in a world where we can be truthful about our emotions because emotions have been sidelined. They are seen as not real and not scientific and not the cause of illness in the body. But now we have fMRIs that show clearly that when you uh take somebody who has a uh a back surgery, has back pain and has, or let's take something more easy. Uh you take a broken leg and you set the leg and it heals, and they get better. But some percentage of people continue to have pain in that side of the body and they don't know why. And they now contract that that exact same pain that was in the brain on this side of the brain in the injury now shows up in a completely different part of the brain that is the emotional center of the brain. The pain is the same, the disability is the same, and any symptom that your body can make from an outside uh uh thing like a disease process, such as a virus or a bacteria or a trauma like a broken leg, any symptom that the brain can experience from those traumas, it can and will also create from emotional trauma.

Sandi Magder

Yeah, and I think it's so interesting. It's what no, it's why, and I think sometimes, because I've learned this on my own journey, it serves a purpose, right? Like maybe when your leg was broken, people were kinder to you or they helped you more, and it was okay to ask for help. And so I think that's maybe where the chronic sort of train, you know, transitions into something longer. And I can tell you this again, from example, I remember recently I was trying to envision what it would be like to not

The Placebo and Nocebo effects

Sandi Magder

have pain. And I had a moment of panic that if I wasn't in pain, people were going to expect more from me and I would never get a moment off. And that was that was like so shocking to me. But I understand, again, that the pain or symptoms, like when I used to get sick, I'd be sick for a month. And towards the end of being sick, I would start to feel panic, like I don't feel better yet. People are gonna expect me to be 100% again. And it's a cycle. And so I think sometimes, again, you don't go in hoping that that's gonna happen. But if you say you have you break your leg, your body learns some sort, your brain learns some sort of benefit to that.

Hillary Rollins

Absolutely. And it always serves a purpose. Your symptoms always mean something. So, but the tricky thing here is that it doesn't necessarily mean it's a secondary gain. Like people have, along with the the idea that's an outdated and misunderstanding of mind-body medicine, the idea that it's all in your head, that does grow out of a concern people used to have about, you know, all kinds of things about people faking it to get disability or faking it to get attention. I mean, there are disorders that run along those lines. And that is not what we're talking about here. We're talking about the way brain science now has come to move pain science along and understand that all pain is in the brain, and the brain is an organ, and it's also the housed, the house of the mind, because the mind is our thoughts, our ideas, our practices, our behaviors. You can't separate them. You are you are experiencing life through the lens of your experience. Yeah, exactly. I was just saying you can separate the purposes of looking at them, which is something science does and does really well. But if you don't put it back, this is where the paradigm shift is hard for people. You have to put it back together with the understanding that the system is a little different than we've been taught it is. And once you understand the system, you're it's you're gonna drive your car better.

Sandi Magder

You know, we No, I love that as an example. And I think too, this was something that resonated with me also that the brain doesn't differentiate between an actual threat, like a tiger chasing you, and a psychological threat. So if you're experiencing stress or you're projecting that something's gonna happen to your brain, it's the same thing. And like you said, we live in this high stress world. So it's not like, and I think there's like an evolution disconnect, right? Because years ago, you would have the adrenaline rush, you'd run away from the tiger, you'd be safe and you'd let it go and you'd move on with your day. And now our brains don't even know to come out of that state. And so we just live in this like literally constant state of the state.

Hillary Rollins

Going on with that day, going on with your day means checking again, checking again, checking again, checking again. Right? And and you know, it's true. We only have, I mean, I don't know if we even let it go. The theory is that this a lot of this mind-body illness or neuroplastic or TMS, we get into that later if you want, but the names, but a lot of this developed in the human system. This is not like if you have these symptoms, and when you have these symptoms and when you do this work to heal these symptoms, it's really important to know that you're not broken. This is not because there's something wrong with you. You've gotten a diagnosis. Let's talk about what a diagnosis is in medicine. It's a collection of symptoms that the doctor looks for connections, right? They do differential diagnosis, they look for symptom clusters, and then they look at prior groups of symptom clusters, and then they look at what works on relieving what has worked on other things, drug-wise or surgery-wise, and then they give it a name, and that's the diagnosis. The story of what's wrong with you becomes your thing that you work with. But everybody is in a mind-body system. It's the human experience is to have pain because it keeps us alive, it keeps us from burning ourselves on the hot stove. It's only a problem when it becomes chronic. Exactly. And so the chronicity is what we're dealing with, what we're treating is instead. Here's another example that is one of the best things that do you know Gigi Kakel? You'll have to have her up. Okay, I would love to. Yeah, and she's she's a brain science expert beyond me because she actually got a degree in biology. She's not a singer, dancer, actor. But um the the uh the analogy she likes to use is really what pain is is an alarm system. It's an alarm that something needs to be addressed. That can be something

Pain as an alarm system: why symptoms persist

Hillary Rollins

physical, that could be something psychological, that could be something spiritual, that could be something in the system, just like in a in a any system. Ding, ding, ding, ding, ding, ding, ding, attention in aisle three. Now, if you come in with a fire alarm that's ringing really loudly, and you call in the fire brigade, and they're really good, and they've got their hose of water, and they point it at the alarm, but the alarm went off because there's a fire, you're gonna have a very wet, loud alarm, and the fire is gonna keep burning. What turns the alarm off is when you turn the hose onto the fire. And what the fire is in this metaphor is the repressed emotion that your nervous system believes for good reason is the same thing as a saber-toothed tiger. Now, that's not your fault, that's not your doing, that's not a conscious process, but it is what's happening. And in this context of this teaching, this understanding of this, that is what's happening in the biological system called the my body system. And so now you have to go, well, how do we turn the fire hose toward the fire so that we are treating what's at the bottom of the alarm going off? Because at one time that alarm might have been going off for a little fire and you put it out and that was fine. And another time you put it out and it was fine, and another time you put it out, it was fine. And then one day the battery's wearing out and it goes off even when there isn't a fire. And then it goes off when there is a fire and you put the hose out on the fire alarm because the fire is no longer burning hot physical problem. It's something else that is threatening.

Sandi Magder

And you don't even know it's threatening. Well, that's the problem. I think when there's a fire or not a fire and the alarm is the same, how do you know the difference? Yeah.

Hillary Rollins

And that is where the journal speak practice comes in and all the mind-body tools.

Sandi Magder

Yeah. And I think too, I mean, we can get into this when we talk about your story, which we'll move on to next. But again, something that I had learned because, and Dan's had experience with this too. Like I was diagnosed with severe spinal stenosis in my back. And I had problems that I was tested for, and that's why I found out about it. But I feel like it got exponentially worse when I learned about it. And then when the chiropractor told me I needed a special back thing for the car, my bucket seats, and I literally was like afraid to sit in the car. And I learned, and a lot of it's through this work, that two people can have the exact same MRI and one person doesn't have pain. And that science can't actually, while it makes theoretical sense, like your back is messed up, there's things, bulging discs, whatever, whatever. It makes sense to think that that's the cause, but they can't actually scientifically prove that that is causing the pain. Because, like you said, it's in the brain. And so that is like a huge realization. And one other thing I want to throw out there, because I know people hearing this, it might sound like a far stretch, like your chronic knee condition or whatever could be related to, you know, the mind-body connection. But as an example, people accept that if they're very stressed, they might have a headache. And for some people, that goes away the next day. For other people, that becomes chronic. But at some level, they accept, you know, stressful day, headache, or they had to do a presentation, they were nervous, they have a stomachache, or they felt nauseous. Those are things people accept on a certain scale without thinking that it's mind-body, but that's those are sort of good examples for people when it's when this stuff sounds far-fetched, because I think most people subscribe to that.

Hillary Rollins

100%. And and here's a couple more examples that I love. Um, when we are embarrassed, we blush. Yes. And no one thinks, oh, I decided to turn my face red. But with physiologically, I don't want to go there, but I don't know why more people don't bring up sex as the point here.

Sandi Magder

That's a good one.

Hillary Rollins

So if that isn't a mind-body connection, we wouldn't have an entire porn industry. I mean, hello. So physiological expression in the body of pain and pleasure and all sensation is always, you know, it from the nervous system and the brain. And and there you have it. So yeah, I think um another example I love of that, to Nicole always says, you know, I start by telling teaching people what they already know, which is what you just quoted there. You know, you nobody here hasn't had a headache and said, what a day, and left it at that. But as she says, that doesn't make us run off to see if we have a brain tumor. And in the the a problem is that we have now created a system in which we do often run off and think, oh my God, it's a brain tumor. Because of the constant, constant hypervigilance that has that we've been brought to in our modern world. But there isn't an ant there is an antidote to this, you know?

Sandi Magder

Yeah. Well, once you understand it, and I talked about this a lot in the episodes where we discussed, like we, I think I told you we went to have full body scans and and and we wanted to talk about it. And I talked about a lot having to be very cognizant and careful that I didn't freak out about every little thing that showed up and cling to it. But knowing that that's how my brain would normally deviate, I was able to monitor that and to manage it. But had I not known that, it probably would have caused me to now have symptoms in places that weren't bothersome before I got the results.

Hillary Rollins

I mean, the brain is so suggestible and we're not surprised. So, and here's the problem. It's not, again, I don't think doctors are, you know, we all know about the placebo effect, right? We use it in, I mean, people use it disparagingly, like, oh, he didn't really get better. It was just the placebo effect. Well, if he didn't drop dead and he's still alive and he doesn't have the pain or the problem. He got better. He got better. So the reason it's so powerful, which I mean, there isn't a scientist. We use the placebo effect as a test for drugs. That's how you pass the FDA. That's how you pass the most conservative Western-trained scientists to prove that it's actually scientific. And Dr. Sarna, who is the source of this mind-body, the grandfather of this mind-body medicine world, always said, My observations are more scientific than the ones that people who don't understand this. I think a great example that brought me in that made it very clear to me, is because people sometimes who don't have never given this a thought. You know, it sounds so outlandish. But then if you rifle through the things you've heard, the outlandish things you've heard, like for instance, phantom limb pain. Lots of people have heard of that. And it sounds very extreme, it is pretty extreme, but they don't question it. They go, Oh, yeah, have you heard that sometimes when people lose a limb, they suffer from phantom limb pain. Now the the leg is gone, and the person is saying, My foot hurts.

Sandi Magder

Sounds nutty, but people but people accept it because they've heard it probably their whole life. It's come up in TV, TV movies, someone mentioned it. Like it's it's for some reason phantom limb is accepted.

Hillary Rollins

It's a great story for people, right? But it's all those stories that are that allow people to start understanding what is actually going on, which is that we have a brain, we have a map of our body in our brain. Brain scientists call it the homunculus, which I just love. But it has to do with the it it has to do with which nerves are more sensitive relative to the rest of your body than others. That's how important the brain in the nervous system is. So that's getting really granular, but there you

MRIs and functional MRIs

Hillary Rollins

go.

Dan Schuman

I just have one specific question because we've talked about MRIs a couple times, and you've mentioned functional MRI, which is a term I've never heard of. Are you able to explain more about that?

Hillary Rollins

Sure. So MRIs, as we've known them, when you go in for an MRI of your spine or any other part of your body, you are getting s pictures of a static uh system, basically, your body. I don't know if they did brain MRIs before that. I guess they could look at the tissue. But what they can do now is look at the brain activity, the neurological uh electrical activity that's going on while you're awake and thinking. And you know, people don't know this either, but when they used to do, I mean, they still do, if they have to do brain surgery, you don't need um pain medication for your brain. It doesn't have any pain if you cut into it. It's only the scalp and the and the housing that has pain. So it's the receiver and and processor. And in that same way, uh it can be read now electrically by an MRI, by pictures. So while you're thinking a certain thought or having a certain experience in your body, you can be wearing these sensors and they can make a brain map of what's going on. It really revolutionized brain s. I mean, brain science was always being done, but you'd have to take a brain apart and look at it under a microscope. Now you could see what people were experiencing in real time.

Sandi Magder

That's very cool. If I wasn't over MRIs for the time being, I would probably go and stick my head in one.

Hillary Rollins

But I'm Yeah, well, that's a really important point. Because here's the problem a lot of the chronic pain is talking about I was talking about that was my point. The placebo effect, we know about that. We don't think enough about the nocebo effect, which is the same power. It's being told by somebody in authority that you will have this particular experience and you believe them. Just as taking a sugar pill, if you think you're getting the medicine, you believe them. Belief is not a woo-woo idea, it's a process of information gathering and processing, right? So when a doctor gives you a diagnosis that's scary and says there's no cure for it, you're gonna go into a fight, flight, or freeze reaction from that very fact alone. So here's the thing about MRIs you look at jacked up backs and you go, I mean, that if a doctor doesn't know about the mind body connection, which is a problem because this Medicine, this is new science that is not being taught in medical schools yet, or it is beginning to be, but anyway, yeah, they're gonna go. They were taught to say, Yeah, your back looks really messed up. That's why you're in pain. You need surgery. And why wouldn't you be in pain then? You you have a messed up back. So it works both ways, the placebo and the nocebo effect. And and MRIs are great for visualizing things. They are not great for understanding chronic pain. They are one tool, and they are often a misleading tool. And that's and that's and in the hands of a clinician who has understands this, it they will read an MRI through the lens of understanding what an MIR MRI is or isn't. But most of us understandably want control of our own. You know, we fought for the right to look at our MRIs. I wonder now if that was a mistake. I mean, it's not a mistake in the big picture, but it needs to be understood correctly.

Sandi Magder

Yeah, so it's a cautionary tale. I think it's a cautionary tale. Like I said, that was the exact thing with the MRIs. Once I knew I had this spinal senosis, I could literally see it in my body, like in my brain. And every time I sat down did something, I envisioned things happening. And I I didn't have that context before I was told I had that. And how severe, again, it was severe.

Hillary Rollins

I love those words. Yeah.

Sandi Magder

And words matter. They matter. Yeah. It's what you tell yourself.

Hillary Rollins

So yeah. It's all the story of what you make sense of of what's going on. Did that answer the question about the MRI, functional MRI?

Dan Schuman

Yeah, it kind of it um reminded me of a sleep study test. I don't know if sleep study tests were electrodes and you're on EKG and it's understanding brainwave and patterns while you're sleeping. I wasn't aware that can be done while you're not sleeping, or that's a test that actually so I'm gonna look into it. I just don't know about it.

Sandi Magder

That was part one of our conversation with Hillary Rollins. And this episode was really about understanding the science behind mind-body symptoms and how the brain and nervous system can create very real physical pain and why conditions don't always come from the structural problems we think they are. We know this episode was full of science and information-dense topic. So if the material resonated with you, but you're still sort of pondering it, we highly recommend you listen a second time. And as always, please reach out to us with any questions or area where you want more information. If any part of this conversation felt familiar, if you've ever been told you just have to live with something, or if you've ever felt like your body is stuck in a pattern you can't explain and you don't know where to turn, then you're definitely gonna want to hear part two next week. In the next episode, Hillary shares her personal story, including her own experience with chronic pain, diagnoses, surgeries, advocating for herself, and the moment she started to realize there might be another explanation. It's one thing to hear the science, it's another thing to hear what this actually looks like in real life. And if you're enjoying this podcast, make sure to follow or subscribe wherever you're listening so you don't miss the next episode in this series. And if this conversation resonates with you, we'd really appreciate you taking a second to rate and review the show. It helps more people find the podcast. And this is exactly the kind of information we want to get out to people who might need it. So thanks for being here, and we'll see you next week in part two.