Chronic pain treatment with Alan Gordon

Hello, this is Julianne Good and this is Psych One-on-One. Welcome. We are here to make psychology more understandable and to help you understand yourself a little bit better and those around you. The world is changing quite dramatically lately, so we are here to help you with that transition and give you tips for you and your family to make your life a little bit easier. So tonight we are going to go through chronic pain treatment through psychotherapy. I'm here with Alan Gordon and I would like to tell you a little bit about Alan. He is a psychotherapist in Los Angeles, California and he specializes in the treatment of chronic pain. Alan is an adjunct lecturer at the University of Southern California and he has authored publications on the treatment of chronic pain and has presented the topic of pain treatment at conferences and trainings throughout the country. He served as a chair for the 2010 MindBody Conference at UCLA. He is a professor at the University of Southern California and co-created the treatment outline and training protocol for the Psychophysiologic Disorders Association. Welcome, Alan. How are you? Good. How are you, Julianne? I'm doing pretty good. Thank you. Now, this is a wide ranging topic here and something that is really a hot topic because we're talking pain treatment through psychotherapy versus or maybe just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just back or carpal tunnel syndrome. You know, headaches are oftentimes ascribed to cluster headaches or migraine headaches. Medication is often prescribed, but the majority of these symptoms can be resolved just through psychological processes. And so that's what we do. First of all, we work with physicians that specialize in this. They can actually diagnose people with this condition and determine that it in fact isn't. You know, if you were an offensive lineman for an NFL team for 10 years and you come in and you have back injuries, there's a really good chance that it's the structural damage that is causing your pain. But for the majority of people with physical pain, unless they have an autoimmune disease or there's something specific. that's going on the majority of the time, it's actually just a physical manifestation of what some sort of underlying psychological processes that's causing this pain. And how long have you been doing this work, Alan? Probably since 2005. The way that I got into it is that I was going to graduate school at the time and I developed physical symptoms. I had back pain. I went. I went to these physicians at USC and they told me that I had a herniated disc. And then I went to another renowned back specialist in Los Angeles and he said that, oh, you don't have pain because of a herniated disc. You have pain because you have disc desiccation. And then I went to a third renowned back specialist in Los Angeles and he said, but there's neither of those. You're just too tall. And it didn't make sense. I was getting all of these physical diagnoses. And none of the physicians were agreeing with each other. And my mom gave me this book by John Sarno. I guess her friend's son got better after reading a book. And I read this book and learned that, you know, 70% of people with no back pain have disc herniation. And I learned that some of these conditions like disc desiccation, disc degeneration are just. And I learned that it's not common with the aging process that most people have these things. Right. And that it isn't responsible for the pain in and of itself. They're just incidental findings. And I was able to eventually eliminate my symptoms through this model and being in graduate school as a psychotherapist, I eventually found my way to specializing in this. Well, that's great. It's like along the lines of healer, healer by self. And then pass this. And then you're able to take these new teachings on to the public so that they can benefit too. I mean, it's amazing that you can go through that process and then turn around and teach somebody else because you've literally walked the walk. Right. Right. And I think it actually helps me in working with people and that I know what they're going through. It's so easy to fall back into the pattern of believing that it's the sitting that's causing the pain. And I think it might be frustrating for a therapist that actually hasn't been able to do that. You know, that person that actually hasn't been there kind of reverting to that type of thinking themselves. So I get it. And that's really helpful. Right. And then you can feel like you're in control of the process a little bit better versus just saying, okay, well this is an outside forces that I can't control or this is my biology or this is like you said, the aging process or excuse me for saying this, but I think the diagnosis of you're too tall is pretty bizarre. right right that was six hundred dollars i've never you know it's a double-edged sword when people actually find out that this is something that their mind is generating which it can be off-putting to some people because i remember when my mom first gave me this book and said oh you know my friend's son got rid of his pain because you know after reading this book it was so invalidating because i was given this physical diagnosis and the thought that i was generating my own symptoms was maddening so for a lot of people it's empowering because they think oh my this isn't something that i'm condemned with i can get rid of it but for a lot of people it can be guilt inducing because they feel like i'm actually causing this which isn't actually true you know it's an unconscious process but usually the type of people who develop this are the type of people who blame themselves a lot anyway so uh you know that's that's often a a consequence of learning about this model right and then there have also been um such like new age healers like i remember louise hay was really big for a while and you know you can heal yourself you know you can start doing these you know meditations and mantras and everything else and it did kind of go into you know the this is what the psychological process could be behind i mean some of it was good and some of it was as you said self-blaming and getting into the well i i should have more control over this whole process would you agree right yeah yes so how long did it take you to heal yourself from your back pain longer than any client i've ever worked with um you know i actually this is a condition that is known by many different names but the most common one is tms uh or which stands for tension myoneural syndrome and um there's probably about maybe two to three dozen physicians that specialize in diagnosing this across the country and maybe 50 or 60 therapists across the country that specialize in treating this and i saw four of them myself when i had this you know eight ten years ago and i i wasn't able to even make a dent in the pain and that's actually one of the primary things that led me to develop my pain and i think that's one of the things that i've been able to do is i've been able to do this treatment protocol um i think you may have mentioned the recovery program in the intro uh but we put a uh a recovery an online recovery program for people who can't afford psychotherapy up on the tms wiki which is a website that discusses pretty much the hub for all things tms uh and i think it was actually the failures of uh tms psychotherapy that i had personally had that kind of helped me to help shape uh a more cognitive behavioral universal approach to some of the primary barriers that people face in getting over this even if someone has this thing and they know that they have it it can be really difficult to overcome some of the psychological barriers to getting rid of the pain okay and i think i'm jumping ahead a little bit a little bit that's okay but that that's we we can always reel it back um now can you explain to the listeners what tms is exactly yeah tms is a term that was coined by john sarno who's who's uh really in the whole tms community is kind of looked at as like the the sigmund freud of this whole field um i think it started back in the late 60s or the early 1970s and he was a uh i believe he was a physical rehabilitation physician and he was a physical rehabilitation physician and he was a physical rehabilitation physician out at nyu and he was working with a lot of people that would come in with musculoskeletal issues like back pain or neck pain and they were given these diagnoses like disc desiccation or herniated disc and he was just so unsatisfied with the results of the typical treatment you know physical therapy or acupuncture because most people weren't getting better and those that were it wasn't really making sense it was very sporadic people had inconsistent results like they might have a disc that herniated off to the left yet the pain was down their right leg so he was the first one that uh not the first one but one of the first physicians that really started looking at i wonder if there could you know off certain things like irritable bowel syndrome and headaches were oftentimes looked at as tension related so he posed the question is it possible that tms is a type of disease that's musculoskeletal pain back pain neck pain carpal tunnel syndrome those types of things could be tension related also or not necessarily structural and uh he he gave people surveys where these people would come in with back pain or neck pain and how many of them have had some sort of tension related ailment before and it turned out that 90 of them had that's incredible he started treating this thing psychologically really just kind of providing you know education and his success rate was so much higher than any of the treatments he'd been doing when he'd been practicing you know these traditional approaches like uh physical therapy um you know working from a perspective of as if the the injury or the damage was structural and and since it has been honed more and more and i think there was three studies that were conducted in the 80s and the 90s and they found that on average 75 to 85 percent of people that were treated through this program got to a point where they had virtually no pain and these are people that were diagnosed with herniated discs many of them it was recommended that they get surgery and most of them got to a point where they didn't have pain anymore that's a huge success rate i had 75 to 85 percent that's a huge success rate that's that's more than you know the average i you know i've read a lot of research studies and such and that that that's really incredible so that's wonderful that dr sarno came up with this because i was in the medical field for a long time just doing medical transcription which is typing up the reports and i would see the pattern and some of the patients that they were treating and i would see that they weren't getting better they were you're right they were going to physical therapy they were getting pain pills and then you know getting the secondary problems from being addicted to the pain pills because opioids are very addictive yeah and then you know and i've known personally a couple of people who had chronic bad pain got on the opioids and had almost impossible to get off of them unless they went through you know some kind of detox program yeah so! it's you know a roller coaster's out of control a lot so and a lot of these people you know they don't necessarily start out as addicted to narcotics but being addicted to narcotics is better than being in that level of pain all day you know so it isn't even the psychological fix that they that they get off of it at first it's just i can't feel like this anymore and then it becomes a you know a psychological uh dependency yeah and then a coping mechanism is a lot of people who are addicted to narcotics and they're like oh my god i don't feel like i'm gonna get that stuff so that's interesting so tell us a little bit about the work that you do with your clients a lot of it is educational a lot of it is educational there's a specific purpose that the pain has like any behavior you know nothing is going to perpetuate if there isn't a reason for it and i can get into that in a little bit because that's That's trying to explain the theory of relativity. It gets pretty deep. But a lot of it is educational. There's probably 10% to 20% of people who could be diagnosed with TMS or read one of John Sarno's books. There's a few other. Howard Schubiner wrote one called Unlearn Your Pain. Dave Clark wrote one called They Can't Find Anything Wrong, I believe. A lot of times when people read these books and they relate to them, their pain goes away. It's remarkable. The reason why is because you're essentially taking away the pain's purpose. The purpose of the pain in many cases is it serves as a source of preoccupation. And the reasons for why that is are kind of complicated. But the purpose of the pain is to serve as a vessel for preoccupation. And it is really a source of fear for a lot. And when that fear is neutralized, when you no longer buy into the pain, then it's no longer serving its purpose. The analogy I use a lot is like a two-year-old kid throwing a tantrum. And you punish the kid, you pay attention to the kid, or maybe you give the kid candy when he throws a tantrum. It reinforces the behavior. And that's oftentimes how it works with the pain is you have this pain and you think there's something wrong with me. Is it ever going to go away? Remember how much better life was? Before I developed this? Oh my God, are there going to be comfortable chairs at this party I go to? If I have a child, am I even going to be able to pick them up? It's really being fueled by this fear. And oftentimes when someone reads the book and they think, oh, there's nothing wrong with me. This is just a psychological condition. They're no longer scared of it. And within a week or two, it often fades. So part of the work that I do is educational. I mean, sometimes a client doesn't even need to come in after initial phone conversation with me. There was a woman I talked to maybe three weeks ago. She called me up from Texas and she said, I think I might have TMS. You know, I just read one of Dr. Sarno's books. And she said, I found a back physician in Santa Monica, California, and I'm quitting my job. I'm moving out there for four months. I already have the plane flight. I'm paying rent on the place. And he agreed to work with me every day until I get better. I think he was a chiropractor. I'm pretty well known. And she told me what was going on with her. She's had three back surgeries. With everything she told me, it didn't really add up. Sometimes it hurt when she sat. Sometimes it didn't. It was really inconsistent. She also had a history of headaches. She had insomnia. There was anxiety and depression there. From everything she told me, it sounded like it was TMS. I don't diagnose people. I'm not a physician. But I just gave her my feedback on what she said. I told her it's probably a good idea to meet with some of these TMS physicians and then we can talk about treatment. I called her up a week later to follow up to see how she was doing. She said, ever since our conversation, my pain is gone. That's all it took. Just that one conversation, it took the power away from the pain. I said, that's great. You don't have to move out to California anymore. She said, everything you already paid for, I'm still going to come. It's just going to be a vacation now. A lot of times people get better and you don't even need to do anything with them. You just need to point out this is what's going on. It takes the purpose away from the pain. That's all it really took. That's called the book cure. The book cure. I like that. I'm sure it's a lot cheaper than a lot of other cures. Correct? Yeah. Yeah. It's really great when someone has three back surgeries, pain every minute of every day for years, headaches, back pain. One conversation or one book and your life is completely changed. It sounds magical. When I had pain, I had back pain, upper back pain. I had lower back pain and I had headaches. I had traces of other things. I just remember I used to daydream. It was all caused by some sort of universal source. Maybe there was some sort of magnesium deficiency I had or something. It seemed like I had all these different problems. I daydreamed about the solution. There really was a universal cause and I was able to get rid of everything. Yeah. It's amazing, especially if you're going to grad school. Then all of a sudden you're like, okay, let's start eliminating. Let's start eliminating possible causes here. Then you start listing things out. That almost makes the process worse because you start worrying about things. You're trying to take logical control of your own life in your pain. It makes sense that some people end up going down that route and just trying to get self-control back. Yeah. It's really difficult when you have a diagnosis. Someone will come in and they'll say, I don't understand how my pain can be psychological. This doctor told me I have a disc herniation. When a physician tells you that you have a bad back, it's really hard to shake that in your mind. That's why it's really important that we work with these TMS physicians so they could actually have a physician with a counter opinion. It makes it a lot easier to wrap your mind around. Exactly. Alan, we're going to take a commercial break. We're going to take a commercial break. Now, we're going to come back to the work that you do with the doctors. Also, I would like to open up the phone line to anybody that has questions or comments. The number is 800-893-9562. That's 800-893-9562. This is Psych One-on-One with Julianne Good. Alan Gordon will be right back. The Chicago School of Professional Psychology, offers numerous psychology, behavioral, and health-related science graduate degrees at three campuses, Los Angeles, California, including branches in Westwood and Irvine, Chicago, Illinois, and Washington, D.C., and online. The Chicago School prepares students to meet the ever-changing mental health needs of society through classroom experience and real-world training. The Chicago School Counseling Centers in Irvine and Westwood provide caring, confidential, and affordable psychology, psychological services to individuals and their families. For more information, visit thechicagoschool.edu. And thank you to the Chicago School for sponsoring Psych One-on-One. And we're back with Alan Gordon, and we're talking about treating chronic pain with psychotherapy. So, Alan, can you tell me about the work that you do with the doctors? How many doctors do you work with? There's a bunch. One in Los Angeles. I work with David Schechter. I actually just met with him. It's great to work in conjunction with some of these physicians because oftentimes getting an initial diagnosis, you need to meet with a physician. They need to look at your MRIs. They need to determine whether or not the pain is being caused structurally or psychologically. And so there's a doctor in Michigan I work with. There's a doctor up in Oregon that I work with. There's a few of them all spread out. And so... So, you know, a client goes into a doctor, and they just kind of assess what's going on, and after taking a history, determine whether or not they fit this diagnosis. If they do fit the diagnosis, again, just like the book here, sometimes people get better just from that. Those that don't, you know, can seek psychotherapy. But it can really serve as a great psychological intervention to get that diagnosis because believing that... the pain is psychologically caused, assuming that you have TMS, is the number one prerequisite to getting rid of it. And the doctors can be really helpful in that arena. Right. And then how many of these specialized TMS doctors did you say were in the country again? Probably two or three dozen. One of them, Dr. Hanscom, David Hanscom, up in the Seattle area was actually just on Dr. Oz. And it's remarkable. Because he's one of the first back surgeons that is actually a TMS physician. He's a back surgeon. He just wrote a book, I believe, who had this himself, and he had a failed back surgery. And being a back surgeon himself, he recovered using this TMS approach. So now, you know, he has clients referred to him to perform surgery, and he'll, you know, check in and determine that they don't need it, they actually have TMS. So it's really great. TMS, you know, they did a 2020, and they're doing a new one. They did a 20 special on John Sarno, maybe about 10 years ago. But over the past couple years, it's really starting to become more integrated into mainstream society. That's wonderful. I think that we definitely need to be moving into a more preventative healthcare module and the society, you know, versus sitting there and trying to get people to go into doing surgery. Because, again, there can be so many, so many complications. And not saying that I'm anti-surgery, because in some cases, that is one of the few treatments that are available to people with, you know, chronic back pain or, you know, degenerative discs, because, you know, some of it needs to be replaced. But, you know, I think just being able to incorporate psychotherapy with doing the medical model is so smart. Yeah. And it really depends. It really depends on the diagnosis. I mean, I know people who have had back pain and it was structurally caused and they got surgery and it relieved their pain. But that's the cause of back pain that the minority of, there's a guy that was referred to me a few years ago who had a 13 millimeter disc herniation, which is literally twice as big as I had ever seen before or come across. His pain was gone in 18 months. And he was diagnosed with disc herniation in eight weeks. So, you know, just because you have a disc herniation or, you know, something going on with disc degeneration in your neck or you've been diagnosed with carpal tunnel syndrome, it doesn't necessarily, I can tell you, I was handed, I was told that I had a disc herniation in my lower back. I was told that I had headaches because I had high cerebral spinal fluid pressure. I was told that I had shoulder pain because I had a partially torn rotator cuff. I was diagnosed with chronic fatigue syndrome briefly. I mean, I had, you know, a litany of diagnoses and none of them were right. You know, I had TMS. It was something that my, the pain that my mind was generating. And so you need to find the right treatment when you isolate the cause. Now, did you get down to the base cause of this? Yeah. You know, I mean, people develop pain for different reasons. Like, like Julian, have you ever had a headache when you were feeling stressed out? Oh, totally. Like the ice picks headaches. Oh yeah, yeah, definitely. Especially around... You mean, tell me a time when you developed a headache. If you can think of one. It was when I was a single mother and my son was rather young and I had to take him to daycare. two jobs and just a lot of pressure all over the place, just trying to keep things in line. Oh, definitely. Yeah. And then I was drinking too much coffee on top of it, which didn't help matters at all. Yeah. You know, oftentimes what happens is we treat ourselves in abusive ways, not by hitting ourselves or cutting ourselves necessarily, but psychologically abusive. There's a part of our mind, our primitive brain. And it's like a little kid. You know, it doesn't like to be treated cruelly. And if we're criticizing ourselves or we're scaring ourselves all the time or we're putting a lot of pressure on ourselves, it's almost like what's going to happen if, you know, you're driving a car and you don't change the oil in 30,000 miles, it's going to start breaking down. So when you start treating yourself in these psychologically abusive ways, the body can start breaking down. So what I was doing, I was in graduate school. And I was putting an enormous amount of pressure on myself. I was reading these textbooks and I was highlighting 75% of every page, which by the way, totally undermines the purpose of highlighting. Because everything looks yellow. Yeah. I was trying to memorize everything. I was putting so much pressure on myself to remember every intervention and do everything perfectly. And in my case, you know, the pain was like my body rebelling against being treated like this. And some people, they develop pain because they're not able to consciously tolerate certain emotions. Maybe they were taught early on in their life that it isn't okay to be angry or it isn't okay to be sad. So whenever any of these emotions come up, then the mind generates physical symptoms almost as a way to protect their conscious mind from these emotions. I know this kind of sounds like typical, you know, psychopath. Little just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just just completely disappeared. So one of the things that we do, you know, as TMS therapists that we do is we help people get to whatever emotions that are underneath the surface that might be difficult for them to tolerate, thus kind of taking away the need for the pain to serve as a defense mechanism to whatever this repressed emotion is. Right, and then they're allowed to do this in a safe and caring environment. Exactly. Right, that's so powerful. I know, you know, I've had a few people in my life where, and I know just from patterning, like I have one friend that when he gets fearful of certain situations, powerful emotions, he will shut down, he will get stomach problems consistently. And I know by this point that that is his way of coping. That's his way of going in the corner and just kind of, you know, soothing himself in an odd way. But as painful as the stomach pain is, it's actually less painful than it would be for him to feel whatever emotions were coming up. Yeah, and instead of processing. And no one ever chooses the pain. I just say, you know, anyone that's listening, I don't want them to interpret what I'm saying is you'd rather have the pain than feel these emotions. It's an unconscious process. You know, as much pressure as I put on myself, I would have done, I never would have chosen that back pain. I would have chosen many emotions over them. But, you know, we don't always get to choose how our unconscious mind processes things. Exactly. And I think a lot of times that our body has a, it has a mind of its own, basically. And, you know, I know there have been times where I've put too much pressure on myself. I've been trying to do things, you know, trying to do too many things. And I was also diagnosed with chronic fatigue syndrome in my 20s. And just all the treatments and everything else going through that was, I couldn't believe what I was going through. Then all of a sudden, I got to the basis of why I was doing that and what exactly the wisdom that my body was trying to tell me. Yeah. And then I started to think, and then I started to think, and then I started to think, and then I started to think, and then I started to think, and then I started to think, and then I started to think, and then I started to think, and then I started to process them and I never had any of those kind of problems again. Yeah. Chronic fatigue syndrome, fibromyalgia, you know, these are, and it is possible to have, you know, a physiologically caused fatigue. There are certain, you know, if you're on certain drugs, there can be some sort of potential vitamin deficiency that can result in fatigue. But just like back pain, the majority of people diagnosed with chronic fatigue syndrome have TMS. Yeah. Yeah. Hmm. Interesting. And fibromyalgia. And I know the sufferers of fibromyalgia mainly are women. Yeah. I don't know. I mean, I think that there's just as many men with fibromyalgia, but the doctors, if I was a woman, I would have been diagnosed with fibromyalgia. Interesting. You know, doctors are more prone to, I think, diagnosing women with fibromyalgia than men. But I went in with headaches, back pain, you know, wrist pain, so many different symptoms. And because I was a guy in my late 20s that presented as confident, I don't think that I was given that diagnosis. But I had all the symptoms to have been given that. Interesting. Hmm. So now looking, you know, looking back and taking all of those experiences that you had personally, how does that translate into the therapy room for you when you're dealing with a client with chronic pain? How do you mean? Well, you know, sometimes as therapists, we can sit with people and go, oh, okay, I know what you're going through because I went through it myself. And kind of putting, I don't know, maybe your own personal experience into it. Do you ever say anything to clients like, well, I was kind of through that myself sort of thing, or you just keep that off? At the table? Absolutely. The number one difficult thing for clients to embrace is when they're engaging in a physical activity or are sitting or standing in a physical position that seems to be correlated with the pain. It's so hard not to believe that it's a cause and effect relationship. I mean, the mind is so brilliant that it comes up with these conditioned responses. A conditioned response is, if there's a specific physical position or activity that becomes linked with the pain and your mind creates a cause and effect relationship with it. My favorite example of this is when Steve Martin was, I think it was like the late 60s or something, and he went to a movie theater, a famous comedian. He went to a movie theater and he had this panic attack. He didn't know it was a panic attack. I think he was on a date or something. He thought he was having a heart attack. He left the movie halfway through. He went home, kind of recovered, realized it was a panic attack. Next three weeks, everything was fine. He goes back to another movie to meet his friends, maybe a month later, and he's standing in line to get popcorn. All of a sudden, he has a thought. My God, last time I was here, I had this awful panic attack. I hope that doesn't happen again. Of course, right then, huge panic attack. He leaves, goes home, doesn't go to another movie, and he's been in the theater for 10 years. Missed his own premieres and everything. Oh, jeez. It wasn't the movie theater that was causing the panic attack. It was the belief that the movie theater was causing the panic attack that was causing the panic attack. This is what happens with TMS all the time. Back pain becomes linked with sitting. Wrist pain becomes linked with typing. Knee pain becomes linked with running. It isn't the sitting that's causing the pain in people who have TMS. But it's just that conditioned response. So I would have pain every time I sat. And it's so hard to wrap your mind around the fact that your mind is causing it when there's such this consistent trigger. It's like embracing a reality where your senses are lying to you. So that's the thing that my clients struggle with the most, is not buying into that cause and effect relationship with these physical activities and physical positions. So I talk about what I went through all the time, and it's really helpful for them. It can be. You know, things that worked for me, just that they don't feel crazy for having such a difficult time accepting this. Right. And then I'm sure that they have a feeling of connection with you then, because it's like, okay, wow, wow, Alan went through this too. So and if he got through it, I can also get through this. Yeah. Because it's... I mean, I think it helps them feel empathy. Yeah. And it helps them feel like they're being empathized with. It helps them feel like I understand where they're coming from. And it also gives us a semblance of hope, because I had this thing and I had it for a lot longer than you did, you know, and I was able to get better. And I think that can also help them trust me, that I know how to get better because I got myself better. Right. And then it's also the getting out of isolation with a chronic condition, because it is isolating. I know when... That was actually a really good question. No one's ever asked me that before. The question I asked you about putting yourself in there. Well, thank you. Yeah. Yeah. Yeah. Because I think that's so important because I mean, there's certain schools of thought and certain schools of therapy that said, you know, do not reveal yourself to your clients. And it depends on what theory it is, which, you know, it's a good thing for that certain theory. And, you know, I'm kind of one of those therapists too that I'd like to interject a little bit of real world scenarios in there because I think it's helpful. You get that feeling of connection and, you know, I think it's easier to instill hope like that. Yeah. And it depends on the therapist if they're comfortable doing that. But I definitely am. And, you know, I only do it when I feel like it's going to be helpful, but it is a lot. Well, I want to go through some of your therapy techniques that you have on. And could you mention your website a little bit, please? Yeah. It's painpsychologycenter.com. Well, one of the things that was going on as we were getting so many people have this, it's one of the rare fields where the demand actually outweighs the supply. So we opened up a pain psychology center in Los Angeles to conduct sessions both in person and over Skype because there's a lot of areas where these therapists don't exist. And we started training therapists to work exclusively in TMS just so we could help meet some of that demand. And that's the pain psychology center. Right. And on here under your techniques, you have cognitive behavioral therapy, psychodynamic therapy, hypnotherapy and guided meditation, mindfulness training, and dual brain therapy. Could you talk about those a little bit? Is ISTDP on there? No, it isn't. No. It isn't? Okay. We're actually changing the website right now. You know, there are some therapists that work from one specific lens, and it can be limiting. Because I've worked with people where utilizing cognitive behavioral techniques, you know, what I was just telling you about, overcoming these conditioned responses. If you have pain every time you sit, and it's so easy to believe that it's the sitting that causes the pain. And so really utilizing a lot of self-talk, forming an evidence sheet. For me, that piece of evidence came during a Laker game. You know, I was at a Laker game. It was double overtime, and I was so into the game. Like Kobe Bryant made like a shot with one second left. It was so exciting. I was two hours in, two and a half hours in, and I realized I don't have pain anymore. Right? So that's a huge piece of evidence. If you can sit and you don't have back pain after sitting for two and a half hours, you don't need to have back pain when you sit. And so really actually utilizing these pieces of evidence that you're able to develop to help sell yourself on the belief that, you know, this is psychologically caused. That sitting isn't causing the pain. That's an example of a cognitive behavioral technique. So psychodynamic would be more helping someone get in touch with certain emotions. There's a woman I worked with a long time ago. And she, when she was a little kid, she was locked in the closet whenever she would cry. And so having experienced that, you know, what is she going to learn about the emotion of sadness? You just shut down. Yeah, that's not okay. Right. She's going to look, she learned early on that feeling sad is not okay. So what happened is every time a feeling of sadness would come up, she didn't even realize that it was coming up. She would develop headaches. It was protecting her against that feeling. So we would use a lot of psychodynamic techniques with someone like that to really help teach them, to teach the right brain, to teach them on a primitive level. Right. That it's okay to feel these emotions. And through exposure, through challenging their defense mechanisms, through providing a safe environment and pointing out when they have an increase in emotion. I was actually just working with a client, you know, earlier today. And that situation came up where there was a hint of sadness that came up. And they immediately, you know, went to something else. And I said, hold on a second. Let's stick with that feeling. What is it? What does it feel like in your body? How do you know that you're sad right now? And, you know, eventually the sadness was able to break through. And they were able to feel it. And what that teaches the right brain, the emotional brain, is this is a feeling that you can experience. And it's safe. And it's okay. And over, you know, time, you could actually teach the person. You're almost like reparenting them that these emotions are okay. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. It's a more psychodynamic approach where you're helping someone feel, be able to consciously tolerate an emotion that they previously were not able to consciously tolerate. They don't have the need for these defense mechanisms like pain or anxiety as much anymore because the emotions are safe now. Yeah. And that's a huge part of healing. Yeah. Most definitely. I'm going to have you, since we're... We're running short on time now. I could talk to you for another hour or two on this. I think this is fascinating. The dual brain therapy. Could you explain that a little bit? Dual brain therapy is great. It's actually based on a book written by Frederick Schiffer, a psychiatrist out at Harvard a number of years ago. It was mind-blowing when I read it. He did a number of experiments. You know, back in the 1960s, there was people who had epilepsy. And what they did was they snipped the corpus callosum. You know what that is? It's that group of wires that connects the left hemisphere of the brain with the right hemisphere of the brain. And they were able to knock out people's seizures by just snipping the corpus callosum. And it was great. They thought, oh my God, we have this cure for epilepsy. And they started doing it on all these epileptics. You know, probably not the level of thoroughness that would exist these days. Not surprisingly, these people started developing symptoms. They would come into their doctor's office and they would say, my left hand and my right hand are acting independently from each other. Like, what are you talking about? Well, I went to light up a cigarette and my left hand just knocked it out of my mouth. There was this man who was like going to strangle his wife with his right hand and he needed to restrain himself with his left hand. You know, a woman woke up to someone slapping her across the face. It was her own right hand. She'd overslept. And what they realized was, you know, the left side of the brain controls the right half of the body and vice versa. And by snipping the group of wires, there was no communication between these two hemispheres. The left half and the right half of the body are acting independent from each other. So first off, they stopped doing this procedure. Luckily, yes. But they were able to work with these people and actually determine, you know, they would give them surveys. Because their left hand was doing things that they had no idea. They didn't know what was going on. It was like their unconscious. It was like having a direct link to someone's unconscious mind. So they would give these people surveys. You know, how much are you bothered by that bully, you know, from when you were eight years old? And their right hand is going to, you know, writing a one out of ten. It was 30 years ago. And their left hand, totally unbeknownst to them, is writing a ten out of ten. And so they've actually determined from all of these studies. Time doesn't exist in the right brain. So what this psychiatrist did is he actually formed these pairs of goggles. Where you can actually only see out of a small area with one of the pairs of goggles. You can only see off to the right. And you can only see off to the left with the other pair of goggles. And what it does is it stimulates these two parts of the brain. You know, one of the brains is usually healthy and one of the brains is unhealthy. And he did this. And he did this. And he started doing therapy with these pairs of goggles. And he was able to do in six weeks what used to take two years. And I read this book and I actually reached out to him. Because it was just so, it seemed so out there. But it was very evidence based. They did MRI studies and everything. And so I actually made a pair of these goggles. I talked to him on the phone for a while. I read the book. He kind of, you know, pointed out some other resources. And I started doing this with clients. And it was amazing. With one pair of goggles they had on. And they can only see out the right half of the right eye. And they'd say, ah, there's this feeling of calm that I have. You know, I feel really subdued. Almost like I feel safe. And I would say, you know, how do you feel about the world? I feel good about the world. How do you feel about the future? I feel hopeful. I have these symptoms. But I really think that, you know, they're temporary. And then you'd give them the other pair of goggles to put on. And they'd say, ah, this doesn't feel good. Like, I feel like there's a feeling of anxiety coming up right now. And you ask them, how do you feel about yourself? Not very good. You know, I think there's a lot of things that I would do differently if I could. How do you feel about your future? Ah, not very optimistic. I've had this for so long I can't see getting better. So it actually gives you as a therapist a way to connect with these two different parts of your life. And it's remarkable, you know, what you can do when you actually have a direct link to these two different parts of people. You know, you have access to their healthy brain and you have access to their unhealthy brain. And it really creates a distinction between these two parts of us. You know, sometimes you probably feel good about yourself. You feel optimistic about the future. You feel good about your radio show. You know, you feel... confident about your ability as a mother. And sometimes you can look at those same things and just feel really bad or really pessimistic. What this does is it actually isolates the two different components of people. Does that make sense? It does. So therefore you can turn around and you can modify therapy to that part of the unhealthy brain and start working to strengthen it through your other techniques, I would imagine, correct? Exactly. You know, you can... You essentially don't have to wait for them to necessarily come to therapy when they're in a particularly bad place. You could access it and you can talk to that part of them and you can help. You know, essentially what I like to do, one of the things that we do with therapy is... I think therapy is one of the only jobs in the world where your ultimate goal is to get fired. You know? We're actually trying to teach someone to be their own therapist. So they don't need us anymore. Exactly. So I'm not just trying to, you know, help heal someone. I'm trying to help someone use their healthy part to heal their unhealthy part so they can be their own therapist. Right. And dual brain therapy can be really helpful with that. Yeah, and it helps them empower themselves. And then... Yeah, exactly. It helps them be their own therapist by realizing that there's these two different parts to them. Yeah, and we give them the tools. And, you know, hopefully they take it and do the training that we've given them and they can go on and lead healthier lives. And, you know, and hopefully if they have anybody else that they come across, you know, friends, family, whatever, then they can refer them back to you because they know that it works for them. I mean, it's a beautiful domino effect. Exactly. So, Alan, as we're wrapping up, is there anything else that you would like to add in that you haven't spoken about? There is. You know, when a lot of people first learn about this and they are exposed to the idea that their pain might be psychologically caused, they automatically equate that with, are you saying that my pain isn't real? A lot of people are actually told by doctors, oh, there's nothing wrong with your pains in your head. When you have TMS, the pain is just as real as if, you know, it was being caused structurally. They've actually done fMRI studies and they've determined... They've determined that psychologically generated pain, it lights up the same part of the brain that when, you know, you actually have pain inflicted upon you. So having TMS does not mean you are inventing the pain. This is an unconscious process and it does not mean the pain is imaginary. Trust me, I had this thing. You know, I remember sitting sometimes at dinner or at a basketball game and the pain was so bad, I felt like I was going to pass out, but it was not caused by my spine. It was not. It was not caused by sitting. It was caused by my brain. And just like you can learn pain, you can unlearn pain. So that's one of the things that we're really trying to do is spread the idea of this. The majority of people that I work with have been in pain for five or ten years, bouncing around from doctor to doctor, seeking all of these different, you know, cures. I was virtually, you know, on the verge of going, going to South America to meet with a shaman. You get desperate after a while. So one of the things that we're really trying to do is help create the level of awareness that if you've been in pain for so long and you have these diagnoses and nothing has worked, there's a really good chance that you have TMS. And, you know, once you get the diagnosis and the treatment, most people are able to recover and not have to spend the rest of their lives in pain. There is help. Yeah. Yeah, exactly. Yeah. And if the listeners would like to contact you, how can they do so? They could, you can just go to painpsychologycenter.com and I actually, I don't know her phone number by heart. I should. Or you can email us over that and our contact information is on that website. And I try to do initial consultations with everyone personally, even if they end up meeting with a different psychologist. I try to get a therapist just to really assess, you know, make sure that they have this, make sure that they could get in the right hands, consult with a TMS physician to make you, we don't ever want to treat anyone that actually doesn't have this. So we do our due diligence to make sure that the candidates that we treat actually fit the diagnosis. So you can just go to painpsychologycenter.com and our information is there on the contact page. Okay. And the studies that you practice out of again? We're in Los Angeles, but we conduct therapy, we conduct therapy sessions in Los Angeles and we do TMS coaching sessions over Skype in different countries and different states as well. That's great. With certain therapists that just specialize solely in Skype therapy, which can be, you know, essentially just as effective as in-person therapy. Yeah, it's incredible what technology is doing now for therapy, isn't it? Yeah. I love Skype. Yes. So, Alan, thank you so much for being my guest this evening. This is Alan Gordon. And thank you so much. And I hope you come on the show again. I'd love to continue this discussion. I'm sure there's so much more that you could add in. Thank you, Anne. And thanks for asking such insightful questions. I felt like it really led to an interesting back and forth. Well, thank you, Alan. Take care. Okay. Bye-bye. Bye-bye. And thank you so much for joining us this evening. I want to remind you that if for some reason you only heard a part of this broadcast, we are on iTunes Store and we are also on Stitcher and Facebook. And all of these programs are archived. There are about 30 programs in for Psych 101 now. So please, you know, get into the rest of the library. There's a lot of different topics that will definitely help you and your family. So I want to thank Jenny Guzman, my board op, and Jeremy Hansen, the executive producer for skidrowstudios.com. And this is Julianne Good for Psych 101. Take care of yourselves. Take care of each other. Bye-bye. Bye-bye. Bye-bye.