[hschubiner]

Thanks for being in the class with us!!

Grace will email you the intake forms that I use.

Here’s the youtube channel from my patient on mast cell activation syndrome:
https://www.youtube.com/@thehistaminedeception5378

The video on trauma and healing vision from Mark Wolynn, which is excellent:
youtube.com/watch?v=YqBhAgqZGSU

Here’s the reference on the article we published on racism and pain:
Racism as a Source of Pain https://doi.org/10.1007/s11606-022-08015-0

Thanks again!!
Howard

[hschubiner]

Thanks for your questions, Jessy.

It is very common for people to downplay their emotions; everyone does it to some degree. It’s a way to protect oneself and avoid dealing with painful emotions. Every parent has times of being very angry at their children. There is often no acceptable outlet for this anger, which is why we developed EAET! One way to show the connection between emotions and MBS symptoms is to tell stories from your own life or your patient’s lives; and another way is to talk about the emotions and see if some symptoms begin to emerge, such as neck or stomach tension. I had a patient who refused to believe that her rocky relationship with her daughter was one of the causes of her pain. One day, in a therapy session, her therapist forced her to face this issue and her pain got very high. Finally, she knew.

The same process is useful for people who hang onto their diagnosis and a structural issue. You can use provocative testing and the FIT criteria to prove that it is MBS. And, you can investigate their symptoms over time by probing for times of pain getting better or worse and looking for evidence of pain that shifts, moves, turns on and off, is triggered by innocuous stimuli, etc. Usually it will become obvious.

Best, Howard

[hschubiner]

Thanks so much for being with us, Jessy.

Many, many people will downplay their feelings and move away from dealing with them. One thing that may help is if you can help them see that talking about these feelings or exploring them will often create some tension in their body (like neck discomfort or stomach tension). Another thing to try is to give examples from your own life (or others) about how everyone has anger towards their own children at times. And when that anger is seen as being wrong or inappropriate, it gets suppressed, and pain can result. Again, tell stories about that, just like I did with getting fired from my job and laughing it off, and then getting back pain due to suppressed anger. I told you all that story, right?

In a similar vein, one of the best ways to deal with skepticism about the diagnosis is to show people the connection, rather than telling them about it. So, I use provocative (or neural circuit) testing, as described in the Ovid app to demonstrate the relationship between the brain and the symptoms. You can also ask them to look for the FIT criteria occurring in their life between visits, such as triggered pain with weather, stress, simple movements, etc. OR pain that shifts or moves or spreads, etc. Over time, these findings will likely occur and then you have evidence for a mind-body cause for their symptoms.

Does that help?
Best, Howard

[hschubiner]

Thanks for your questions, Makse.
By the way, I will be in Norway in the fall and will hopefully be doing some lectures or workshops there.

You’re right the that mean scores in the EAET fibromyalgia study were not that different and not even statistically different at 6 months than the CBT group. However, the proportion who rated their improvement was much greater. It is very difficult to show that one psychological intervention for pain is actually superior to another. There are virtually no studies that show that. Our fibromyalgia study was possibly the first to do that; and yes, the results do not “knock you over.” In practice, we combine assessment, predictive processing education, PRT and EAET on an individual basis; and we couldn’t do much of that in that group setting of the fibromyalgia study.

The Boulder back pain PRT study did show better results, but there was no active comparison group. That study (PRT versus CBT for back pain) is now being planned and will be conducted by Yoni Ashar in Denver, so we’ll see how that goes (in a few years). 🙂

The likelihood that someone gets better doesn’t really depend on where their pain is or what symptoms they have. It’s more dependent on if they can accept the model, do the exercises, let go of fear, deal with stress and trauma, etc.

Does that help?
Best, Howard

[hschubiner]

Hi Lilia.
It’s so good of you to post such a simple and straightforward case!! 🙂

Clearly, this will be very challenging, but you are absolutely doing the right thing by engaging her family and helping her to have more social activities and happiness in her life. I think you can also engage her family to help you and her to see that her pain will be less when she’s engaged and busy and happy; and her pain will be worse at other times.

When you talk about difficult issues and the pain recurs, that is about a good an educational process as you can have. And, I would continue to help her see that. But if that doesn’t help her to see this, then she is probably not going to see it, at age 82 and with some cognitive decline. You are helping her, but you may not help her deal with the pain. Have you done any EAET work with her at all?

Best, Howard

[hschubiner]

Thanks for being in the class with us!!

Grace will email you the intake forms that I use.

Here’s the youtube channel from my patient on mast cell activation syndrome:
https://www.youtube.com/@thehistaminedeception5378

The video on trauma and healing vision from Mark Wolynn, which is excellent:
youtube.com/watch?v=YqBhAgqZGSU

Here’s the reference on the article we published on racism and pain:
Racism as a Source of Pain https://doi.org/10.1007/s11606-022-08015-0

Thanks again!!
Howard

[hschubiner]

Thanks for being in the class with us!!

Grace will email you the intake forms that I use.

Here’s the youtube channel from my patient on mast cell activation syndrome:
https://www.youtube.com/@thehistaminedeception5378

The video on trauma and healing vision from Mark Wolynn, which is excellent:
youtube.com/watch?v=YqBhAgqZGSU

Here’s the reference on the article we published on racism and pain:
Racism as a Source of Pain https://doi.org/10.1007/s11606-022-08015-0

Thanks again!!
Howard

[hschubiner]

Hi everyone.
I think we forgot to tell the peppermint story. On the first day of class, a psychology professor places a jar of liquid on his desk. He tells the class that it’s a jar of peppermint extract and he asks if anyone can smell it. He then asks each person to raise their hand when they smell the peppermint. One by one, most of the students raise their hand. After a few minutes, he takes a drink from the jar, and explains that it’s just water. One of the students remarked several years later, “I can still remember the smell of that peppermint aroma.”

🙂
Howard

[hschubiner]

The case Karin presents is an excellent one and there is lot going on; a lot to unpack. So many things point to so many mind-body conditions! You have to feel for this person who has worked so hard for so long, despite so many challenges, from childhood on.

It’s true that she has had back injuries and surgery, but I know that all injuries heal and scars don’t cause pain. It seems that her neurological exam is normal in terms of muscle strength, sensation and reflexes. And the MRI doesn’t appear to show any significant problem from surgery, such as a screw in the wrong place.

Obviously, the widespread nature of her pain suggests MBS. But it’s important to explore the back pain specifically if we want to know for certain that it’s also MBS; and more importantly that she can be certain of that. To do that, I would make a careful assessment of the FIT criteria and use provocative testing.

We will discuss these in the class, and of course, they are described in the OvidDx mobile app and in my book, Unlearn Your Pain.
If you’d like to test those with this patient, it would be useful for all of us to know what the results of that investigation.

Best, Howard

[hschubiner]

Thanks for your first question, Karin.
The brain’s danger signal is there to alert us to immediate danger, so it can activate at any moment. If our brain feels threatened by some event (physical or psychological), it can create pain or other mind-body symptoms. Most people have had some of these in their lives, whether they recognize them or not. I tell all my patients: “You are just human, and it’s human for our brains to warn us if we’re in some kind of danger.”

Clearly, some people have had many stressful life events that lead the danger signal to be sensitized and more easily triggered to create pain or other symptoms with even seemingly small stresses.

How quickly one can recover also varies widely as Alicia has pointed out!

Best, Howard

[hschubiner]

Hello out there. Anybody home??
I was just able to access this forum and I don’t see any posts as yet.
Am I missing something? Is no one posting any questions? Or ideas? Or cases?
Looking forward to seeing everyone next week!
Best, Howard Schubiner

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