Connections: Part 1 Chronic pain and the nervous system
Transcript
Colleen Jorgensen 0:03
The nervous system's number one role in life is to keep us alive, so it tries to protect us from anything that is perceived as unsafe. And it doesn't distinguish. This is slightly unsafe and this is really really unsafe. It just looks at this is safe, or this is not safe that's it's kind of a black and white sort of thing. And it will have a reaction in response to that.
So when you've been living with chronic pain, it's like that protective system becomes like an overprotective parent that it becomes so hyper vigilant on the lookout for danger everywhere that it starts to see danger, even sometimes our danger is not.
You're listening to the work IN, where warriors like you can find a natural path off the battlefield of trauma, chronic stress and stress injury can be a debilitating enemy, whether your fight is on the front line or the homefront. Join me as we explore natural balanced ways to work through the body to reestablish safety in the body, and find recovery for lasting resilience to all sources of stress tension and anxiety.
Our nervous system is designed to protect us at all times from all things. And because of that, it's connected to every other system in our body. When we're suffering from an injury, chronic pain or illness, big T or little t trauma, chronic stress or anxiety, it's easy to forget just how important those connections are to our physical, mental, and emotional health.
My guest today is Colleen Jorgensen. She's an osteopath and graduate of pain care University's professional pain care program as well as therapeutic Pilates yoga and somatics teacher who got her start in movement with dance at the age of three. She has a deep fascination with how the body moves, and that led her to a Bachelor of Science in exercise science with a major in athletic therapy from Concordia University. Her curiosity about how the body, mind and spirit are interconnected led her to osteopathy and yoga and 97, she founded core basics center of osteopathy and Pilates and was the proud owner of this small multidisciplinary clinic for 16 years until some challenging health issues, changed her path stillness in motion was born in 2017, combining manual therapy with creative embodied movement, mindfulness awareness self regulation practices, and a distinctive heart centered approach to pain care. That is what Colleen is best known for living with chronic pain herself for over a decade has given her an invaluable perspective on the day to day challenges of those who are facing pain.
In 2020, her desire to empower people with knowledge and awareness and practical tools, inspired her to create Discover to Recover: Move from pain to potential, a six week online pain care program. She loves teaching and offers many courses, workshops and teacher trainings in embodied anatomy somatic movement and compassionate, creative, pain care.
Ericka Thomas
I learned so much from my conversation with Colleen, we covered so many things throughout our discussion, too many to squeeze down into a single podcast. So, I broke it up into a four part series. The overarching theme throughout our discussion was connection, making, keeping and healing connections throughout the body and the nervous system.
In this four part series, we're going to explore those connections between chronic pain, the nervous system. Integrating movement and breath and finding new ways to befriend our body and fully experience life.
This is part one of our connection series, chronic pain and the nervous system. Please welcome my guest. Colleen Jorgensen.
Welcome back to The Work IN everyone. Colleen Welcome to the podcast.
Colleen Jorgensen
Thank you so much for having me Ericka, really happy to be here. I'm so excited to have this conversation with you.
Ericka Thomas
Before we get too deep into all of the details, all the connections that we have between the nervous system and chronic pain and the polyvagal theory and all of these things that we're going to talk about today. Can you just share a little bit about yourself about your background, kind of what brought you to this field with chronic pain and, and all of these things that you are so brilliant at teaching.
Colleen Jorgensen 5:22
Yes, I would love to, it's kind of it's kind of funny because I didn't, I didn't start my career thinking that chronic pain would be the thing that I specialized in which is often how it works right. So I started as an athletic therapist, I got my degree in exercise science with a specialty in athletic therapy and I got my rehab Pilates certification. around the same time. So the first several years of my career were really working with athletes who had acute injuries, and I love that space. I come from a dance background. So creating sports specific rehab programs was really in my wheelhouse. And then as soon as I graduated from athletic therapy. I started the five year osteopathy program. And it's just kind of happens organically that once you're in your third year of osteopathy your colleagues start to refer their chronic pain cases to you. And if I'm being honest. At that time, it scared the hell out of me. I was not in a place where I felt ready or equipped with the, with enough skills to help people who had complex issues, the way that I hoped to.
But you kept getting them so you have no choice but to learn and figure it out and then by the fifth year of osteopathy by the time you're graduating, it's just interesting to see that all of a sudden, now you're more comfortable with the chronic complicated cases than you are with the acute ankle sprain, so it kind of happened a little bit organically.
6:49
Although at the same time, I'm no stranger to chronic pain from the ages of 17 to 22 I had a chronic pain issue myself, which led to a spine surgery on my 22nd birthday and that really fixed, the chronic aspect of my issues so that I had very functional relatively pain free life for 20 years, but in 2010, I had a spinal cord compression issue that had that has led to an ongoing chronic pain issue that I'm still dealing with today and for sure being a patient, living with chronic pain and going to see all these different specialists. It gave me a whole new perspective.
And there was a moment during the process of being a patient in the system. And I had wonderful wonderful people that I was working with, doctors physiotherapists osteopaths massage therapists, you name it, I was very lucky to be surrounded by a wonderful team. And I don't know how I would have gotten through without them.
But having said that there was a moment when I realized, well I'm only with them for a little bit of time, but I'm living in this body, 24 hours a day seven days a week. They're not with me when I can't sleep all night. They're not with me when I have to choose, am I going to shower today, or am I going to be able to work today, and they're not with me when I had those years of going to the grocery store I couldn't take a grocery bag with me because I could only handle lifting one orange at a time so I had to have individual items in my basket. So it really gave me an appreciation for how important it is for us as teachers as therapists whatever your profession might be that you're helping people who are living with pain.
More important, I think, than what we do in that treatment session or what we do to them, is what we teach them that they can do themselves, because they're the ones that live in their bodies all day every day. You are your own best expert.
You know the professionals have the theoretical knowledge. But you're the one who has the lived experience of what it's like to live with your pain, 24 seven so that's really become my specialty and my mission is to teach as many people as I can, the skills to be able to help themselves.
Ericka Thomas
That is a beautiful thing, and you're so right Coleen when you're talking about people who are in that chronic pain space, this so often we go to a doctor to fix that one thing, but they are very focused on that one symptom rather than that whole person's experience. And I love that your mission part of your mission is to kind of help people become and sort of own their own body wisdom.
Colleen Jorgensen
I wanted to point out one thing, you know it's to no fault of their own that doctors as an example, focus on that one symptom that's how our medical system is set up right. That you specialize in one system of the body. Unless you are someone who specializes in chronic pain as an example.
As a doctor, let's say.
So you know sometimes we go in as a patient with these expectations. Let's say we're going to an orthopedic surgeon, and then we come away disappointed that they don't have the time or don't seem interested to listen to all the other symptoms we have, we have to understand that that's not what their specialty is so you have to either find someone who has a chronic pain specialty, and or become your own specialist, that can rely on teams who specialize in other things to help you for the individual stuff if that makes sense.
Ericka Thomas
Yes, exactly. Exactly. So what are some of the most common issues that you see that your patients are coming to you with.
Colleen Jorgensen
Yeah so it's an interesting question it's constantly evolving and had you asked me this 10 years ago, I would have said back and neck pain. post concussion syndrome digestive issues and newborn babies that's what I probably saw the most of, but I would say that every single year the people that come to see me they don't even have a specific diagnosis.
They usually have a really complex story with many different symptoms that are challenging them, and they don't have a diagnosis that they're coming with. And that used to scare me to not have that diagnosis as a guide to where I should start and what I should focus on, but I have to say that the more I understand about chronic pain,I actually love it now when they don't come in with a diagnosis because the diagnosis is another label and all labels tend to put us in a little box.
And even though I might be aware of that and consciously I don't want to have any biases against that, that label that they come to me with. We have those unconscious biases whether we want them or not. So for example, if someone comes in with a diagnosis of fibromyalgia. There's no question that unconsciously I'm going to go to all the hundreds of fibromyalgia patients I've treated over the years, and think of what worked for them and I'll probably start with those things that have worked for all those people. Whereas when someone comes to me and they don't have a diagnosis. It's like a blank canvas. And I don't have tunnel vision.
12:00
So, from my end, I prefer it now, when I get that complicated story that doesn't have a label. However, it’s really hard for the people living it to not have that diagnosis. There is something about us being human. We seem to have this idea that if there's a name for what I have, then we must have a solution for it, which is not always the case but that seems to be a belief that people have. So when they don't have that diagnosis. They crave it, they want to have a name for it because it makes it feel more concrete and it makes it feel like there must be a solution out there.
It's also very tough for people to try to explain to the family and friends in their lives. What they're dealing with when they don't have a name. You know people understand when you say you've got cancer and you're going for chemo or radiation treatments they get that they understand what you're what you're dealing with maybe not on a minute to minute day by day thing but on a global perspective they kind of get what you're going through.
When someone's living in chronic pain one of the toughest things for them is the invisibility of it, because it's really tough to explain to someone. And so most of the time you just don't even try. And then nobody understands what you're going through and you've got no one to share it with,
Ericka Thomas
I loved what you said about the invisibility of it, because there are so many systems in the body that can get fired up when the body is perceiving something is wrong somewhere. So whether that is something that has a name or not doesn't really matter. The body doesn't recognize the name of the issue at all. It just says something is not right here. And I need to do something so that this person that's living here pays attention, and changes something.
Colleen Jorgensen
Exactly. Yeah.
Ericka Thomas
Yeah. So what we're talking about there is neuroception. Well, I'll let you explain. Can you explain for people who have never maybe heard that term neuroception, and what it really means to, to just everyday people.
Colleen Jorgensen
Perfect. So I'm not going to give you a scientific definition, I'm going to explain it sort of in an easy to understand kind of way. So neuroception is our nervous system's ability to understand what is going on. So that as we're going out in the world and challenging things happen, good things happen, our physiology has a response to that. So our breath will react. Our heartbeat will react or muscles will get tighter or softer and as a reaction, all of these different things are a neuroprotective response that happens at an unconscious level.
But they're really hopeful news about it is that we can bring our conscious awareness to neuro ception, to help create more choice for us and we'll get into that a little bit more as we talk more about the polyvagal theory and all its different branches.
But essentially becoming aware of how your system is physiologically responding to the different things you face all day every day, gives you the opportunity, not to try to control it because we can't control it,but we can engage with our neuroception. Become a partner with it, if you will, so that we can, over time, create more options and more choice for our system to choose from. And we'll go more into detail with that as we go along together today, but is that a good first step?
Ericka Thomas
Yes absolutely, absolutely. It makes total sense so what we're talking about is the body, communicating, somehow, with the mind, and it does this through and neuroception is just the way it senses, the world, either the external world or its internal world, is this something that communicates through our nervous system, in some way, and how does that relate to chronic pain?. What is going on at that autonomic nervous system level?
Colleen Jorgensen
Okay, great questions so it's very connected to chronic pain. So one of the, one of the challenges when you can live with chronic pain is that your nervous system starts to see danger, where there may be is not danger, and our nervous system's number one role in life is to keep us alive. So it tries to protect us from anything it's perceived as unsafe.
16:46
And it doesn't distinguish this is slightly unsafe, and this is really really unsafe. It just looks at this is safe, or this is not safe that's it's kind of a black and white sort of thing. And it will have a reaction in response to that.
So when you've been living with chronic pain, it's like that, that protective system becomes like an overprotective parent that it becomes so hyper vigilant on the lookout for danger everywhere that it starts to see danger, even sometimes where danger is not.
And then the issue with that is that it will have it will trigger an activation of your stress response, and then the irony is in is trying to protect you, what it ends up what ends up happening is if we are in that chronic state of a stress response activation, that manifests as the very things you're trying to fix.
So it can manifest as an increase in pain as new pains, as inflammation, muscle tension, muscle guarding, anxious feelings so all the things that you're actually trying to help. The nervous system in its effort to protect you actually ramps up all of those things.
So I think of it like a house alarm. We need this protective system, it is what has kept us alive as a species so we don't want to get rid of our stress response that would be terrible. But we want it to be activated when it's appropriate. So, for house alarm as an example you want it to go off if somebody is trying to break into your house through a door or a window that's a good system. What If, on the other hand, your house alarm started going off. And keep in mind, try to try to visualize and hear right now, the piercing intense quality of your house alarm when it does go off. It's very loud, it's very invasive and it's like that on purpose so that you can't just ignore it and slough it off.
The same is true in our nervous system, it gives you some sort of signal which is often pain, because we don't like pain and we'll pay attention to it. So imagine if your house alarm went off every time a fly landed on the outside of your house. It would be going off constantly, and try to picture for a moment how irritated, annoyed, how on edge, how hypersensitive you would then become to any other sound or light coming in. How if someone comes to talk to you and they just want to have a conversation you might snap at them, because if that alarm is going off all the time. It would make you crazy.
So it's a little bit like that when you have lightning if your system has gotten hypersensitive over vigilant and over protective inside of you. It feels like you're on alert, all the time. And I haven't really seen any studies comparing this but I feel like since I've been living in chronic pain for so long now I have a much better understanding of what I imagined I could be wrong, but what I imagined it must be like for people who have autism or PTSD fully understood the sensory aspects of what they were living with. How hypersensitive it becomes to things. So we can sometimes call it a noisy brain, or sensitized nervous system, are terms that you'll commonly hear to describe this.
Ericka Thomas 20:09
Let's stay on the topic of that nervous system as kind of our, our alarm system, our internal alarm system and I love the analogy with the house security system, because I think of it like that as well. can we go a little deeper into exactly how that nervous system response is working specifically with the Vagus nerve, because I think more and more people are hearing about the Vagus nerve. But what exactly is going on there? What is that nerve, what it's supposed to do. And why is it so important?
Colleen Jorgensen
Perfect. So, let me first just describe what the vagus nerve is so you can get a little bit of picture and this is the only drawback of being on a podcast for this is I wish I could show you beautiful images of the vagus nerve because I think it's gorgeous but you can you can just Google as you're listening to us it's vagus if you want to get an image.
21:13
So we think of the vagus nerve as the wanderer because it's a long nerve that has a lot of circuitous routes, it goes to many different parts of our body. It comes from the lower brain, exits the skull, and then innervates many different things.
Now we used to have the understanding that our autonomic nervous system had two options: sympathetic fight or flight or parasympathetic rest, digest and repair. Steven Porges presented the polyvagal theory a while back, and he discovered that the Vagus which is the parasympathetic aspect actually has two distinct and separate branches.
So we're gonna talk about those, and the sympathetic so the vagus nerve has a ventral vagal branch, which we can speak of as the ventral vagal circuit, the social engagement system, or the New vagus, those are three terms that all mean the same thing.
22:15
That one goes and innervates the things above the neck, mostly. So it does have branches that go to the heart and lungs. But then it also has branches that go to the throat and the inner ear, and it's intimately connected to four other cranial nerves that are responsible for our facial expressions, whether our eyes have a sparkle in them or not. Our tone and prosody of voice. So that's why it's called our social engagement system because we communicate with each other very much through our faces, our facial expressions and the sound of each other's voices. So that's the ventral vagal or social engagement system, and that's a newer branch of the vagus nerve, if we look at evolution.
23:03
Then we have the dorsal vagal branch of the vagus nerve. So that's a completely separate branch of the vagus nerve. That one also has branches to the heart and lungs, so there is shared innervation to the heart and lungs by both branches. But then that nerve goes down in the other direction. It innervates the diaphragm. And then, almost the entire digestive system.
So that dorsal vagal branch has branches that innervate the stomach, the liver, the spleen, the kidneys gallbladder our urinary bladder, our small intestine, the pancreas and the ascending and transverse colon so almost all of the organs in the abdominal area.
So you can when you have a gut feeling often it's signals coming from your literal gut and traveling up that vagus nerve and informing the brain or the mind. So one of the really interesting things to understand about the vagus nerve is that it's like a two lane highway that communicates between the brain and all of those different parts that it has branches to. But here's the really fascinating part. Only 20% of the information along that vagus nerve is going from the brain to the body. 80% of the information is informing the brain, about what's going on in the body. So sometimes we have this misunderstanding that we can talk ourselves out of pain, but we can't.
24:37
We can use self-talk to assist in things. Yes, that's one tool that we have in our toolbox, but it's actually much more powerful to work from the body to try to change what's going on in the mind.
So what do we mean by that? You can use movement to try to influence what your thoughts are as an example, and what your emotions are as an example.
Ericka Thomas
Now, correct me if I'm wrong, I'm assuming that this dorsal vagal branch of the vagus nerve is a far more primitive part of our nervous system and the communication that's coming from the body and the gut coming up to the brain is much more... I guess the word is primitive also in its messaging. Is that why it's not possible for us to think our way out of maybe those butterflies in our stomach or that feeling that something is wrong? What is the difference in that communication? Do you know?
Colleen Jorgensen
I think that's beyond my scope to be able to answer it properly but my. I'll give you my suspicions. There's so first of all that you are correct that the dorsal vagal is the more primitive branch. So it's a more instinctual branch for one.
26:05
But I think part of it comes down to that our mind is made to generate thoughts, and we can't just replace a thought with a new thought it's not as simple as that. However, it is true that if we continuously keep introducing a different thought that maybe over time that thought will become more powerful than the original thought, because by bringing in a new thought we are creating new neuronal connections. And if those new connections outnumber the previous thought, that's when that one will start to take over.
So it's not the first time you know it's not in the moment, that if you're feeling anxious and you tell yourself just don't feel anxious you're safe, that's not quite enough. But you can combine that message with doing some things from your body like trying to soften and slow down your breath. Like noticing if you did have muscle tension that crept in, we'll take a moment and wait for that to soften before you continue doing what it is you're trying to do. Things like that where you're using the messages from the physical body to support the messaging you're trying to give from the mind. That is much more powerful and part of it I guess is because 80% of the information is afferent, meaning that it's going from the body to the mind, whereas only 20% is going in the opposite direction so it's a it's a more a more powerful way in, I guess, ideally we combine the two.
Ericka Thomas 27:34
Yes, it sounds so it sounds like, what we need to do in order to communicate on that 20% side is to back it up with some sort of physical practice that actually speaks to the body in a language that it understands. That physical communication of safety.
Colleen Jorgensen
Absolutely and and just even bringing our awareness, you know, we're so programmed and it depends on where you live in the world but many of us are programmed to ignore or run away from the messages from the body. Think of in North America, what we teach our kids. We teach them. So first of all, Think for a moment of a newborn or a toddler before they start going to school, just kind of picture them in your mind right now, how much they move. And they don't move linear, they don't move necessarily to do a task. They're moving for the pure enjoyment of exploring movement. And we still have that instinct in us, but we think it's not socially acceptable to all of a sudden stretch our arm and leg up by our head if we're in the middle of a restaurant. So we don't listen to the messages of the body because as we were growing up, we were taught that you have to be still when you're at the dinner table or when you're at church or when you're in school or when there's company. All of these things so we really trained these natural instincts out of our bodies we taught our system our nervous system, that when you're getting certain messages, you're going to cognitively stuff it down.
29:06
And so it's not it's not really surprising that now that we're adults and you have something like a chronic pain issue for example. Now all of a sudden it takes work to learn how to actually listen to those messages again. And I can't help but wonder, and I hope it gets there one day I think it's moving in that direction. If we had mindfulness and awareness practices in our schools, which is starting in some places from a very young age. If we all grew up learning those tools. how many issues would we be able to prevent down the road, right. I think it would be quite staggering. Rather than the situation we're in now, where we have to undo all of these bad habits we maybe have created before we're even able to learn the appropriate responses.
Ericka Thomas
You're exactly right, we have basically socialized ourselves out of every natural response that our human animal has to resilience, basically to find some comfortable balance of resilience. So, yes, you're exactly right and, fingers crossed, we can get some more of that into our schools.
Colleen Jorgensen
I think we're getting there. I think it's heading in the right direction. Yes, yes, exactly what you just said, with just your reference to animals, it just made me think of pandiculation. So if you're listening and you've never heard of pandiculation, you can try it right now. It's that whole body yawn where you're contracting some muscles while you're stretching others. And if you've got a dog or a cat that lives with you. Just watch them, they never get up from lying down without pandiculating before they then go about whatever they're going to do next.
30:57
Again, just think of even that small change if we as humans, every time we got up from sitting and every time we got out from lying down. If we took those few moments to pandiculate the body in whatever way it organically feels like it needs. What a gift.
You know, it's, we think sometimes that it's so complicated but there are a lot of really simple solutions that we can add into our day that don't even extend our day, you know. We can add them into our existing life without having to find an extra three hours to do some of these self care practices which is kind of encouraging.
Ericka Thomas
Yes, absolutely. So yes pandiculation is a beautiful thing and it's interesting because, in my practice with trauma release exercise there's something that happens after certain amount of time of practice, where the tremor mechanism actually moves into the fascia, and it, it moves into pandiculation. That's basically what is happening in the body, the body's fascia will move in that way it feels exactly what like what you said like a yawn. It's a full body yawn and travels along the fascia chain. In all different areas of the body, it might be across your back, it might be through the arms, it might be one of the cross lines, the diagonal lines of fascia. So it feels like this beautiful twist. And afterwards, it's not even i mean it's a level of openness that's left in the body that you just cannot get by simply stretching, because it comes from the inside of the body out. And the same thing with pandiculation, while you can start that movement when it comes from the inside of the body out It almost feels better. Just like when we actually get to yawn. Right?
Colleen Jorgensen 32:59
You're so right. And I think part of that is because the fascia has that intuition. To do that, and regulation where it needs it. If we're cognitively trying to figure it out we don't always get it right because we have become disconnected from our signals a little bit right. But if we just trust in the body, the fascia is what holds a lot of those past traumas and those past emotions, so it knows what it needs and sometimes we just need to get out of the way and let it happen. So yes, I've witnessed that same thing and it's, it's like you say it's, it's a relief like no other right. It's like you said there is no stretch that's going to give you that same whole body, whole spirit, kind of a release it's fabulous.
Ericka Thomas 33:42
Such great information. Isn't she amazing. Thanks for joining me on The Work IN. Don't worry, we're not done with this discussion yet. We're going to continue next time with part two of our connection series entitled states of being human, and you won't want to miss it. If you like what you heard today and you want to learn more from Colleen, please be sure to check the show notes for all of the links, but if you can't wait, head over to Colleenjorgenson.org and sign up for her free pain care ebook. And of course, you can follow her on Facebook, Instagram and YouTube where you'll find all kinds of free resources.
Ericka Thomas 34:31
And as an extra bonus throughout the month of March. Each Wednesday, you'll find Colleen Jorgensen, and a few of her colleagues on Clubhouse sharing mindful wellness practices. Once again, thanks for joining me and I will see you next time on The Work IN.
Transcribed by https://otter.ai
Colleen’s free pain care ebook:
FREE pain care tools | Mysite (colleenjorgensen.org)
Info on Discover to Recover 6 week online pain care program:
FREE pain care tools | Mysite (colleenjorgensen.org)
April 28th, 7pm EST I'm giving a free webinar on Embodia Academy:
Discover to Recover - Creative Pain Care for Health Care Practitioners
https://www.facebook.com/stillnessinmotionwithcolleen/
I’m Ericka
Whether your fight is on the frontline or the home front, past or present, personal or professional... chronic stress & stress injury can be a debilitating enemy.
You’re not alone.
Join me as we explore natural balanced ways to work through the body to re-establish safety in the body and find recovery for lasting resilience to all sources of stress, tension & anxiety.
I offer online, on demand private sessions, courses & memberships for individuals, small groups and corporate clients looking to build resilience and recover from stress injury.