Interpreting chronic pain science with Colleen Jorgensen
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“So we want to approach things from both bottom up and a top down approach. So top down is more you're using your thoughts and emotions to influence what's happening in the body. Bottom up is we're using the body to influence what's happening in the thoughts and emotions. Really, what we're seeing is that combining the two is what has the most effect”
Colleen Jorgensen
Transcript
Ericka Thomas 0:03
Welcome back to the work in everyone. There are so many frustrating things about health and wellness information. As fitness professionals and coaches we watch for the latest information in science and do our best to curate and explain it to our clients and students. As consumers of that information, it can be so confusing to try to understand what the latest science actually means for our day to day lives, and for a topic as complex as chronic pain, that becomes even more challenging. On the one hand, it's great to get new science, new understanding about the body and the nervous system so we can make the best choices in our care. On the other hand, what does that mean for everything that we knew before? does it all go out the window? How do we how do we integrate that new understanding of pain care science in meaningful ways, and share it when it comes to posture, alignment and movement therapy? My friend Colleen Jorgensen reached out to me a few weeks ago with this question as a topic for the podcast. And I thought it was a really great idea. I love bringing clarity to topics like this and I always learned so much from Colleen. She's been on the podcast before. We've talked about chronic pain, the nervous system pain care where language and the importance of professional communication skills. She's an osteopath, the yoga Pilates instructor and a teacher trainer was specialties in pain care where language among many other skills and she is the one I trust to help translate some of this new information. I am thrilled to have Colleen back on the podcast to talk more about this topic. And I think in the course of the conversation, we can find new ways to evaluate other areas of health and wellness science as well. So let's start our work. In with Colleen Jorgensen. Welcome back Colleen.
Colleen Jorgensen 2:07
Thanks so much for having me again, Ericka. I love being here. I love our chats.
Ericka Thomas 2:10
Yes, yes, they're always good. So let's start with what was the trigger for you to kind of bring this topic back into the light when it comes to alignment and posture and movement therapy with this new understanding of pain care science, compared with the old way, what was it that had you reaching out to me
Colleen Jorgensen 2:41
what you said what triggered me to it was exactly that. It's become a trigger. That social media posts. I just saw yet another social media post from somebody very respected in the field and I love their work, but sort of saying sort of interpreting the science in a way that would suggest that now that we have this new understanding of pain science, posture doesn't really matter. Alignment doesn't really matter, and what exercises we choose for people doesn't really matter. And that's not quite the correct way of interpreting the science. So I wanted to have a discussion about it so that we could not throw everything we know out the window just because we've got some wonderful new information.
Ericka Thomas 3:24
Yeah, I mean, that social media is just rife with basically clickbait you know, sometimes that's that's kind of what they almost teach, right? You want to say something that's going to hook someone a little bit triggering. And what that means for everybody else out there who's just trying to get the latest information is that you have to really be very savvy when it comes to filtering that information. Because those headlines, those headlines are not always really what they're going to be talking about. It's so easy to misinterpret. Even if you're very skilled at reading those scientific rigorous studies, right. So let's begin here kind of what we mean when we say this old way of understanding pain in the body, like how was it that we were originally understanding what was going on there? And especially when it came to like, for professional fitness professionals and movement professionals in helping students and clients? Yeah, so
Colleen Jorgensen 4:40
I'll say it in a very simple way that we fought for a very long time, like hundreds of years. We thought that we had pain fibers throughout the body, so that when we got injured, let's say you sprained an ankle, it would wake up these pain fibers. And those pain fibers would go to the spinal cord into the brain telling us that we have pain. And so the way that we address that issue, the issue of pain is we would work on the body because we thought or we interpreted this information as that. It's the body that's telling the brain that we are in pain, so we need to treat the body to fix the pain and we would do that through exercise postural corrections, alignment cues, and hands on work. We now know fast forward I keep my timelines are terrible, I'm very terrible with with time so I keep saying 10 years but probably more like 2025 years now that we have a new understanding of pain. There's been a lot of research on it. So much has come to light and it's continuing to evolve. So if you're interested in this space, keep your eyes open for new information because it is constantly changing as we learn more. So I will share what we know right now, as I understand it, so we actually do not have any pain fibers anywhere in the body. So just that alone pause for a moment and think about that we do not have pain fibers anywhere in the body. What we do have our nerves, neurons called nociceptors. And you don't need to remember that name but we can think of noci scepters as alarm bells or danger detectors. So if we take that same example of you have some kind of injury like an ankle sprain, for example, it will wake up those alarm bells. That is not enough on its own for us to feel any pain. Those signals get sent to the spinal cord. Still not enough for us to feel any pain. Then the signals get sent up to the brain. Still not enough for us to feel any pain. But here's where the really interesting part happened. Now the brain has to go through everything you've ever lived in your entire life, not just physically but every emotion you've ever had. Every love every heartache every success, every failure, every injury, every thought everything over the m&e, it combines that with the information that's coming up from your physical body in the moment and where you are and who you're with in that moment. And it also tries to predict what you have coming up in the future. Based on all of that information, the brain has to make a determination. is Erika safe in this moment, or is she in danger? It's kind of black and white. So if your system decides, Okay based on everything I know based on her past based on what I think is happening in your future, I think Eric is safe. In that case, it will send messages down the spinal cord that block the signals that were coming out from your body. And in that instance, you either feel no pain or very little pain. On the other hand, if your system based on your past, your present and what it predicts as your future, it decides Oh, I think Erica is in danger here. She's being threatened, then it's gonna send different messages down the spinal cord that will amplify the messages that were coming from your body and that is when we feel pain. So one of the important things to understand here is that pain is not something that comes into us it's not an input into our body. It is an output created by our nervous and by our brain. Yes the body is an influence the body is a strong influence. But it is not the only influence. So what that means for us as people who teach movement, the body doesn't. It's not that the body doesn't matter anymore. But the important message is that the body is not the only thing that matters. We used to have this more dualistic idea that body and mind are separate. Finally, the science is catching up with Eastern medicine and understanding that you we cannot separate the body and mind. Anytime we Sorry, I'll just say this one last thing. Anytime we have a physical sensation, whether it's pain or any other type of physical sensation, there is an emotion attached to it always we cannot have a sensation of pain without also having any emotion attached to it. So we need to address that full picture.
Ericka Thomas 9:10
Yeah, yeah. So let me let me pull back so yes, it because you mentioned you know how we often addressed this pain in the body with posture and alignment and movement. This is why you can have perfect posture and perfect alignment quote unquote right, quote unquote perfect look fine. Do it right and still experience pain.
Colleen Jorgensen 9:41
That's a great example. Yes. So why is that that makes us scratch our head. What else is an influence here and there are so many other things. And that's
Ericka Thomas 9:50
really important for people to hear out there. I think because I think especially if you're someone who is in chronic pain, it can be really demoralizing over time. If you feel that you are doing all of these things right? Correct. And still there isn't any, you know, maybe improvement in that situation. At least not right away.
Colleen Jorgensen 10:19
It's such a great point. Yes, and change takes time when it comes to the body when it comes to pain change. So first of all, pain is changeable. Always doesn't matter how long you've had pain doesn't matter. What kind of pain doesn't matter what diagnosis you do or don't have. Pain is always changeable. Does that mean we can always get rid of pain? 100% Sadly, no. That's not always the case. But it is it always has the potential to get better. How much better is individual?
Ericka Thomas 10:45
Yeah, and so when we say changeable? It isn't necessarily the goal isn't necessarily to be pain free necessarily. It's just to change that state in some way.
Colleen Jorgensen 11:00
I mean, look for someone who lives in chronic pain, of course their goal is that they want to be pain free. But I would suggest to take that pressure off yourself because in that in that strong desire to be pain free. We're really grasping we're really hooking on to an outcome that may or may not happen it may. But when we're only focused on the outcome like that we tend to trigger our stress response and when we're in our stress response, that's not the place we heal from. So instead and this this could be a whole different podcast to talk for the two of us Erica, having some degree of acceptance of where you are in each moment. And working with the body you have the thoughts and emotions you have the pain you have in that moment. And trying to change things for today or not even for today for this moment, and taking it one moment at a time rather than and then when you have a change, celebrate it, celebrate it no matter how small or how big that change is. Celebrate every little win no matter how big or small, every single moment it happens. And then it's by adding up those little moments of change that you start to see a much bigger result. But if you're always only focused on Well, I didn't get rid of my pain. So nothing has happened. Nothing has happened. Nothing is working. Well if we pull back sometimes and look at more than just the pain, which we can talk about to then you might start to see oh yeah, things are shifting. My pain maybe hasn't changed yet, but there are a lot of other interesting things that are starting to shift.
Ericka Thomas 12:38
Yes. So there's it sounds like there's a long list of things that can affect those changes. Can you kind of go through again, I know you mentioned a few of them some some different pieces to the puzzle that that can really influence that that pain response for people.
Colleen Jorgensen 13:01
Absolutely. So I will first start by making a really broad statement that will make a lot of people frustrated. And I'll say that everything you think everything you are and everything that you do, everyone around you will influence your pain. But let's break that down to some more specific things that you can that you can manage. So, I'll give you the list of the things that we've seen that we see that seem to help the most if you combine these. So awareness, being able to turn inwards and notice what's happening in your own body and in your thoughts. Mindfulness, so that instead of thinking of what you have to do next, whatever you're doing, you're focused on that for the time that you're doing it. Breath. Our breath is a huge indicator of what our nervous system is doing. You can think of it like like holding up a mirror to what nervous system state you're in. So the breath can be used both as an invaluable all of these can be used as both as an evaluation tool and as a treatment. muscle tension, muscle weakness muscle guarding anxiety, feelings of depression. What whether you're having thoughts that are feel fearful, angry and frustrated compared to whether you're having thoughts that are hopeful, self compassionate, and full of gratitude, all of these things make a huge difference. As well as your work. Are you going to a job that you despise where you're not respected and you don't like your coworkers or are you looking forward to going to work every day and your work is respected and you can't wait to get there? Are you in a happy healthy relationship or does the relationship you're in like hurt you to your very soul like all of these things will play a part on whether or not when your brain is doing that evaluation of is Erica safe or in danger? All of those things and many more will play a part in that decision. So everything that you can do to establish a sense of safety, comfort, connection with others connection with yourself connection with the environment. Those are all ways to make your system feel safe. So when a signal is coming up from the body that's threatening, your brain is less likely to amplify the threat and is more likely to actually turn down the volume on the threat and maybe stop it altogether.
Ericka Thomas 15:27
That makes sense that that makes sense to me. And I can see examples of when that has happened in my own life. I'm sure listeners will be able to see some of things that have happened to them. Maybe there's that that one point about how pain sensations are connected to our emotions. That is just fascinating to me. Because sometimes I think emotions I mean for a long time I thought emotions were like not controllable. Like there's nothing I can do about the emotions that I feel but that's also not exactly true. Right. So So where is it? Where is that connection? Where's that emotional connection? To the great question this musical sensation of pain? Yeah, so
Colleen Jorgensen 16:30
when we have those alarm bells or dangerous signals that are coming up from our physical body, it goes to many parts of the brain, but I'm going to I'm going to oversimplify imagine that one part of that signal gets flipped and goes to the part of the brain that's in charge of what we feel physically sensation. And then another part of that signal goes to the part of the brain that's in charge of what we feel on an emotional level. So every time you have that threat signal coming up from your physical body, imagine it splitting like a fork like a fork in the road and it goes to two different destinations. One is what you're going to feel physically in your body in the form of sensation. And the second one is what you're going to feel in terms of your emotional feelings. So that's huge. It doesn't happen on one or the other. They always happen together. So there's always going to be an emotion tied to a physical sensation.
Ericka Thomas 17:30
And that's, that's important for the brain because it's it's trying to create meaning for future moments to keep you safe. Exactly. Yeah. Yeah. So so the higher the intensity of both of those of the emotion and that sensation, that physical sensation, Will is will tell the brain how long it has to hold on to this in memory in memory. That's that's where those things get wrapped up in the memory and so in the future, whenever you feel either the emotion or something, some physical sensation that reminds the brain of that moment in the past that's when it hits again. As if it's happening in the moment. That's that's the way I understood that. Yes, I
Colleen Jorgensen 18:23
just I just want to clarify one part and and easily even as I'm addressing it, I'm not 100% sure that I'm right. But when you said the intensity of the pain and the intensity of motion will dictate how long it holds on to that memory. Not quite right. It's more about the value, that emotional side that your brain so it can actually be a very low intensity pain, but for some reason it was really important to you in that moment. Maybe it kept you from walking your daughter down the aisle on her wedding day. So it might not have been a really big pain, but it had a really big value. So your your system will be more likely. So if you have that same moderate, maybe even mild amount of pain, but it was associated with something that was really important. To you emotionally, that will be more likely to be determined as a threat again, compared to something that was just a high intensity pain but didn't have as much emotional value attached to them. Yes, totally.
Ericka Thomas 19:22
Yes. That's thank you for that clarification. And, and you're exactly right. So what we're talking about here a little bit is your perception of the importance of what is happening in that moment. Yes,
Colleen Jorgensen 19:34
and not your conscious perception, right, but your brains and this is where it gets really tricky, because you might not think it was very important. at a conscious level. Yes, your system decided it was very important. It will do all kinds of things in the background for you to protect you, even if you consciously don't feel that you need protecting. And that's where it gets really tricky. Yes.
Ericka Thomas 19:58
Yes and frustrating, right and frustrating. You have these higher order thought patterns that are like I'm totally
Colleen Jorgensen 20:08
and your system is gone. I don't think so.
Ericka Thomas 20:11
We do not agree with you.
Colleen Jorgensen 20:14
But another important thing to understand is that our system doesn't always get it right. So that's when we need to intervene. And I'm just going to backtrack to something you said because it was important I don't remember exactly what you said. But something about that connection between the emotion and the and the physical. We don't always recognize that there is a connection. And just like if you have an addiction, you can't get well until you recognize that you have the addiction. The same thing here. You don't recognize what the emotion is that is connected to the physical, then it's very difficult to address it. So for some people, that is a great first step, just start to turn inward. And just try to notice try to explore a little bit. Okay, well, when I had that injury, what else was going on in my life around that time? Was I in the middle of a messy divorce? Had I just lost my job like before that and see? Okay, well, what if I address some of the some of the things on the emotional side? How does that affect the physical part and play with that a little bit, but we can't fix what we don't know. We can't address what we don't know.
Ericka Thomas 21:15
Sure. Sure. Yeah. And so what would you say to someone who's kind of in that moment, having this light bulb, come on, and thinking, oh, gosh, maybe there is something else here beyond just my physical body that I need to address. Are we talking about Okay, some structured therapy, or is this something that, you know, people probably work through on their own what, what does that exactly mean for moving forward? An
Colleen Jorgensen 21:50
important question, and I think it's highly visual. I think for some having that outside support is excellent. And whether that's in the form of a therapist or a somatic worker, or who knows there are a lot of people out there who can help with that. Having said that, for a lot of people, depending where you live, there might be a long waiting list to get into somebody like that. There's a lot that you can do to start and sometimes it's just being still for long enough to just pay attention. And maybe you just pose the question to your physical body, you know, like literally say, I'll give the example of my own self for a second year to give you an example. So I had a very difficult spinal cord compression injury. I was non functional for several years. When I started to get a little more functional, I was doing everything that I know how to do and I'm an osteopath and athletic therapist. I teach yoga and pilates. I had so many tools at my fingertips, surrounded by great professionals. I was getting treatment, I was doing all the right things on paper for myself, and I kept getting worse. And there was a day where I just dropped to the floor and I asked my body out loud, was the first time I'd ever asked my buddy a question out loud. And I said, What do you need from me? I'm doing everything I can think of. I don't know what else I can do. And the message the response from my body was so clear. My body just told me Stop, stop doing you need to rest, whereas I was doing the exact opposite. I kept giving my body what I thought it needed, instead of giving it what it was asking of me. And I think that's something that I see probably the most, when I see people in the clinic is we're always trying to address the body that we used to have before we had this pain and we're trying to be that same person. We're trying to live the same way. And we're trying to do what we think we should do, as opposed to pausing long enough to turn inward and ask your body is you so we think of it as this physical thing that doesn't have a mind but your mind and body are 100% connected. And often, the beauty of asking the body is that the body doesn't bother itself with emotion and shame and all those other things that when we're looking at it only from our mind perspective, we we kind of get trapped in the I should I could I shouldn't or this person exactly do this. The body just tells you the truth. It just says it like it is it just tells you what is happening and that it and sometimes we just need to learn how to listen.
Ericka Thomas 24:31
Right? Right and then but then you know sometimes those those messages and we've talked about this before, like the the way the body talks to you is often ignored for long periods of time, right until it's too late. And then it's screaming and then you're like oh my gosh, which specialists do I take you to? So, you know, it's it can be difficult if the message you're getting from the body is rest but you know, rest is sometimes it looks different. You know, does rest mean stop completely? There is is that? You know, always the answer. Probably not. I I'm wondering if there's like some way to kind of discern there exactly what that might look like, in the moment for people.
Colleen Jorgensen 25:32
Yeah, you're absolutely right. A full on rest is not what everybody needs. Absolutely not. It's kind of like you said if you've sort of not paid attention to or not understood the whispers and now it's the screams when you get to that point. often one of the only solutions is resting for a very long period of time and how long is different everybody? I'm talking more about these very short tunings, where you just like life is so busy and input is constant, you know, often people are looking at their phone as they're got the TV on as they're cooking dinner and as their children are asking them question like that's a lot of input coming in that the brain is having to process all at the same time. So what I'm talking about is taking very short pauses and how long is different for everyone, but it could be seconds, maybe it's two minutes. Just pay attention to not to tune everything else out and tune in to what's coming from inside your body. Now, for someone who's living with a lot of pain that can be very challenging to do same. If it's somebody who's lived with trauma, it can be very difficult to turn inward. And if that's the case, you definitely work with somebody and you start literally maybe with a second at a time and you build on that skill to be able to do it for two seconds and then three and then four and you slowly but surely reassure the system that I'm okay if I if I look inward for just a couple of seconds, and you build on that.
Ericka Thomas 27:03
And and so in terms of making these shifts and changes, being able to integrate this idea of awareness and mindfulness and breath and all of these other these newer things that can influence pain in the body, integrating those with our posture and alignment and movement therapy. Are we still doing those things that we know, like physically that the body needs? As far as let's say if we're, we're moving in a particular way and trying to move in a particular way where we can activate the correct muscles in you know, when they're supposed to be activated. And at the same time pulling in these other, these other influences with that inner awareness and mindfulness and breath and all of those things.
Colleen Jorgensen 28:05
Yeah, so let's talk about that. That's why we're here today. So we want to approach things from both bottom up and a top down approach. So top down is more you're using your thoughts and emotions to influence what's happening in the body. Bottom up is we're using the body to influence what's happening in the thoughts and emotions. Really, what we're seeing is that combining the two is what has the most effect which makes sense because it is all you it's all one person, it's all one body, we cannot really separate the top from the bottom. So let's try to get them working together from every way possible. So a few different ways that we can do that. So first of all, just understanding as teachers, that information is coming in both directions, that we're getting information from the brain and it's sending the information down the spinal cord to the physical body. And the opposite is true that's happening all the time. So we need to understand that as teachers. So the cues that we give a very simple example is I remember distinctly I don't know how many years ago, probably about 20 years ago, a teacher that I had, in a teacher training highlighted how different it was to remove any negative words from your teaching. So taking the word no and don't or can't, you know those sorts of things out of your teaching and such a small thing, but what a huge impact that when you only give cues that have the positive phrasing in it. All that is experienced as the person on the receiving end of those words is huge, because as soon as they say things like Oh no, don't do that or you shouldn't be doing this or don't ever blah, blah, blah, those words signal threat to that person system, and then their body will go into their stress response, which creates more muscle tension and if they're experiencing any pain is going to likely send more pain because of that
Transcribed by https://otter.ai
Colleen Jorgensen 30:00
is going to increase those protective responses. So something as simple as our language as teachers can be one of the things that can can play with that threat levels, threat, threat or safety. Then if we look at posture and alignment, pardon me. So sometimes we're always thinking of it as the execution of the of the pose or the or the movement. But let's look a little deeper than that and look at the anatomy a little bit. So I have a favorite quote from the founder of osteopathy, Dr. Andrew Taylor, still and he said that show me the moment that circulations compromised. And I will show you the moment that disease began. Essentially what he's saying is, circulation is essential. Circulation is what delivers oxygenated blood to the whole body to all of our different systems. As soon as that is compromised in some way. We don't function as well. It's as simple as that. It's just like a garden hose that you're watering your garden. With the hose at full full force, you get this nice flow, but if you put a kink in the garden hose, you may still get some flow but it's a lot less. So it might take you quite a bit longer to achieve the same result. Well, it's very similar in our body. So if you take for example, someone with a forward head posture, which is becoming more and more common because of how much we're looking at phones and computers and whatnot. Well, if you open your anatomy book look at the structures that that rest between the ear and the shoulder. In the area of the neck, we have three of our most important structures in the whole body. The vagus nerve, that jugular vein and the carotid artery. So as soon as we put that little bit of a kink in there, we're still functioning, we're still going to be humans that can do all the things that we need to do. But I would suspect that a system that is so built on wanting to protect its person that when we put a little bit of compression or kink in those important vessels, I would assume that is going to take that as a threat. So now just that posture that you might be in 24/7 is that constant message that's just kind of aggravating the system with that little influx of threat all the time, on its own. Not enough for anything to happen for most people. But then you add another thing and then maybe another thing and then maybe another thing, and now the brain says, Okay, now I feel Erica's under threat and I need to intervene and then changes the message is coming down the spinal cord, and all of a sudden you're feeling pain. Does that make sense? That was a lot but something sense.
Ericka Thomas 32:42
Yeah, it's just this layer. It's it's layers of information. And you it's like the straw that breaks the camel's back. Right, exactly. So you can handle this layer and you can handle this layer and maybe this layer is something not not so good and safely. One more thing and those things don't aren't and always some of them start in the body, which I love this, this part of the conversation because some of that stress level starts inside the inside the body. And so you're not necessarily conscious of those kinds of pressures on your system. And so when something happens outside of the body to come in, now, all of a sudden, it's like, how come I'm just losing my mind right now. Yes, it doesn't seem like this tiny little thing should do that. But exactly. The body is already handling so many other things that just can't take one more.
Colleen Jorgensen 33:45
That's exactly it. And then And then who are those stories come in? So I have an example of being in a movie theater and there was a group of elderly women behind me. And one of them was sharing the story of I'm going to use her words she threw her back out and we can't throw her back out. That's why I'm putting in air quotes. That's one of those things where language makes it sound like a really horrible thing. So she was explaining that she threw her back out when she lifted her cat. And I heard her say to her friends that she was never going to lift her cat again, and I got so sad for her. But I see this all the time because in her mind, she associated her back pain with that one action. But let's think about how many times she lifted her cat in her life. She's probably had many cats. In her whole life. She's probably lifted a cat hundreds, if not 1000s of times without any issue. But our brain attaches the story to the thing that had important and so now here's this woman who probably loves cats, thinking she can never lift her her cat again. And that's what happens. Our brain associates these sensations that feel awful with something else and then we change our lives around that. And that's where we can intervene a lot as movement teachers because if I had that person in front of me, I would want to do movements with her that mimic what is involved in picking up her cat. And every time she has a success in those movements. That's signaling to the system. Oh, we're actually safe when we do that. And if you do it enough times, it's when it's almost like a think of it a bit like a teeter totter. It's not quite like that. But that's what I think that to have an analogy that if you have more of those threat signals associated with picking up the cat, then you're likely to get that pain again. But if we can, through experience and through education and understanding how it all works with both the bottom up in the top down, if we can create more and more experiences of safety well once the scales tip, and you've got more or more important messages of safety that outweigh the messages of danger. Well now the next time she goes to pick up the cat, the brain is going to block those signals that are coming from her body and she won't experience pain. So this is huge for us as movement teachers every time we're able to get our clients to experience movement in a way that feels good. That is a signal of safety. That turns down the threat that turns down the protection which turns down pain.
Ericka Thomas 36:11
Yeah, yeah. So the idea is to replace those experiences with with with safety, basically, replace that
Colleen Jorgensen 36:23
and I'll even go a step further. If we can replace it with a feeling of safety and even joy. Like not only does this feel okay, but wow, it feels good. And like I feel you know, I feel strong when I do this or I feel empowered when I do this or it makes me smile when I do this, you know if we can add those little nuanced parts of it or if we can be playful when we do it, or if we can make the movement really novel and not do it exactly the same way every single time as a teacher in a class but keep changing things that so that it's novel for the system. Now you've got not just one way of reassuring the system but you've got many ways of reassuring the system and
Ericka Thomas 37:02
and you're bringing in that emotional connection there with those those other pieces.
Colleen Jorgensen 37:08
There's other associations, curiosity, play joy, I'm 100%. Yes.
Ericka Thomas 37:15
Yeah. So we, we had a question come in, and it's got kind of an interesting angle on it because it's related to being able to trust your body and, and those messages that are coming out. And so you know, everybody's in a different place. Everything you know, we're all coming from different places. But this question is question of how do you trust those signals in the body? It is, it is big, because it isn't take anything to break that trust. Yes. And, and so, you know, like that lady, that the example you just gave it, the lady with our cat, just one thing and now all of a sense, she doesn't trust herself do like her, her cat, right? And so, and there's many folks that are dealing with things that are far more chronic than just a single event. But how do we how do we find that? That trust we've talked about trying to replace these things, but you know, it's a little bit goes a little bit deeper there then just, you know, a few successful times going through these movements.
Colleen Jorgensen 38:37
Do you mind if I actually read her question because I don't really like how she put it? Yes, it shows that I have a chronic pain condition. So I can always trust the pain signals my body sends. How do I know the difference between what pain should I be concerned about versus what versus something I can ignore? So it's such an important question. It's so it's so complex. It's not it's not black and white so you're not the only one everyone who's in this situation is thinking that same thing and this is where it gets tricky because once you've been in pain for a while, a while usually being more than three to six months. No, I'm gonna change that. That's that's the definition of chronic pain. But even if you've been in pain for our system is plastic. So we adapt really well, which is both good news and bad news. So the longer you've been in pain, the better your system gets at producing pain. And the longer you've been in pain, the more protective your system gets. And if you remember what we first talked about, it is about that protective response. That's what makes it decide to produce pain or not so and more protective system is more likely to produce more pain. A system that's less protective protective is more likely to stop the pain. Okay, so that's, that's at the bottom of all of this. But exactly as this person is saying, How do I trust it? Well, the truth is, you can't trust it at first. So this is where it becomes really, really tricky. But one thing that you can hopefully use to help you get to know your system so that you can start trusting those signals is that pain and damage are not the same thing. So we can feel a tremendous amount of pain and that does not equate with how much damage there is. Even many times there can be a horrible amount of pain and there's no damage whatsoever. And the opposite is true, we can have a lot of damage in our tissues and have no pain. So the the main point here is that there is not a direct correlation between pain and damage. So that's one thing to help you get to know your body again, that it's okay if you get pain when you do something because it's not the same thing as damage. So that's one thing. Second thing that's really important and helpful to understand when you're trying to relearn how to understand how to how to trust your signals, is something we call the Protect by pain response. So we have this wonderful response built in is the thing that helps you if you put your hand on a hot stove, and you pull your hand away. It's not you consciously doing that your brain told you to do that because it doesn't want you to get hurt. So let's take one more example of that. If you think of a wrestler, who's getting their arm pulled back into a certain position, at first they feel nothing then maybe it's going to pull and at a certain point they're going to tap out when they tap out is because they're protected by pain response kicked in, and kind of told them figuratively if you go further, you're going to damage your tissue. So we have this system built in that you know it's going to warn us and so we stop and then no damage. Great to keep going on. Everything's fine. When you've been in pain for a while or you have a fresh injury this system changes and that protect by pain response becomes much more protective. So if before the person was able to get their arm pulled back quite a bit before they had to tap out. Imagine now like 60 degrees sooner. You're barely getting your arm moved, and you get that protect by pain response. The good news here is that you actually are so far away from damaging your tissues that you have tons of movement you can still play with and you're at no risk of re injuring yourself. So it gives us a little bit of confidence, a little bit of freedom to be able to play and know that okay, I'm dealing with a highly sensitive system. So yes, at first I'm going to try to do something my body's going to be give me a signal like more pain as though to say don't do that. But it is telling you that but think of it as a helicopter parent who is so highly over protective that they're afraid to let you live. They don't want you to move because they're so afraid you're going to do damage. So you acknowledge that and you go you know, it's like you're having a conversation with your own body and say, Okay, I get that we're a little hesitant, but I'm gonna give it a try anyways and see how it goes. And it may not be the first time that you try it, but it's, it's by going to that edge of that sensation that doesn't feel good. Reassuring yourself through thoughts and emotions, reassuring yourself through calm breath, reassuring yourself through softening through the muscles, and then you back out and you try again and you back out and you try again in this by repeatedly doing this that you start to shift when that protect by pain response will start to kick in. So that over time, you will only get that protect by pain response when you're actually about to do damage but if you're living in chronic pain, and you go to do something and you get more pain, it's not because you've done damage. It's just your system saying, Okay, well we're well let's think about this for a second. Is it okay that we're doing this? And then you say yeah, it's okay, let's give it a try. So it's a lot of trial and error. It's a lot of trying to override the fear with curiosity. It's a lot of reassuring your system by softening the breath, softening the body tension and changing the story that's coming in. So if there's that story of fear you want to replace it with a story of strength or self compassion or curiosity, and you kind of keep going with that. No, that
Ericka Thomas 44:32
was a lot. Yes, no. So that was all very good. So that that assumes that the there is a pain response that is stopping range of motion. But what about this, your pain response is confused the other way where it's a little slow to respond, or something like that, and I don't know if you have any experience with anything.
Colleen Jorgensen 45:02
So you're talking like you, you do you feel fine when you're in the class and then your pain blows up after? Yeah. Oh, yeah. Great example. That happens to a lot of people. Yes. So again, it's about it's a little trickier in those situations. So I'll say a couple of things about that. One is to not only use your pain as your barometer as your measuring stick, so typically, there will be other things that shifts either with the pain or outside of the pain, not one of the ones is breaths, that if your system so again, we're if it always comes down to does your system perceive this as threatening or not. But that's always what it's about, because if it feels threatening, it will increase protection which increases pay, if it thinks is not threatening, it will decrease protection, decreased pain. So that's at the heart of all of these concepts. Okay. So I lost my train of thought Eric out, what was I just saying before? Oh, sorry. Okay. Yeah. So. So let's forget about pain for just a moment. You're going to keep some attention on the pain but you're going to split your attention to look at some other things. So one of those things is your breath as soon as your breath becomes shallow, quick, kind of jagged and uneven or if you hold your breath, all of those will signal threat system will become more projective pain will ramp up. So as you're doing whatever you're doing it could be movement or something else. Pay attention to your breath. And if you notice that any of those things have happened, it's worth pausing and softening the breaths slowing it down a little bit. Either as you do that thing, or you stop, get the breath back under control and go back to the thing it depends how easily you're able to multitask. And usually if you're starting, I would say pause, reset the breath, come back to your thing. And if you if you start doing that thing again and the breath gets shallow again, you pause again. And you keep doing that until you're able to do the thing and keep your breath soft. And slow and smooth. Okay, thank you. Second thing that we want to split our attention on is the body tension. So we've all had these experiences that when something's happening, that that we're afraid of or nervous about our body will react. For many it can be things like clenching the jaw, frowning, getting a lump in your throat, curling the hands into fists or spreading the fingers out really long and wide. Same thing at the toes either curling them or reaching them out, squeezing the anal sphincter, wheezing, the glutes, clenching in the gut. So you can do a brief little body scan. So as you're doing the thing that you're trying to do, whether it's a movement or something else, and pay attention, how is my How are my muscles reacting? And if you see that there are areas that are tensing up that are not helping you to do that. thing. Then again, you can pause, take a moment to let those areas let go get them to soften whatever that means for you. And then you come back to the space and then it's a little bit of this and there's one more piece the third piece is your thoughts and emotions. Sorry, let me go back one second. So anytime we've got that extra tension in the muscles, that's another thing that signals threat. So more protection, more pain. But if we can soften those areas, that's like reassuring your system off, we're actually safe. Okay, great threat is decreased. I'm going to turn down the protection that's going to turn down the pain
Ericka Thomas 48:33
and you're talking about muscle tension. That is a way from the working whatever the working parts of you
Colleen Jorgensen 48:40
are correct. Yes. Yes. And for some people like they might be doing something for their quads, but their quads are firing on all cylinders, but you really only need them to fire at 60% Perhaps you know what I mean? So it could also be the thing that you're using for the activity. Is it working more than is necessary? Is it actually creating more effort rather than efficiency? Right? Yeah, that makes sense. Yeah. And then the third piece that we're checking in with our breath, we're checking in with our muscle tension and the third piece is checking in with your thoughts and emotions. Because those stories that are like that woman with a cat now she's got a story, that if I bend down to pick up my cat, I'm gonna throw out my back again. So you first want to acknowledge notice, is there a story? Okay, acknowledge it, and then flip the script. So give it a different story. So let's say this load of picking up the cat would if she instead said I picked up my cat for 25 years. My back was an issue that time because of something else that had nothing to do with picking up my cat so I'm going to enjoy picking up my cat again. The studies show that even if she doesn't believe that story, flipping the script and giving a story that is hopeful, has self compassion, gratitude or joy or curiosity. All of those things will shift us out of our stress response into more about parasympathetic that ventral vagal that we've talked about on other podcasts, and that's where we heal. That's where the threat comes down. So I'll just summarize that because that was a lot so. So for this person who's not getting signals in her body of pain. She can look at breath, muscle tension, thoughts. And emotions. And it is quite likely that those things were happening during the class and then not only showed up as pain the next day or that night or whatever the case may be. So you might have to be a little more discerning, as you said, pay attention to more nuanced issues. These are the whispers so that she doesn't get the scream in the form of pain later on. And it can be trickier. It takes a little bit more awareness, a little bit more discernment. But the good news is that we can train awareness, introspection and discernment, just like we can learn to play an instrument. It just takes time and repetition
Ericka Thomas 50:59
and and we should also just point out to something that came into my head. Like when we're talking about pain now we're talking about not active injury, necessarily. Yeah,
Colleen Jorgensen 51:15
very different. If you've got a fresh injury, that would be a whole different conversation. Well, we'll leave in comments if you still want to, it's still it's still would be helpful to pay attention to all the things that we're talking about. But you would also need to pay more attention to the pain when it's a fresh injury. Your pain is giving you more accurate information, so we need to listen to it more. When pain has persisted. Beyond the point that an injury has healed. Now it's not giving you truthful information anymore. So that's where it gets a little trickier. That's where you have to be a little more, a little more fancy, a little more nuanced in what you do. Because you're not getting just like the person's question was you're not getting accurate information from your system. So you have to sort of tease it out. You have to pull it out sometimes.
Ericka Thomas 51:57
Yeah. And so this is this is part of that. That that trust issue. And what comes to mind, to me is, is like with joint replacements, because we have so many of those these days, it seems like every other person I meet is either on their way to surgery or coming out of search without burning and some of them go fantastic. You know, some of them, it's life changing, and whatever joint was replaced, works great. And they can go and do whatever. And then sometimes it's just worse after. Yeah, and so and so if you've got some part of your body that is not yours anymore. And this is this is something that I've thought about quite a bit like what is the what is what is the nervous system reading about that? I mean, I can imagine that it can feel it would feel very threatening to have something else instead of a knee instead of a shoulder you were born with and all of these things and so it's always surprises me when somebody says oh no, I've got I've got no pain since that. And since that replacement, and I'm like really? That's awesome. He's awesome. But I am very curious about it because I do know people who really struggle post surgery, even though he might look on the MRI and X ray like, Yeah, this is this is should be fine.
Colleen Jorgensen 53:43
So one of the one of the things that sort of pushed the research on chronic pain is that doctors were starting to see that what we're seeing on MRI and someone's symptoms, were not matching up, that you could have someone who came in for something else. Let's say they MRI of the spine, and then they saw this huge disc herniation that was compressing on a nerve root and in theory, you would assume that this person is going to have terrible back pain with pain going down their leg, but they didn't have any pain in their back or their leg. So this is what sort of sparked this curiosity into well, how is pain actually working because it's not matching up. You have other people who on an x ray, they call it bone on bone that there's no cartilage left in the joint and yet that person is fully functional. And then you've got someone else with the exact opposite that they've got plenty of cartilage, and yet they have terrible pain and restriction. So it's just another example. That is much more complicated than just what's happening in the physical body. The physical body is one piece of the puzzle and it's a very important piece, but it is by far not the only piece. So for people like you're talking about who had surgery, oh, my gosh, there's so many components that come in there. What was their surgeon like? Was their surgeon compassionate or not? Were they treated with dignity or not? Were they well rested and had good nutrition going into their surgery or not? Did they come home to a partner who was supportive and help them through the rehabilitation process? Or were they pushed to get well fast because they had to do things in the house or get back to work like there are so many components that factor in and much more much more than what I just said? But literally everything you think everything you say everything you do everything that you are everything that people say to you, the environments that you are in physically and more. All of that is going to influence whether that surgery goes well or not. The piece that you've talked about is a really interesting one is there's now a foreign body in your in your body. So how how do people respond to that? And for some people, they don't even notice they don't think about it. It's just now that it's their new normal and they embrace it. For other people. They do think of it as, as a foreign entity or even an invader that has come in and and think about what kind of thoughts that would generate what kind of emotions that would generate. So for anyone out there who's had some kind of hardware put in or some kind of a joint replacement a nice practice that you can do is to try to visualize that prosthetic so you might even want to pull up an x ray. If you have your own that's even better. If not just pull one up generic on the internet and try to visualize it in your own body and embrace it like a visitor that you're welcoming into your home that you that this person is coming to live with you and you're you're glad that they are it and I'm sure that sounds really cheesy to someone out there who's in a lot of pain. But it is amazing how things like that can make a difference because it will shift your thoughts and emotions around that prosthetic, which is going to shift that from going from a threat into a safety message. So what does that do? The system will be less protective and what does that do now the brain doesn't have to produce pain to protect you because you don't need protection anymore.
Ericka Thomas 57:14
Yeah, yeah, that is so great. And it makes so much sense when you put it like that. I think we really minimize the impact of our environment of our relationships with other people. And definitely our own internal thoughts and emotions when it comes to everything that's going on in the body. So I think that is that is fantastic information for Pete
Colleen Jorgensen 57:42
May I share two examples, Erica that might help people pleased about how much the emotions can play on things. So one example is a client who had stage four pancreatic cancer. And the symptom that sort of led her to go to a doctor and eventually get a diagnosis was that her intestines were not happy. She'd get bloated, either constipation, diarrhea, that kind of thing. So now she has been diagnosed in treatment for her cancer, and she would come to me anytime her intestines didn't feel good and we would work and there were physical restrictions in her intestines that I could work on. But we started to talk about it and I could have just worked on the physical intestines and it would help her short term but she would always keep coming back with it. But we started to dive into that and try to find is there an association? Do you notice that you're more stressed when you get these symptoms or can you pinpoint anything and what she realized is that as soon as she felt any kind of sensation in her gut, her mind went to my cancer must be spreading. And then the fear and the stress overthinking her cancer must be spreading now upset her gut even more and would turn into symptoms that she needed to seek treatment for a once she made that connection. Now, every time she started to get a symptom in her gut, she would talk to herself and she would reassure her system. Getting treatment, everything's under control. My cancer hasn't spread. This is just my stress surfacing in my intestine, and it would settle and she wouldn't need to come and see me. Like it really can be that powerful. That is a
Transcribed by https://otter.ai
Ericka Thomas 1:00:05
Yeah, that is that is so important. That's like what you just described really is, is like a source of internal hyper vigilance in the body.
Colleen Jorgensen 1:00:16
Well, that's exactly that's exactly what it is that drives pain. It is that internal hyper vigilance so that even when an injury is fully healed, it can still be in that hyper vigilant state and still drive pain. Even sometimes when there's no longer anything wrong with the tissues. Now, sometimes it can be both right? Sometimes there still is something with the tissue that you need to address. But many times with these chronic issues, there's actually nothing injured in the physical tissue anymore. But the system like the system doesn't recognize that it hasn't. It hasn't gotten the memo. So it stays hyper vigilant and over protective. Yeah. Yeah. And then if I could just show the other story that's the opposite is a client who's really struggling with back pain and neck pain. So I've only seen him a couple of times and they came to me and he was talking about his neck pain a lot on that particular day and I just asked him, I wanted to know his priority, which was which was interrupting his life more his back pain or his neck pain. And his answer was really? I get it. It made me sad for him. His answer was that well, my back pain doesn't matter because there's nothing that can be done about it. So I guess my neck pain. So he'd written himself up, like, in his mind. He's had a surgery, it didn't work. There is no solution for his back. So he just has to deal with this back pain, which it turns out is actually the worst pain but he wasn't even like to talk to me about it. Online.
I know how many people out there thinking like that. But what I hope that message I hope that people understand is that just that thinking is enough to keep your back pain going. It's enough to keep him in that loop of hyper vigilance, too much threat over protection produce more pain. So until we can help him with that mindset around his back end. It doesn't matter what I do physically. To his body and might decrease the fret threat level a little bit. But if he still has that constant message coming from his thoughts around that back pain, it's highly unlikely that I will be able to change his pain very much.
Ericka Thomas 1:02:35
Right that is that is such an interesting point about the beliefs that that we carry. And and so that that's just so interesting. So how much in your, in your experience, Colleen, how much change can really happen when you start to shift those beliefs when you start to shift those emotions.
Colleen Jorgensen 1:03:12
It's highly individual, but what I have found to be really fascinating and it seems to hold true in the research as well. So if someone believes we're really really driven by the thought that pain means damage, and then when they not only when they hear the new pain science, but they they really take it in and they believe it to be true for some people, even people have horrible intensity of pain for years. For some people just understanding that pain doesn't mean damage can make a significant shift in their pain, with no other intervention. But then, what I what I see in clinic and again, what seems to be true in the research is if fear is not that primary driver, then getting that new understanding of pain doesn't change things as much because if fear was not your big driver, understanding that pain is not something you should fear isn't going to change your life so much because they didn't think that anyways, right right. So it seems to me that in those cases where fear is not the main driver, we need to do more of all the other little things, right. But regardless of whether someone's fear is a main driver or not, across the board, it is a combined approach. of using many different things movement that feels good. Awareness, mindfulness, breath, hands on therapy, I believe in very strongly because it's one way to decrease the threat that's coming from the body. It's also a way to decrease the threat at the nervous system level, which we can talk about in the moment if we have time. And then the pain education so that you do get that understanding of what's really happening in your body so that you don't have this misperception of oh, if I have more pain on a particular day, I re injured myself. That's what so many people think I did something now I have more pain. I re injured myself, so now I can never do that. thing again. You know, that's not that's not reality. The reality is, you did something, you got more pain. That was an overprotective system, just trying to get your attention to make sure that the next time you do that thing, you're being a little more mindful. So that you maybe do it a little differently. Maybe you do it a little less long. Maybe a little slower. Maybe you want to know your breath and your muscle tension while you're doing it. You know, that kind of thing, but it's not a hard stop that I had more pain when I did that thing. Now I can never do that thing for as long as I live. No, I really hope people get that message. That's not the case.
Ericka Thomas 1:05:38
Yeah, I hope so too. And also, if if you can kind of wrap your head around that it really lifts this. There's a lot of self recrimination, I think about these things like
Colleen Jorgensen 1:05:53
I shouldn't have done that. Yeah. What did
Ericka Thomas 1:05:54
I do now? Like what was it that I did now to this this or this?
Colleen Jorgensen 1:06:01
And it's such a good point, Erica, because as soon as we go into that place of self judgment, self judgment, single threat, so more protection, more pain. Whereas instead in that moment, if we met ourselves with self compassion, that's, that's not easy, but I did that thing that I love doing and now I have more pain. Well, that's, that feels a little unfair, but okay, I'm gonna learn from it. And let me try to do it a little differently the next time I go around.
Ericka Thomas 1:06:26
So you mentioned some hands on therapy and what what does that look like? What could that look like for people?
Colleen Jorgensen 1:06:34
So physiotherapy, athletic therapy, osteopathy, massage, chiropractic, it, even acupuncture anything where we're intervening at a tissue level fascial work. Again, there's this school of thought Now that all of that is useless, because pain is not coming from the body. But that's not quite the right story. Right? We know now pain is partly coming from the body, but it's also about how the brain is interpreting what's coming from the body. So if we can decrease the threat level, from the tissues, through manual therapy that has a lot of value, because now we're decreasing the threat value is probably not the only thing we need to do though. So that's the important message is we need to combine things like manual therapy and movement with those other things that we talked about awareness, mindfulness, breath, etc. And in terms of movement teachers, one of the things that I think is really important, so let's say we do go ahead and correct posture and alignment in class, which I believe we should. But here's the big change. Well, here's the two big changes, I would say. One is for us as teachers to understand that. Okay, let me take a specific example. If someone is doing a posture or movement, they have pain. So they asked you about it. So you say okay, I see that your knee is falling into doing it. So if you pull your knee this way, and you try this and you move your pelvis this way, try it again and again. Ah, my pain is gone. We all celebrate fantastic, but we can't stop there. Because the problem is, if we just do that, unconsciously, that person interpreted as I changed something in my body, and that affected my pain so my body is causing my pain. So it's reinforcing the idea that it's not true. That pain is only about what's happening in my body. But what really happened when you address that for that person, so let's think about that. So yes, you change their posture, you change their alignment. So you you decrease the threat value coming up from the body, great, but you also did other things. They addressed a concern you heard them, and you offered a solution that makes people feel safe. So there's this therapeutic alliance between the two of you, that decreases the threat value, so that's huge. Now you've also changed their nervous system, because if you've, if you've given a postural or an alignment cue that makes that movement feel easier or better in their body, well, now they're not in a threat system. Now they're in this calm place, and that's changed their nervous system. So even though it seems in the moment that we changed this physical thing and pain went away. We also changed a lot of other things. And probably when you did that alignment change, their breath probably changed because if they were in a position that didn't feel within their body, their breath probably got shallow. Now you gave them excuse, their breath, like they got softer and smoother and more easy. And so all of that is why all of a sudden, they don't have pain anymore. So I think that one of the simple things that we can do as teachers is just bring that to people's attention, you know, so if you're my student and you tell me you have pain, I give you an alignment cue Your pain is gone. You said that's fantastic. That's amazing. My pain is gone. I just take two minutes to say you wonderful, and the reason your pain is gone and because you feel better, because I heard you. Your breasts change when you did that. Your muscle tension change when we change that alignment, so your nervous system feels better about the whole thing. So you as a person is experiencing this posture differently now. So that we just start to get people to be aware that it isn't just about the body. It's also about all those other things.
Ericka Thomas 1:10:20
Right and so empowering. Actually, yes. Because you know, we are looking at and dealing with the whole self at this, you know, all at once. I think for so many people whether you're in chronic pain or not. Sometimes it feels like kind of all or nothing. It sounds like you know, whenever you get like the latest bit of information, the latest science it can sometimes look like oh, this is the only thing now that we look at when actually Okay, now we have new information. So let's just layer that on what we also know to be true, and make it even more effective.
Colleen Jorgensen 1:11:16
I couldn't agree more.
Ericka Thomas 1:11:18
So, Colleen, before we wrap up this incredible conversation is there anything else that you would like to share on this topic before we go out?
Colleen Jorgensen 1:11:33
So much but I think I just put people as teachers we can get very afraid of people who have pain, and you know, we're afraid to make them worse. So I hope that the teachers out there listening also feel empowered, that isn't just about their tissues, their thinking your class and again, when I'm talking to an acute injury, we're talking payments versus it's not just about what's happening in there to free yourself from that pressure of feeling like you have to have some sequence of exercises to address the pain that everybody's experiencing in your class. It's almost that is one thing that's important and one thing that you can look at but what's almost more important is making sure that everybody in the class is feeling good in their body is feeling good in that space. is feeling welcome, is feeling heard, is feeling seeing is feeling like they don't have to take themselves too seriously when they're on their mats that they don't need to be comparing themselves to how the person next to them is doing that posture or how you as a teacher is doing that posture. CO regulation so if you as a teacher is well rooted in your parasympathetic state of safety, comfort and connection, you are likely to bring the class with you into that regulated state. Whereas if you're super nervous and terrified of not wanting to be in your stress response thinking of things like CO regulation and therapeutic alliance and the importance of everybody in the class, paying attention to their breath as they're doing things, paying attention to the tension in their muscles as they're doing things and paying attention to the thoughts of emotion. It's like a few words that we can add to our cueing every now and then through the class that all of a sudden something other than that one physical sensation they're getting from their body.
Ericka Thomas 1:13:33
Yeah, yeah. So great. So such an important conversation today. And I really I'm very grateful that you brought it to our listeners. So thank you
Colleen Jorgensen 1:13:45
for having me. I appreciate you. Joining me on the journey.
Ericka Thomas 1:13:49
Absolutely. So good. Helene, where can people find you these days? What are you up to? How can how can people
Colleen Jorgensen 1:13:58
so on my website, Coleen jorgenson.org and on social media, I post quite regularly on Instagram, for stillness in motion, Facebook, just stillness in motion. They instantly get on my mailing list. Every two weeks I send out little bits of information about the kind of thing that we talked about anatomy, pain care, compassion, breath, movement. So if you want to get little pieces of this information, you can DM me and get on my mailing list. That's all free and on my YouTube channel, which is still emotionally calling Verizon. They have over 100 Free practices, movement brands, vagal tone, that kind of thing.
Ericka Thomas 1:14:41
So all of that will be in the show notes. And so that'll be the easiest place where you'll be able to just click to get straight to Colleen. And once again, Colleen, I am so grateful to know you. This was fantastic conversation and thanks so much for being here.
Colleen Jorgensen 1:14:59
Thanks so much, Ericka. I really appreciate it.
Transcribed by https://otter.ai
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