Therapist John Gasienica talks with physician Dr. Becca Kennedy and patient “Sarah” about shifting from rumination to safety, processing medical trauma, and using simple emotional and somatic tools to calm the nervous system and reduce pelvic pain. A practical look at feeling safer right now—even when your brain wants certainty.
In this episode, we explore how “thinking less” and feeling safer in the present can quiet the nervous system and ease chronic symptoms. Dr. Becca Kennedy, a board-certified family medicine physician who treats neuroplastic conditions, joins John to unpack medical invalidation, loneliness in chronic pain, and why learning to access anger, compassion, and play can unlock recovery. You’ll also hear a real coaching segment with “Sarah,” navigating vulvodynia, fear, and uncertainty with step-by-step emotional work and somatic tracking.
What you’ll learn
Why certainty isn’t required for recovery—and how to “negotiate” with the brain’s demand for it.
A gentle, repeatable way to sit with fear and sadness so safety messages can finally land.
How practicing anger expression (safely) restores agency after medical gaslighting.
Somatic tracking: Relaxing bracing and signaling “nothing to protect”.
Re-introducing play and joy as evidence to your brain that you’re safe—even while symptoms are present.
Rough timeline
0:00 Intro — symptoms fade when we feel safer, not when we solve everything
2:00 Disclaimer & PRT training mention
3:00 Meet Dr. Becca Kennedy; path to neuroplastic care
6:00 Vulvodynia labels: validation vs. harm
7:00 Sarah’s story: yeast infection → persistent pelvic pain, despair, isolation
14:00 Processing the emotions of being in pain (not just past trauma)
20:00 Guided exercise: feeling fear/helplessness with compassion in the “life raft”
29:00 Accessing frustration/anger and why it’s protective to express it
37:00 Living with uncertainty; safety in the now vs. promises about later
43:00 Safety visualization and re-introducing play
50:00 Fun as medicine; nature, joy, and daily moments of ease
51:00 Parting encouragement & hope
Guest
Dr. Becca Kennedy — Resilience Healthcare (neuroplastic conditions, long COVID, chronic pain)
Mentioned/Concepts
Pain Reprocessing Therapy (PRT), somatic tracking, Emotional Awareness & Expression Therapy (EAET), nervous system regulation, medical trauma, safety signals.
John: [00:00:00] Welcome back to another episode of the PRT Podcast where we teach actual patients how to heal from chronic symptoms and break down the tools they use. My name is John Seneca. I'm a therapist and the director of clinical research and Development at the Pain Psychology Center in Los Angeles. Chronic diseases or diseases of uncertainty.
When you're in long-term discomfort, you face questions that are impossible to answer questions like, did I hurt myself permanently? Or, why is this happening to me? Or, will this ever go away? The bad news is no one can answer these questions for you with the perfect certainty you crave. The good news is you don't need to be a hundred percent certain to break free of symptoms.
The solution to this riddle is actually letting go of trying to understand everything all at once, and instead simply figuring out how to just feel a little bit safer in the very moment you're in. This might mean different things at different times, but if you can accomplish this task over and over again.
Instead of getting stuck in [00:01:00] rumination, your nervous system will calm down and your symptoms will fade out of your awareness. For some people, this method of soothing and relaxing instead of overthinking is an intuitive switch. But as you'll see with the patient I meet with today for a lot of very intelligent analytical people, this pivot can feel like learning a new language.
Today's episode is about learning how to feel safer right now, even when your brain is dead. Set on over analyzing. And I have an amazing doctor and pain expert, Dr. Becca Kennedy joining me today to help show you how to get on the path to recovery. As always, the PRT podcast is brought to you by the pain or processing therapy center, a training center where thousands of doctors, therapists, nurses, and coaches have learned how to treat and eliminate their patient's chronic conditions.
If you'd like to become a PRT practitioner and support the podcast, use the coupon code, heal 10 to get 10% off training@painreprocessingtherapy.com. Now, before we get started. A brief disclaimer. [00:02:00] This podcast is presented solely for general information and entertainment purposes and is not intended as a substitute for the advice of a physician, psychotherapist, or other professional healthcare service.
If you have specific medical concerns or questions, please contact your personal healthcare provider. Now, let's meet my guest for today's show.
All right, so joining me today is Dr. Becca Kennedy. Dr. Kennedy is a board certified family medicine physician with over two decades of experience in treating patients before founding resilience healthcare, where she specializes in the treatment of neuroplastic conditions. Dr. Kennedy led a long COVID specialty group with Kaiser Permanente.
As a board member with the association for the treatment of neuroplastic symptoms, Dr. Kennedy has become one of the leading and incredibly compassionate advocates for getting people out of pain. Dr. Kennedy, I'm so excited to have you here today.
Becca: Thanks, John. Really excited to be here.
John: I, I got introduced to your work by Dr. Shuber, and I've been watching your YouTube clips and [00:03:00] podcast interviews. You have such a compassionate voice for people that are getting out of pain and for having been a doctor for 20 years. What was the breaking point for you to get more into this chronic symptom work and, and the, the psychological aspects behind it?
Becca: Well, as a primary care doctor, I first worked in a migrant farm worker clinic for five years, and then I moved to Kaiser Permanente. And 10 years into my career, I mean, as anyone knows in Kaiser Permanente, we see a lot of patients and, um, I think we're in a really unique, uh, vantage point as a primary care doctor at Kaiser where we have such huge volume and we're closed system to really see the patterns of what's going on over time with people.
Just noticing the pattern in many, many, many patients that didn't get better with all of the different interventions and specialists and everything that we could possibly try that often, it was the same sort of symptoms that happened in the same sort of people. [00:04:00] Often there was. Mental health diagnoses that neither caused the symptoms nor were the result of the symptoms.
Exactly. It was just more, there was sort of coexisting and then often people were more likely to have had a history of trauma. Not always. But just seeing this pattern over and over and over and, um, it's really hard. It was, I was frustrated along with my patients that they would just keep coming back over and over and over, and I would try everything under the sun.
And as a primary care physician, they come back to us and there was nowhere else to go. I just, it sort of became this curiosity for me, sort of like this itch. I couldn't scratch that. We were missing something huge in medicine and so I looked, I just started this journey to f. Figure out what that was.
And I just kept looking and looking and looking for, for years really. And it, I just never was quite there. I would [00:05:00] find some information about the, the nervous system, but yet those tools weren't enough. And so, um, finally a friend of mine from medical school, um, is the one that told me about Howard Schuur and I found this work and then just really dove right in.
John: So the patient we're gonna hear from today, she was given the diagnosis of vulvodynia, which is a diagnosis that doesn't have a clear cause, isn't often given a clear treatment. Are idiopathic labels like vulvodynia helpful or do they sometimes cause more harm than good?
Becca: Gosh, it's such a good question about, I think the line between sort of validating people's very real often terrible experience with the symptoms.
Then also understanding, explaining it and also not worsening the problem. Um, I do think it's helpful, something like that in general. I think that's helpful. So. [00:06:00] We have the validation, you know, that, you know, this is going on. Um, and I think with, with, you know, there's lots of different diagnoses that like vulvodynia, that it's really a more of a description of the symptoms rather than, you know, something deeper.
But I, you know, I think it can be helpful in this circumstance.
John: I'm really excited to, to show you this patient and let's get to it.
So, Sarah, why don't you catch me up on what this has been like since the pain started.
Sarah: So I started having discomfort around November of last year for what? Turned out to be this weirdly presenting yeast infection that they didn't catch for like too long. So I finally got treatment for that in December.
And then the initial set of symptoms were just a very uncomfortable burning, uh, subsided. And I was very happy for about a day and I was like, this is done. And I had like a day where I felt totally normal and I was like, this is incredible. Um, and then I woke up the next day and I [00:07:00] had a new different pain, but.
What I would call like actual pain and I just got trapped in this loop of going to like urgent care and here and there. Like I think that was what made it unbelievably stressful because I was like, this is happening. I know this is happening. I'm trying to communicate that I'm in discomfort and like.
You know, whatever we can get into that. I think I, I have a lot of lingering anger about that period, but, um, when it turned to just this sort of 24 7 pain that was pretty intense at the beginning, it has subsided in the, you know, months since. But it was just, uh, absolutely terrifying. Uh, because at that point I got retested for everything and everything came back clear.
So now it was like triple sure. That. Nothing was wrong. And I just had now this like unexplained unexplainable pain. Um, I did have like, I was like, I guess lucky enough that like I finally got to see my doctor, who's my doctor now, who did say, I think it just, it's just your nervous system and I didn't really understand what that meant.
Hmm. And I was [00:08:00] diagnosed with Vul Demia, which, uh, I also found to be. On one hand, I guess it's good to have some kind of label, but in the other, when I realized that all it meant was you have pain and that it was like a diagnosis of exclusion. Yeah, I was just, I guess, angry, saddened. It just seemed to hopeless.
It's like, oh, okay, here you go. You have pain. We don't know why. Best of luck. I mean, it wasn't exactly like that. I got referred to, uh, PT and you know, there was some sense of like, maybe we can do something, something about this, but mm-hmm. Um. You know, then you go and you Google it and it's all despair. I don't know.
It felt like I had fallen into a very deep hole and nightmare-ish, and I had no way to crawl back out. Yeah.
John: So just right off the bat, what are some of your first reactions to hearing that clip?
Becca: Oh gosh. Yeah. So [00:09:00] common that experience in just so many different places in the body and, um, you know, all of that. And it is a deep despair. I mean, if you have these symptoms that the people, that, the experts that you're going to, that are supposed to have the solutions.
Don't have solutions. And she talked about, you know, at first she felt like they were just saying, okay, bye-bye, good luck. And then she said, well no, they didn't do that exactly. You know, they sent me to a pt. But at some point. You do get to that end of the road, you've seen the PT and you've seen the, you know, this and that, and everyone under the sun.
And so people do get to that end of the rope. And it is a, a terrible sense of despair. And just like we were talking about before, having a label can be a little bit helpful because, you know, we're. Saying, Hey, yeah, here's, here's something that lots of other people have, and but then to find out that there's not an answer for it in the mainstream medical system is, is very disparaging.
John: [00:10:00] Yeah. That, that disparaging feeling comes up in so many patients and can really turn into a medical trauma. A lot of emotions come up because of that. Mm-hmm. Why do you think it's helpful to learn how to cope with those emotions? Not even from the traumas in your past, but just the trauma of being in pain and not knowing what to do.
Becca: Oh my gosh, a hundred percent. I mean, not only just the emotions that are there around experiencing that suffering, but also around the anger towards the doctors and the system, and it's perfectly normal to feel angry. Even if your doctors and medical providers are really caring and, and showing that empathy and doing everything they can to help, but unfortunately, a lot of times that's not, that's not how patients feel either.
And so all of those emotions are on, all of it are so important.
John: Well, it's good to hear and, and I could see how. Doctors are hesitant to bring up this idea that it's neuroplastic in the first place because there can be a lot of anger with finding out that it is [00:11:00] something to do with your nervous system as well.
Have you ever had that experience where somebody has a adverse reaction to the suggestion that their symptoms are neuroplastic?
Becca: Yes. And. Before I learned about this approach and the language to use and the science to explain, I think a lot of physicians in, you know, in medicine understand that there's some sort of stress involved, or that it's the nervous system or it's the anxiety or depression.
It's just we don't have the right language and we don't exactly say it right. So I actually think that there's many physicians that do present this. But just don't have the right language nor the right solutions. And then a lot of times patients get angry at 'em. I mean that definitely happened to me over and over and um, and then I think that then makes you just stop even saying that as a physician.
You know, understandably, when I learned this new language in the new science, it was when I was working at Kaiser and I was in the [00:12:00] integrative department, so already people. Seeing me, you know, thought I was doing something a little bit different than the medical system, but it still was within Kaiser and I was very afraid to have this conversation with patients.
Uh, but I did, you know, and I was actually surprised at how many people were actually on board with it. Hmm. Because I think if you have a different, and I didn't know how to say the language very well when I began. Right. So I was still practicing that and figuring it out. I think that when you really lean in and look at someone in the eyes and allow them to have their story heard and really hear them first, and then give them the reassurance that I've seen other patients like this and there's new science, and then we can explain the science and if we really connect up with them in a, in an entirely different way in the communication, that there's so much more receptive than I think that.
We think they'll be. And many of my [00:13:00] patients, I, especially my patients with long COVID, said to me, wow, this is the first thing a doctor said to me that actually makes sense. And um, and that was like, that was what was really encouraging to me to actually just keep going with this. And yes, there were a few patients that got really angry with me and it's hard.
It's really hard, but fortunately it wasn't very many.
John: That's really good to hear. So Sarah's been trying all the tools to get out of pain, but hasn't quite found a solution yet. And what this usually tells me is something's getting in the way of Sarah's brain feeling safe. So usually in this scenario, I like to check in on what her experiences been like to see if there are any clues.
As to what's keeping her nervous system so active.
What are you feeling right now? What comes up when you think about this idea of being in this hole?
Sarah: I love powerlessness. Yeah. Frustration. Um. [00:14:00] I have always been able to fix things and I think realizing that I was trying so hard to fix this and every tool in my toolkit that I've developed throughout my whole life was no good.
That was terrifying as well of like, I get to get out of this. I have to develop a whole new skillset to just be, have a baseline comfort in my body, I guess. Yeah. Um. Yeah, and I feel incredibly isolated, which I realize is, you know, I think the more that you, um, read about people in pain, you realize it's the thing that connects so many people is that feeling of isolation, which is almost a paradox.
But, um, I think no one in my immediate context kind of got what I was going through, you know, and I feel like something about pelvic pain too, which is so intimate and so personal, and I think there's a sense of. Certainly my family, which I don't think is exceptional in this way, is not that [00:15:00] comfortable talking about people's pelvic areas.
Uh, mine included. So it was very much like, uh, don't, the feeling that I got was like, well, you're fine. The doctor checked you out. You're fine. So can we stop talking about this?
John: Hmm.
Sarah: Um, and it was like, oh, okay. I, no, I am glad that I'm healthy, but also. I'm in like some days, eight outta 10 pain all day. Like I got, I think it was that very confusing.
Very initially disempowering, but I think a lot of, I'm sure like the last few months for me have been realizing that and developing the patience to understand that even if it's not quick fix, there is a, an afterwards. Um, but it's, yeah. It's, I think it's the hardest thing I've ever had to do, like as a, as a person.[00:16:00]
John: So I actually started my career in mental health on a suicide crisis line. I was a counselor and one of the best things I learned from that training is the worst thing you could say to somebody on a crisis line is it's all gonna be okay. Because there's a piece of them that feels terribly scared and lonely.
And where you wanna start is kind of sit in the darkness with people. And I can imagine as a doctor, there's this impulse to want to fix, but I, I see so much compassion in you and hearing people's stories. Why do you think it's helpful to kind of stay in the darkness with them for a little bit before you run into fixing that?
Becca: Gosh, that's so beautiful. And Yeah, absolutely. And I think first people need to be heard and we need to connect with people. If we are saying that they're gonna be okay, even if we genuinely believe that because we have seen other people in that circumstance and you know, on and on. If, if their brain, if their conscious and unconscious and nervous system is [00:17:00] not believing that right, then, then, then that sort of makes them feel like we're not hearing them.
We're not connecting with them. And it's actually, frankly, can be actually not that much different than the doctor in the clinic. You know, sort of not hearing them as well. And I think also because we really understand their suffering. Like if we don't understand their suffering, how are we gonna be able to actually help them?
If we don't really first understand that really the degree of the suffering, then, then I think their protection is is still gonna be up, and they're not gonna be able to just sort of relax down into believing and trusting us.
John: Sarah's dealing with a tremendous amount of loneliness. You can hear it with her experiences with her family, and I see this in every patient.
Why is chronic pain such a lonely experience?
Becca: Gosh, for so many different reasons. I mean, certainly just like she said, when there's a, certainly a [00:18:00] body part that's just uncomfortable to talk about in the first place and many of the areas are so, you know, that's uncomfortable. Often chronic pain, you look fine, you may be look fine.
Mm-hmm. You maybe look very healthy, like I'm sure she looks healthy. And so it's sort of what can be considered even like sort of an invisible illness. And so their family members just can't relate, and especially if they haven't gone through it themselves, maybe even they believed how much suffering there was in initially, and maybe they were very compassionate with them.
But often as time goes on and they've seen specialists and gone to doctors, I think that compassion can wane from the family members. And then, you know, so they don't have that part. And then it's just hard to go out and be in the world and connect with people. And so many patients that have said to me, well, I thought I had all these friends, but they've really dropped off.
And it, I don't think it's even necessarily that. The people [00:19:00] don't care about them or they don't like them, but I mean, there is a certain sort of reciprocity that you sort of need to have in order to maintain friendships. And so all of those different pieces just really get, um, broken away.
John: So what Sarah is feeling is completely normal and natural and not something to be feared.
Yeah. But it's something I want her to help process so she can move on to feeling better. So let's take a listen as she takes her next step.
Let's stick with this emotion that's coming up because I think, you know what makes it so difficult to get out of pain is that this is a traumatic experience just being in pain. And those emotions that come up from the trauma often block you from writing these new neural pathways 'cause they put you on such high alert.
And so let's start out with just dealing with these emotions before we go into any of the like logical brain stuff. Yeah. I want you to just close [00:20:00] your eyes for a moment and I want you to just feel that despair, feel that hopelessness coming up and just allow it to be there. There's so much in the pain journey where you wanna fight that and just let that piece of you that feels horribly hopeless.
And horribly scared come up. And as you're feeling these sensations, and I almost want you to imagine you're in a life raft with this emotional piece of your brain, and they're terrified. And we just need a piece of you to be the one member in the life raft who's actually the caretaker. And so I don't want you to tell them to quiet down.
I want you to tell 'em, tell me about how hopeless this has been, but take on this role of the compassionate, empathetic. Leader of your brain and just let it know. Of course you feel that way. I don't have to tell you to be quiet anymore. Kind of be the family member you want to have and let that piece of, you know, this is horrifying.
You go on the internet and you find an idiopathic diagnosis that says, this is just pain and there's nothing we can do for you. Oh my [00:21:00] God. To let that piece of, you know, I was there when you saw that and it was so scary. And just encourage that piece of you to feel as hopeless as it wants, almost as if it's on the ground in the life raft.
And you just say, I'm just standing over you. Not gonna let anything happen to you, but you're allowed to feel this way. And just feel that connection with yourself.
And how does that feel?
Sarah: I feel, I feel like I kind of soft, um. I think I've been so afraid of being afraid because of course the messaging you get immediately is like, you have to get outta fear. And I think this part has felt very much like, I don't know, there's like an shame around being afraid. Yes. And uh, yeah, it's good to connect with it and be like, it's.
It's okay. I think for so long it felt like, you know, that nightmare that you have where you try to scream at the top of your lungs and nothing comes out. A [00:22:00] really hard feeling to be in sort of, yeah, in a sustained manner.
John: If there's one thing I want your brain to understand in this session, it's that idea of we want to decrease the fear.
That's step two. That happens on its own when you do the right step one and the step first. Step one is to actually feel that emotion. Let it come up. And if we give you the right tools to where it doesn't totally take over to where like everybody in the life raft isn't panicking. Yeah. And one person's still there to take care of the other part of your brain.
That piece of your brain feels heard, it feels validated. And now when you want to give it messages to safety, your brain doesn't have its heels locked in. Does that make sense?
Sarah: It does make sense. Um, and it, yeah, I think it's something that I'm very unused to, like connecting to those parts of yourself because I think, again, before this experience, I've always been able to push through.
John: Yeah. Yeah.
Sarah: I think I've been a little bit dysregulated a lot of my [00:23:00] life, and I just have this flashback of being in the fifth grade and sort of puking from stress before school every day because I was so concerned about performing academically in the fifth grade. So maybe it's okay if it take you a little bit of time to learn a new way of being, but um, ugh.
Is it really hard to quiet that part of your brain that is like, but can I just push a button somewhere and have this be over?
John: So Sarah says there, she gets this flashback where she realizes she's kind of been dysregulated for a lot of her life. Why do you think it's helpful for a patient to make those type of realizations? To see where this stress has been coming from?
Becca: Because often the situation that's happening, happening for us in the moment, as an adult, we may not be able to recognize why that's having such a huge impact.
Look, why is my brain responding to something that doesn't actually seem that stressful to me? I've gone through all these other [00:24:00] stresses in my life in the past, and I didn't respond like this. Why am I doing it now? So really making the connection of. Where did your brain learn that as a child? And then why is it over responding?
Oh gosh, it's such a huge piece. And then also I think recognizing how when we are chronically living in patterns that don't serve us, and we're a little bit dysregulated, that it's really those patterns that, that don't help us. I was talking to a, a clinician in this world and he was talking about how patients say, I just wanna go back to how I was.
Right. You know, before these symptoms started and he was like, no, actually trust me, you don't, we wanna, we wanna get to those patterns. That was laying the foundation of why your brain then created these symptoms.
John: It's such a common experience for people to just say like, I wish I could just turn the clock back.
And when they do go through this process, I, I agree. They, they find this voice [00:25:00] that says like, no, that, I don't wanna go back to that. Yeah. That wasn't a good way of living.
Becca: Yeah.
John: Um, but it can be definitely hard to see when you're in the thick of it.
Becca: Oh my gosh. Mm-hmm.
John: I so relate to Sarah in this clip where she's like, this is just not a skill I'm used to.
It was a skill. I was not taught self-compassion or taking it easy on myself. How did you learn to be compassionate to yourself? Was this a childhood thing? Was this an adult thing?
Becca: Um, oh, this was an adult thing. This was a this work thing. Um, yeah, I mean, I have all the personality traits, like I wasn't puking in fifth grade, but I definitely had a lot of pressure on myself and, um, that I have found is the key.
If you can teach someone's unconscious brain that they deserve unconditional love. I mean, the nervous system can just let go, and there's just so many reasons that people's brain didn't learn it or didn't learn it. I mean, sometimes certainly it was, you [00:26:00] know, egregious. Abuse. Absolutely obvious when that happens, but so many other times it wasn't egregious.
It was a loving parent that wanted them to succeed, so put a lot of pressure on them, or maybe a parent that was ill, but still very loving. A lovely household or just so many, so many reasons. And, um, and that's just a protective mechanism that our brain learned just because we were a kid, just because we, we went through.
And, um, really getting to the root of that is key. And I find like for myself and for my patients is that I found the emotional work can be so helpful in that. You know, one technique that I use is the emotional awareness and expression therapy, and for people to be able to express their anger and they're not being, you know, if they weren't treated in the way that they deserve, that shows their unconscious brain that they do actually deserve to be treated well.[00:27:00]
But then to finish it with. Really bringing in the self-love as and let that emotion fill their body as they're thinking about themselves as a child or whatever they went through, is really key.
John: And take it from both Dr. Kennedy and I who learned these skills in adulthood. It just takes time. Right. Like how long did it take you to, to learn how to be compassionate and vent those emotions and listen to yourself?
Becca: Yeah, I mean, it took me a couple years for sure. Yeah. You know, and I'm still learning. We're all. Learning is a journey.
John: And I think a good thing to point out too is that it is a journey and you can get outta pain pretty quickly in the journey. You know, for a lot of people it's getting outta pain and then it's maybe anxiety comes up, or maybe it's just being a more, uh, joyful person.
That's the next stage in the journey. But sometimes I find that patients get overwhelmed with this idea of like, I have to clear out all these emotional cobwebs before I get outta pain. And it's often maybe 10, 15% of the work. Um, before they can start making a change. Does that [00:28:00] feel true in your line of work?
Becca: Yeah. Yeah, I agree. I think that, you know, there's different reasons for the pain or other symptoms to be there. One of them can certainly be the, the, the pain fear loop, and that can get dialed down relatively quickly and then sort of getting deeper down into the root of it. And I think it's also, I often say it's not easy, but it's more possible than you think it is.
John: I like that. Well, so what we've been talking about so far is good in theory to have clients feel their emotions, have them come up. But we also wanna teach people how to deal with that frustration, as Dr. Kennedy was talking about with some expression, uh, to actually help the nervous system process these emotions and not get held back.
So let's take a listen
and do you feel any frustration coming up about this situation?
Sarah: A lot of frustration, and I'm also, this is something I've been working on, is like, [00:29:00] I've always had a lot of trouble expressing anger for, you know, for various reasons to think of. Certainly that was a taboo emotion in my, uh, family of origin.
We're like, you couldn't, you couldn't get angry. It was just not. Available option. Um, and I have, because of course I'm angry. I'm so angry about my experience, why were, make my complaints not taken seriously. Um, why was that my discomfort minimized? Um, it's, it's unacceptable. Yes. Um, and I'm part of this sort of long line of women who get disbelieved in a medical setting and whose pain is not treated seriously.
And it, it, it produced me a great harm. Like I was so hurt by that. Um, I think without, see, I'm like, I'm getting sad and I think it's because it's so hard for me to act as anger that I go to sadness first.
John: Totally. But
Sarah: I don't like that. I, I know I'm doing it and I don't like it, but it's like, oh gosh, that feeling of ex [00:30:00] like exteriorizing anger and directing it towards someone that is, ooh, that's, that's a, that's a tough one for me.
John: This'll be a, a quick way to kind of speed up that learning. I want you to close your eyes and use that, almost that same imagery of you've been the lifer, half of this other piece of you, except now you're not calming them down. You're telling them, I need you to get angry. Imagine this piece of you that's horribly angry and just encourage her anger on a little bit.
You know when like you're trying to get a friend a little bit angry and you're like, that is bullshit. There's no way you should have been treated that way. Think about how many women are like you that got put in this scenario. Just visualize her screaming, yelling, punching, and every once in a while just let her know.
Of course you feel that way. You have every right to feel that way. I just keep asking her, what else are you, what else are you angry about? What else are you frustrated with? And just see what pops up.
Sarah: Yeah, I think I was a lot of anger about how when I was, you know, when I first developed [00:31:00] pain, not having support from my family, I think that that was.
Just add it to the fear. Um, and I know why I got the response that I got, which was some version of, you should be more resilient and you're making too big a deal out of this. But that's so unfair,
John: so unfair. I want you to visualize being in front of them. Now, this piece of you that's emotional and this piece of you who's taking care of that emotional piece?
And I want you to imagine you protecting this emotional piece of you almost putting a force field around her. And if there were no ramifications, if they just had to sit and listen, what would that emotional piece of you that's very angry say to them?
Sarah: I just needed to be heard without judgment and I just needed to know that I was loved in that moment.
Like I know that obviously they couldn't take the pain away, but just feeling like there was space for me to be in distress and to feel like they were listening. I think that. A lot of the anger comes from feeling like I needed something very [00:32:00] simple. I just needed someone to say, I hear you. That sounds awful.
I'm sorry you're in vain. And the fact that that seemed so impossible or so much not available was shocking to me.
John: Mm.
Sarah: And I kept asking for it. And, you know, probably not in the clearest ways, but I, I just kept kind of going up to them and think, well, that I feel. So scared. I'm in so much pain, I don't know what's happening.
And it was so much like, and I, I understand I'm part of my family of origin. I understand why, you know, that's just pushing through. It's absolutely the way that we were taught how to function and I know why that is the shorthand of our family. I know why that is, how things get addressed. But that was so opposite from what I needed and it felt.
Just devastating to, to not be heard and to just be told that. [00:33:00] I should buckle up and be more resilient because like I was being as resilient as I could be.
John: I want you to give this emotional piece of you what you wanted from your family. I want you to close your eyes and I want her to, I want you to tell her I'm listening to you.
I understand how much pain you're in. You're worthy of my time. You're worthy of my attention. You're worthy of me taking you seriously, and I'm here to listen to you no matter what, and just really deliver that piece to this part of you that needs to hear it. And do you believe that? Do you believe that piece of you deserves to be heard?
And has value.
Sarah: I do. I think it's taken me a while to say I do, to sort of give it permission because I think there's also the sense of, oh, if I give it permission to feel these things, then I'll be so overwhelmed. Yeah. That I'll never get out of those emotions. Um, but I think a big lesson of this whole period is you feel what you feel.
You can't stop feeling something because you decide it's the wrong feeling. Um, yeah, I think that is like a big part of me that probably not new. I, I, I think I've [00:34:00] sort of pushed it down many times before. It's just that this time I couldn't quite do it. You know? I think that that part of me that is like, oh, but I feel terrified, or I feel so frustrated, or I feel vulnerable, um, has popped up throughout the years.
It's just, it was so much easier. Before I, I got away with it for a long time of just saying, oh no, you, there's no room for you. Go away. Um, and of course being in pain brings a whole new urgency to it of like, oh, okay. I think, I think maybe I can listen to you,
John: you can hear Sarah starting to access some frustration, but you can hear the cheeriness and the sadness kind of coming in to almost overtake it. Why, why do you think it's so difficult? To access anger for so many people.
Becca: Well, I, uh, was one of those people for sure. Um, yeah, I mean, the way [00:35:00] that I describe it to my patients and myself is that we need social connection in order to keep, to stay safe as a human.
There's nothing else that brings a safety like other humans in that connection. And especially as a child when, you know, when you're born, you will die if you don't have a, a social connection with your. Caregivers and your parents, you need to get them to love you in order to get them to take care of you so you don't die.
So if your caregivers treat you in a way that you don't deserve, then that self-agency, that anger is not safe to rise up with anger towards your parents who are your lifeline and potentially break that social connection that's not safe for your unconscious brain's perspective. So as a child, it's. It's pretty easy for our brains to learn that it's not safe to express anger, and for many people they, they get taught a healthy way to [00:36:00] express anger for sure.
But then there can be all these different ways that that unsafety of expressing anger gets reinforced. Maybe the parents specifically teach them that it's not okay. They get sent to their room, or maybe their parent or a sibling rises up in anger in a really scary way, or their religion teaches them it's not okay or.
Being a woman in this culture or a marginalized group in this culture that is not okay to be angrier or even I've had very, very big men that they don't wanna scare other people. And so, I mean, there's just so many different reasons that our brain can learn and get reinforced that it's not okay to express anger.
John: So we've given Sarah empathy now and compassion, and she's able to express herself a little bit. And now we wanna move on to giving her a sense of safety, teaching her how to start inputting these messages to her brain. But as you'll see, this isn't always a smooth transition.
[00:37:00] But now that that emotional undercurrent, that feeling of your unconscious brain is taking care of a little bit, it's just soothe a little bit. We wanna push back a little bit here and let that piece of our brain know, I know you're feeling this way, and you have every right to feel that way. But we're also gonna be okay.
Ugh,
Sarah: that's hard because there is a fundamental uncertainty to recovery, right? It is like, no, you know, sometimes I feel like I would take being in pain longer, which makes no sense. I would take being in pain longer if someone could tell me the date by which I'll be out of pain. But being in pain a shorter amount of time, but not knowing exactly.
Uh, which helps nuts when you say it, but that's just how it feels. You're like, I want, I, I would kill for some certainty. And I think like that is, like, that is there, that's a reality. You have to somehow accept uncertainty in some, in some manner, which is so hard. So I think then you try to do this thing of you're in pain right now, but we're, we're gonna be okay.
That puts the uncertainty. It just, [00:38:00] that makes it very tricky for me to sort of sell that idea to my system because it's like. Okay, but like by when,
John: this is the grand negotiation. 'cause you're right, there is no certainty you're gonna be able to give your brain, um, it's the thing that freaked me out the most, even when I'd say I'd be okay, I believed it like 92%.
Some days I believed it, 64%. And there's that gap left where you don't believe it. And this is where you start to negotiate with your own emotional brand. Your emotional brain says, you're not giving me what I want. And you can say, I can't promise we're gonna be okay later tonight. I can't promise we're gonna be even okay later this week.
I can't give you a timeline on when we're gonna get better, but let me use my somatic tracking tool right now to show you that we're okay right now. Let me let you know that we're okay in the short term. If I can feel safe and comfortable, even now while my symptoms are present, it's way easier for me to project in the future.
I'm gonna be okay. And so I want you to just close your eyes and kind of throw your emotional brain a bone [00:39:00] first. Let it know. I, I hear you. I know you're scared. And notice where in your body do you feel that kind of like leftover uncertainty, anxiety.
Sarah: It was like, I'm scared. It's always like my chest.
John: And you just feel that in your chest and let your brain know.
Of course you feel that way. Of course you're scared. I'm not giving you what you want. I know how frustrating that is. And we just spend a little time with this anxiety before we even move into the. Other sensations and just feel your breath beginning to slow down. And this is where you start kinda showing your unconscious brain.
You're okay. I want you to just feel your muscles go loose. Notice any bracing you're doing in your neck, your shoulders, particularly with pelvic pain and vulvodynia, you'll notice you're like clenching your abs or your hips to almost protect that area that feels sensitive or broken. And just feel with each exhale, feel those muscles let go and just let yourself know, I don't have anything to protect.
There's no damage. There's just a sensation, and I don't have to protect a sensation. And [00:40:00] feel your legs loosen up a little bit. Feel your toes, even the arches of your feet. Just use your exhales to just kinda let those muscles go. When you're just practicing letting your brain know we're safe now. See, I'm not even protecting anything and nothing bad's happening and sometimes it spooks your brain letting your shields down.
Do you feel any emotion coming up?
Sarah: Uh, yeah. I feel a lot of sadness. I think when you said there's nothing to protect, um. Or the part of you that you have felt is broken, uh, got really emotional then got, yeah. Yeah.
John: And so let that sadness come up. This is another way we signal to our brain that there's nothing to protect.
We don't have to defend against sadness. This has been a long road. And just let that sadness come out and each moment you just kind of allow these things to come up. You're teaching your brain, Hey, we're safe right now. 'cause I'm not. Blocking anything. And each moment that goes by where your brain sees that your shield is down and nothing bad happens to you, it realizes, oh, we're safer than I thought.
And feel that connection with yourself, that nice kindness you have toward the sadness as [00:41:00] you allow it. And as that emotion kind of comes up and it plateaus, and then it starts to peter out, see if you can sneak in a few messages of safety. Let your brain know we're gonna do things a little bit differently, and that's why we're gonna get better.
We're gonna be okay.
So you seen that exercise, it was difficult to accept messages of safety or even positive visualizations at first. Why do you think it's difficult for the brain that's been in chronic pain or been in drama to even go there to even fantasize about, uh, good feelings or good thoughts?
Becca: Gosh, that's so true.
And um, you know, if the brain doesn't feel like it's been fully heard, it hasn't because it's expressing a message. It's saying, we are not safe here. Hey, you need to pay attention to something. And if we haven't allowed ourselves to pay attention to that first, then it's really hard for the brain to. Dial down that signal [00:42:00] and just, you know, allow ourselves to go straight to the, creating the new neural pathways of, you know, sort of the positive pathways that we want.
But I think you said it, so adeptly is the processing the trauma, or processing the fear that's gone on. And we need to process that before we can then move on to then. Showing the brain that it's okay that we can go forward and it needs all of those parts often, um, in order to get there.
John: And so this is the last piece of the puzzle. As you're watching it now, you're feeling this kind of sense of acceptance, not acceptance, that it's. Damage but acceptance that you're just letting whatever come up, come up. And now we wanna just introduce a little bit of safety. I want you to just visualize a time in your life where you felt free, you felt unencumbered, you felt that play, you felt like you were safe, and what comes to mind.
Sarah: I [00:43:00] lived in New York City for a couple of years and I loved walking there and I like put my headphones on I to music and just sort of walk. I think one time I walked like a hundred Streets of Broadway and just kind of people watching and stopping by to get a grilled cheese. And it was just like nice weather.
John: Good.
Sarah: I just, yeah.
John: So I want you to just picture that. Just visualize yourself walking down the street, you got your music on. What time of year is like your favorite memory from
Sarah: like early fall, like it's not very cold yet, but it's like nice that you can have, you know that it feels good to walk.
John: Yeah. And feel that temperature on your skin, almost like that little bit of dimming of the light in September, October, and we're just reintroducing what safety and ease feels like to your brain.
It's the lens we want you to start looking through and just imagine being that version of yourself and just looking down now in your sensations. Just watch 'em from that lens. Nothing has to change. [00:44:00] Just watch them through the eyes of a brain that feels safe. And how does that feel to watch it that way?
Sarah: It feels good. It feels like I'm reconnecting with this part that I have felt that I'm not entitled to while I'm in pain. Yeah, I, it's a big part of me that thinks like, oh, fun play, you know, doing the things I love. It feels good to like invite that part of myself and be like, Hey, it's okay. You can like I don't have to renounce.
All that is good and fun in life because of, babe,
John: this is why we do this annoying hard emotional work is 'cause your brain gets its needs met. And then the feeling of safety and fun and relaxation feels appropriate. You'll be listening to some music later watching a movie and they'll get the kinda like a little bit of like childish giddiness back and it'll be like, oh, that's what that felt like.
And if you can start increasing those moments and having your symptoms present while you feel like you're at play, it speeds [00:45:00] up the process incredibly. 'cause those things don't make sense. Your brain's like, wait, she's having a ton of fun. The sensation's there, something doesn't match up. Maybe she's not so broken.
And so like the textbook version of this would say like, don't fear, have fun, be joyful. And sometimes there's a step before that, which is taking care of the trauma that you've been through and taking care of the emotions that have come up in that trauma so that your brain feels like its needs are getting met so that that fun and excitement and easiness feels appropriate to the brain.
Does that make sense?
Sarah: It does make sense. And I think it's something that when I do somatic tracking often, right? Like rather I'm gonna go into the sensations, my anxiety piece, or it spikes and then I think, oh, I can't do it right now because then my brain is gonna know that I'm anxious and as I'm doing this.
Uh, so it's a, I think it's a good. To look at it and sort of try to sort of call in those emotions before I do it. And I think it relates to something else that [00:46:00] I have been trying to do, which is I don't have to solve the whole thing today. I don't have to solve all of recovery today. Yeah, I can just solve like the next hour.
I can just figure out what I want for lunch or what I wanna watch, or who I wanna call on the phone. I think that's solving part of your brain that is like, no, but we need to figure it all out. And I think sort of saying, no, actually we don't. That's not, that's not the homework. The homework is what do you want to do right now?
What is like the next best thing that we can do? Uh, that, that's it, that's all that you have to do. Uh, which is a big relief when you remember that, oh, I don't have to solve. The next five years of my life, the next, you know, I don't have to figure out perfectly how recovery's gonna go. Oh, that's very soothing, because I can, I know how to make myself hap happier right now.
Uh, versus like, I have no idea what I'm gonna need. You know, in [00:47:00] like a, a longer, longer timeline,
John: really liked what Sarah said in that clip about not needing to solve the whole problem.
Becca: Oh my gosh. Me too. I was like, oh, I felt like my own, like burden off my shoulders. There's Oh, yes. Right. I can just be in this moment right here, right now. Yeah. That was so awesome.
John: When you are dealing with uncertainty in your life and you, you need this kind of perspective check of, I can just take care of the next five minutes.
I don't have to solve every issue in your life. How do you get yourself back into that perspective? How do you kind of pull yourself out of the weeds of really getting scared with uncertainty?
Becca: You know, I learned this piece of information over the last couple of years. That's really key for me. And it's the idea that there are no bad decisions.
Hmm. And when I first learned it, I was like, oh, no, no, no, no. That's not true. Uh uh. [00:48:00] Absolutely.
John: They're a bad decision. I know, right?
Becca: But it's either if we choose to look at the world through the lens that either whatever decision we made went the way we wanted, or what lessons can I learn from it? And again, when we can really come to that, just belief in that we are unconditionally lovable no matter what.
We are all doing our best, and our best is enough. And I think if we can really let go of that pressure we put on ourselves and really think about that. And so my unconscious brain automatically goes to, oh, there are bad decisions. But you know, if I can take a breath and just sort of remind myself and kind of come back to, I'm doing my best.
My best is enough. What can I learn from this and, and that really helps me go forward in my life.
John: I grew up on the East Coast, and when Sarah's talking about this. Uh, fall time in New York City walking through the streets and just getting that almost sensory information [00:49:00] back of what the air felt like, or the leaves kind of the crunch of the leaves sounded like.
Mm-hmm. It brings me so much joy, but I know that when I was in pain it was so difficult to even notice those things. Mm-hmm. And it wasn't until I started intentionally just seeking them out, even if they didn't hit as well as they used to. Um, that was really kind of when my recovery turned. I, I know you're a, a, a big fan and colleague of Dr.
David Clark, and he so emphasizes this idea of fun is so important in the chronic pain journey. What do you do for fun? What's your outlet and, and how did you learn those things about yourself?
Becca: Well, it certainly took me years to learn how to have fun. I have to admit, I mean, when I was in medical school, I lived in this big house with seven people and we would watch The Simpsons every week, but I was the one that had to be paying my bills, and I still had to be doing something productive.
I couldn't just let loose. So it, it took me years, um, absolutely. But [00:50:00] again, I think that actually learning that I deserved to have fun. That I deserve to just relax and let go. Was was a lot of it. One of the things that I just love so much is nature and just having sort of the mindfulness of nature.
Sometimes even I just look at my backyard and I just. Look at the birds and I listen to them sing and I look at the sun on the leaves or the rain or the, you know, gray clouds or whatever it is. But really just connect in with the sensory experience of nature is really a great thing that I love.
John: It's been so wonderful having you today.
I just wanna s. Give you an opportunity to give a message to anybody listening who's going through their own journey. Um, any hope or any wisdom you can provide them?
Becca: Oh, yes. Well, definitely a lot of hope. And when I first learned about this approach, it was, I had sort of a [00:51:00] cognitive dissonance. I mean, I almost sort of dissociated because I was like, what?
This is what? Chronic pain being curable? No, no, no. That's not, that's not possible. But it was my best friend from medical school who was the one that told me, which is why I chose to let go of that part of the belief and then just dive in and explore. And what I say to people is pretty much everyone thinks that they're gonna be the one that doesn't get better.
And I actually developed my own chronic pain and fatigue after I learned about this work. 'cause it's about our unconscious brain, not our conscious brain. So I went through this journey for a couple of years and I also was thought that I, I was the person that wasn't gonna be able to get better. So that part is normal.
And again, it's not easy, but it's definitely more possible than you think. It's,
John: yeah. Thank you so much.
Becca: Yeah, thank you. It was a pleasure to be here.[00:52:00]
John: Thank you for listening to the PRT Podcast, brought to you by the pain rep processing therapy center. I wanna thank our guest, Dr. Becca Kennedy for joining me today. You can find her center@resiliencehealthcare.com. Finally, I wanna give a special thank you to Sarah for allowing us to broadcast a piece of your journey.
If you'd like to partake in a session for the podcast, message me on Instagram at John g Therapy where I answer questions and provide information on the tools