66% of Chronic Back Pain CURED: The Groundbreaking Study Changing Medicine – With Dr. Howard Schubiner

29:31Shawn Stevenson:And that's a great signal that, and this goes to pain principle number two, not all pain is due to injury, that there's a good chance that this is more of a neural circuitry issue and not necessarily due to an injury. This is something that we can have more influence over if we're aware. And just being able to see, and again, that, hey, you know what? Sometimes my pain is a five, but then other times it's like a three or sometimes it's like a two, sometimes it's like a seven. But just the fact that it's constantly changing, if you have an injury, it's pretty consistent. But different conditions, you mentioned the weather changing, stress changing the volume.

30:18Shawn Stevenson:Time of day. This is a good indication that this is not due to it. And can you talk a little bit more about that? So pain lesson number two, not all pain is due to an injury. So we did a study, my good friend in Louisiana, Bill Lowry. He's a physiatrist, PM &R doctor, and he took 222 consecutive people coming to his practice with chronic neck and back pain, no exclusions. So if they had a tumor or a fracture, whatever, they were all included. And he looked at their MRIs and he examined them and he asked these questions that you're asking right now. 98 % of them had abnormal MRIs. The average age was 50 or so.

31:03so you know a typical doctor would have said 98 percent of you have damage in your back that's the cause of your pain it's obvious couldn't be more simple but bill didn't do that because he knows the data that 80 90 percent of people in these age groups have had these same abnormalities so then he looked deeper and asked these questions the results and we published this study in the Journal of Pain, the results were 88 % were non-structural. 88 % were non-structural. About 6 % were, he thought, structural. About another 6 % were probably a hybrid of some of each. So obviously, injuries can cause pain.

31:47I'm a doctor. I know that. But when you think about the fact that we think, and this has been corroborated in some of our other studies, 80 to 90 percent of chronic back pain non-structural. What about headaches? The vast majority of people with headaches are non-structural. The vast majority of people with abdominal pain, pelvic pain, widespread pain are non-structural. The vast majority of people with chronic anxiety, chronic depression, chronic fatigue, non-structural. I mean, there's things that can cause, medical things that can cause anxiety, high thyroid levels, cardiac arrhythmias. There's things that can cause depression, low testosterone levels, low thyroid levels, right?

32:30There's things that can cause chronic fatigue. But when you examine closely, as we've done over these last, I've been doing this for 23 years now, the vast majority of people with these chronic conditions that modern medicine has not great answers for, sometimes they do, and that's great, but oftentimes they don't and people are suffering. We think that people can have a good chance at not just coping with it better, but recovery by using this model.

33:03Shawn Stevenson:Yeah. Can you talk a little bit more about the neural circuits? So, you know, I wrote a chapter about the neurophysiology of chronic pain a while ago, and I wrote it with a great neuroscientist named Ian Kleckner at University of Maryland. And I kept looking at the literature and pointing out why he's saying, well, what about the dorsolateral prefrontal cortex, Ian? What about the insula? What about the anterior cingulate cortex? You know, what about the prefrontal cortex? And he's like, Howard, it's the brain. And it's, and you know, and there's, there's data and we, you know, part of that boulder back pain study, we did fMRIs at people.

33:46And we found areas and a lot of great neuroscientists that I've worked with and others that are doing this work have found different parts of the brain that are responsible and can be seen as being involved with chronic pain and other conditions. But the circuits are very broad. And it's circuitry, you know. And that's why he was telling me, you got to think about it more in total. And the thing is that they can be learned, the whole point of neuroplasticity is understanding that neural circuits can be learned. Why do some people have pain that's worse with certain types of weather or certain, some people it's worse with heat, some other people it's worse with cold.

34:36Because that's been learned by the brain. These associations have been learned. So the story I always tell about this learned associations is my helicopter story. So, and it's a true story, is a guy I met who was in a war a long time ago. He got injured, trapped in a wound to his leg, had a lot of pain, got medevaced out in a helicopter. Okay? What happens to his injury? They heal. All injuries heal. Rule number one, all injuries heal. Rule number two, scars don't hurt. Okay? So his injury heals. What happens to his pain? It went away. His brain turned it off. His brain could have kept it persistent.

35:14I saw, I got an email today from a person who said, I had surgery and I've had pain ever since. Well, unless the surgery went wrong, which chances are it didn't, everything's healed. The pain is now being run by the brain. Anyway, his injury healed. The pain went away. He's fine. 20 years later, he's walking down the street. He gets startled by the sound of a helicopter in the sky. All of a sudden, he gets the same pain in his leg he had 20 years earlier. His brain learned the pain. It remembered it as a neural circuit, and then it activated it at the sound of a helicopter. That's a conditioned response.

35:49That's the kind of pain that once we see that, we can help people unlearn it. Wow.

35:56Shawn Stevenson:That's so powerful. You know, just even thinking about that and how these emotional injuries create pain as well, it has a potential for that. In that instance, it's like a danger signal. Totally. And that circuitry exists from a traumatic thing that happened and he just went on about his life. But there was a danger signal. There was a triggering event that can activate that pain pathway, essentially. And it can be as real as an injury happening. And what if you were criticized when you were young? What if you had a critical parent who nothing was good enough for? What if you had abandonment, parental loss, and then you get older and your brain is remembering that.

36:50It's sensitized to that specific type of emotional injury. And then you grow up, you're in your teen years or you're in your 20s, and then you get a partner. Oh, the partner's really critical. Or the partner seems to be abandoning me or threatening to leave. And what does that do to those neural circuits in the brain? The neural circuits have been sensitized to that specific type of danger. And then the brain can turn on stomach pain or headache or anxiety and so the danger in this case wasn't a physical danger that the brain is responding to but an emotional danger that the brain is responding to and when people can understand that it can open up a whole whole new way of of understanding you know what's going on because the brain is trying to protect them from being abandoned the brain is trying to protect them from being criticized.

37:49Shawn Stevenson:Silly brains. Yeah. And what happens when you do that? You know, when you look at it that way, you don't develop disdain for this person because they have pain. That's not real. You don't develop contempt for them. You don't blame them for faking. You understand them and you understand they're in this pain or other symptoms in the context of their life and you help, and then you have compassion for them. You wouldn't want to be in their shoes. And how many times have I seen people who were heavily criticized or abandoned or whatever when they were younger, and they learned not to have compassion for themselves?

38:33and then that compounds the injury and so part of our work is helping people have more compassion for themselves

38:46Shawn Stevenson:you mentioned this already but just to touch on this really quickly so pain lesson number three all injuries heal and this is directly from your book all injuries heal and it is the brain that decides whether to turn the pain off or make it persistent. Exactly. And nothing could be truer than that. We're talking about injuries healing and the corollary to that is that scars don't hurt. People have keloids, really big scars don't hurt. And one of the, again, just going by the data, if you look at post-surgical pain in scars, areas of scarring where the surgery was, if you look at cesarean sections, women who have childbirth, they have a scar from the surgery, the rate of post-surgical pain is three to five percent.

39:44It's pretty low. If you take women who've had a mastectomy, breast surgery for cancer, the rate of post-surgical pain is 30 to 50 percent. What's different? It's not the scar that's different. It's the emotions that are different. Having a baby versus having cancer. Huge difference.

40:08Shawn Stevenson:I want to ask you about this. And I, you know, this is something that we have not talked about recently, but it is kind of this cultural phenomenon that's taking place right now. You took some time in the book to even kind of lay out morbidity versus mortality and talk about all the morbidity issues that our society is dealing with right now. But in recent decades, there's been this strategic war on pain, like a war targeted at eliminating pain. And the result, have we won the war? Pain's gotten worse. And there was a, of course, behind that has been this focus on, specifically on external ways of manipulating biochemistry through medications, pain medication, specifically the opioid crisis specifically.

41:04Shawn Stevenson:And this war on pain, again, you kind of lay this out in the book as well. It's not really bearing very great results because we're not addressing where the pain is really coming from. And what a lot of people who've turned to these very strong pain medications have found is not just the physical pain, but it also is the emotional as well. And being on these types of things can start to mute all kinds of data potentially. And it's not helping us to address the root cause of the pain. So I want to ask you about your perspective on this war on pain. Yeah. So to give props to modern biomedical science, we have had improvements in cancer therapy in the last couple of decades, improvements in heart disease treatment, improvements in stroke treatment, improvements in diabetes treatment.

41:53All these have come about for biomedical problems with good, reasonable biomedical solutions. Rates of a lot of these disorders have actually gone down. In pain, it's doubled. Back pain has doubled over the last 20 some years. Other pains have doubled. We're talking about a worldwide epidemic of chronic pain. Anxiety has gone up. Depression has gone up. Chronic fatigue has gone up. All of these things have gotten worse. Not because people are different. Our genetics are different. Our bodies are different. But because of what's going on in society and how biomedical treatment is geared, as you say, toward the biotechnological approach.

42:38If you look at, there's an article just recently in JAMA Neurology, just came out, and they're talking about how pain is in the brain, how the brain constructs pain. And I'm like, yeah, yeah, you're right, exactly. And you read the article and it goes on and they say, okay, what are we going to do about it? We're going to modulate pain. Well, how are we going to modulate pain, all these biotechnological solutions, that's their solution. We're going to do these zapping. We're going to put electrodes in. We're going to, all this stuff. And pain is so diffuse and it's so individual and it's so related to changes in our society, social injustice, COVID, uh polarization in society uh social media uh neglect and abuse of children i mean there's so many things that are involved in in these uh disorders that are of a psychological and social nature and the biomedical solutions haven't worked and so all we're saying is at least ask the question at least ask the question of what's going on underneath and most of the time it doesn't it's not hard it's not hard to find the answers when you tune into people and you talk to them and you listen to them and you hear about their lives and you see what's been going on in their lives and how that is connected to the onset or the exacerbation of their pain or other uh symptoms

44:08Shawn Stevenson:yeah amazing can you help us and again everybody needs to have this book if it's not for you you know somebody who is struggling with pain so unlearn your pain please get yourself a copy get a copy for somebody that you care about you help us to actually analyze some of these pieces and also provide some direction on what to actually do about it to find that relief that we're looking for. But just for everybody listening today, if we could talk a little bit about how we can assess for ourselves, maybe have some insight into, is this a neuroplastic pain versus a true structural injury that's causing the chronic pain that we're experiencing?

44:53Shawn Stevenson:What are some ways that we could start to assess this? Yeah, yeah. Great question. Well, first, you know, everybody needs medical evaluation. You don't want to miss a medical disorder. Nobody wants to do that. I don't want to do that. I'm a very careful and cautious doctor paying attention to looking for disease if it's there. So doing that first, ruling out a structural problem. Most of the time, most of the people we've seen have gone to great lengths to rule out a structural problem and haven't found it. Either the doctors say, we don't know what's causing it. We're not sure, all the tests are normal.

45:32Those are signs that it's most likely neuroplastic condition. Then if you get a diagnosis, if the diagnosis is one of the conditions that is commonly seen in our ballpark, irritable bowel syndrome, migraine headache, tension headache, fibromyalgia, chronic pelvic pain, chronic neck and back pain, again, making sure there's no structural problem. Anxiety, depression, chronic fatigue, long COVID. There's a whole variety of other newer emerging disorders. POTS, postural orthostatic tachycardia syndrome, MCAS, mast cell activation syndrome, Ehlers-Danlos syndrome. All these are being viewed by a lot of physicians now as being structural and maybe they're not.

46:25So that's first step. Second step is what we were talking about before is investigate deeper. Do the symptoms come and go? Do they turn on and off? Are they variable? Are they in a wide area? Do they not make sense medically? Are they triggered by innocuous stimuli like sounds, light, heat, cold, weather, stress. Do they come on when you anticipate having, being in a certain triggering situation? And that's one of the tests we use. It's amazing how common this is, and I write about this, and I do it every day, is one of the stories in the book, I was talking to a woman who had severe stomach pain.

47:08It was like three or four years she'd been to the top medical centers in the country. Nobody could really figure it out. Nobody could tell you what it was. But she noticed that she had more discomfort when someone touched her belly. And why would that be, you know? Doesn't really make sense. There's something going on inside, just touching the skin. So I had her close her eyes and take her own hand and start moving it toward her belly. And the closer she got, she got within a couple inches, she said, oh, the pain just went up. She hadn't even touched herself. Or I had her imagine touching herself.

47:47It's another way you can do this. Just imagine touching it there and the pain goes up. It's like, wow. It's like that click moment where people can understand it. So we're using all these techniques and tools for evaluating the underlying source of the pain and then looking at your life. What was going on in your childhood, were there sensitizing factors? And then looking at your life later in life, were there stressful life events that correlated with the onset or exacerbation of the symptoms? When you put all that together, it's usually pretty clear, Sean. It's usually amazingly clear.

48:27Shawn Stevenson:With this being said, again, being able to have some awareness, which is part of kind of, if we're looking at kind of practical, with this being related to the brain, rewiring techniques really, and what you're teaching people, I want to talk a little bit about some of these. And you mentioned this a couple of times already, and I don't know if this is like the first piece of it, but it's validation. Yes. So why is that so important? People need to know that they're seen and they're heard. People need to know that their pain, their fatigue, their anxiety, their depression is real. It's not all in their head.

49:07It's not made up. It's not fake. It's not imaginary. People need to be validated. It's so important. I can't stress that enough. I say it all the time. I say it to every person I see. I teach it to every doctor and therapist that we do training for. Nothing is more important than that. If people aren't seen and heard why would they trust you? Why would they believe you? Why would they trust you when you tell them something, especially something that's at odds with what other doctors have told them or with what other alternative doctors have told them? Why would they believe you unless you know you love them?

49:46Basically, I mean, that's just how I put it. And so that's, it's just crucial. That's step one. And then once we kind of do that, people don't, they sometimes can lose, drop their guard. And, you know, we've had people who, and I understand it, who are offended because no matter how nuanced we say it, or we say it's not in your head, but it is in your brain, that's hard to grasp. And people are in such severe fatigue or such, they can't get out of bed or such severe pain that they can't move without severe pain? How can they possibly grasp this idea that, oh, it's all in my brain? Come on. It's so at odds with what we all know.

50:36But on the other hand, people sometimes can get it so quickly. And like I think we were talking earlier, sometimes you can read a book. Dr. Sarno's books have been famous for this for 40 years now, at least, people can read the book, they see themselves in the pages, bang, pain goes away in a day or a couple weeks or whatever. Or it goes away and then it comes back and then it goes away again and it comes back and say, holy God, what's going on? Well, neural circuits on, neural circuits off. So it's frequently amazingly obvious once you open the door to understanding this model.

51:17Shawn Stevenson:Yeah. Thank you for bringing that up too of somebody again, if you're experiencing the pain and you're like, no, this pain is in my leg. What the hell are you talking about my brain? Like this is the pain right here. And this is a result of separating ourselves into parts and not really understanding. We are one whole synchronistic system and everything is connected to everything. and so keeping this in context but also part of this as well and this is another start step in this rewiring the brain and you do this so well is just bringing about the awareness that it is the brain that is potentially behind the pain that you're experiencing just having the idea because for most people we don't we don't think about that we don't consider it because we see the pain is the pain.

52:08Shawn Stevenson:And our practitioners, unfortunately, are trained to attack the pain. Oh, the pain is in your back. Let me crack your back. The pain is in your back. Let me do this surgery. Let me prescribe this medication. And again, it's kind of this superficial going after the pain, targeting where the pain is expressing and not rooting it back to the brain's decision of whether or not to express that pain for you. And I've had this myself and everybody has really. it's a huge it's part of the human condition it's part of the mind-body connection that everyone has and i was in my 30s and 40s i was being a young doctor i wasn't sure i was good enough i was young kids i had family i was trying to teach i was trying to do research i was trying to run this run these programs and every now and then you know every month or two i'd wake up in the morning my neck would be like way over here i'm like i'd go to work like this and they go well, what's wrong with your neck?

53:05I said, I don't know. I must have slept wrong because I had a physical understanding of it. And I went and I had x-rays and I had bulging discs in my neck and I went to PT and then it would get better and then it would get worse again and then it would get better. And it was a signal. My brain was giving me a timeout every now and then when things built up too much, but I didn't recognize it at the time. And I still get pain now. I mean, I'm not immune from this. I'm human. and uh you know it's it's funny it's not funny but it's funny when I when I lie down in bed at night and my legs are like aching and I I didn't do anything I mean nothing changed I was did my normal day or whatever and it's like my brain just doing its thing you know and it's just so strange when you have this understanding you can see these things you can see them in yourself Yeah.

54:00Shawn Stevenson:How often do people come in like, you know, I think I slept wrong, you know, like people were getting into fights at night, you know, barely like you're waking up, you went through a battle. But it's again, even even when we're sleeping, we are our brains are very active and processing. And there's so many stressors. And, you know, just to go back to, I, I'm so grateful that you're talking about this, because the fact that back and neck pain is doubled, you know, in our society, is not an accident. And I think that the conditions that we're existing in today, when we are this piece with validation and for somebody to feel seen and heard and to feel like they matter, our attention is so scattered today.

54:44Shawn Stevenson:People are reaching out through social media, for example, and posting, looking for attention, looking for likes to feel validated. And the people that might be there in your life, your friends, your family might be so distracted. They're not really seeing you. How many kids are now growing up in conditions where they're not really being seen and acknowledged as much by their caregivers, by their friends, because friends get together and they hang out on their phones together, right? And so, you know, we're adaptation machines as well. So, you know, I'm always optimistic that we'll figure things out through this, but we can see that there's this very strong connection between our lack of attention for one another and that deep human need to feel seen, to feel like we matter, to feel that sense of contribution as well.

55:35Shawn Stevenson:And so we can find ourselves looking to abnormal places to address these needs, or we can start to express dysfunction or even pain because of not getting these needs met. Yeah. And how many people, I've just seen so many, so many people who just put pressure on themselves. and aren't feeling good enough and aren't feeling smart enough or beautiful enough or whatever, especially young people. Because these disorders that we're seeing, they're not increasing with age, like the mortality conditions, cancer, stroke, heart attack, they all increase with older age. These conditions strike young people, people in their teens, in their 20s and 30s and 40s, people who are going through their lives and trying to figure things out in stressful life conditions.

56:33And every now and then, when enough stress builds up, your brain is going to send a message. And the message could be a knee or a toe or a nose or, you know, a shakiness or, you know, a stutter. So many things. Or dizziness and lightheadedness. So many ways the brain can send these messages of alarm. And then if we don't understand it and we kind of go to the biomedical and start to worry about it and focus on it and it gets worse and worse and our focus is on that as opposed to what's going on in our lives.

57:17Shawn Stevenson:When it comes to energy and performance, it all starts with the powerhouse power plants of our cells called the mitochondria. Our mitochondria are so abundant, they actually make up about 10 % of our overall weight as adult human beings. We got a lot of mitochondria to run a lot of processes. Now we want to make sure that we're not gumming up that process of energy creation. And not only that, how can we add to it to create more mitochondria and more energy efficiency? Well, one of the most important components nutritionally has to do with these incredible minerals that carry an electric charge called electrolytes.

57:55Shawn Stevenson:In particular, something like magnesium, for example, is required to make new mitochondria. It's a process called mitochondrial biogenesis, the creation of new mitochondria, depends on magnesium to be present. Pretty amazing. Plus, we've got this remarkable sodium-potassium pump that has a lot to do with the energy exchange going on throughout all of our cells. It isn't just about the mitochondria, of course. There's a huge data network that runs this amazing human entity, but again, it all works together. And those three electrolytes in particular are an important place for us to focus. And so we want to make sure that we're getting plenty of electrolytes from our diet.

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59:55Shawn Stevenson:Element is a big part of my life, my team's life, my family, friends, it's really an incredible supplement, super easy to travel with. I always have their little packets on the go with me when I'm traveling. Also, when I'm working out, I was just in my water bottle today during my workout. Truly love Element. Head over, check them out. It's drinklmnt.com to take full advantage of this very special offer and this special gift. And now back to the show. One of these preceding steps as well, and you talk about this in the book, is pain reprocessing therapy, so PRT. Can you talk a little bit about that?

1:00:32Yeah. So pain reprocessing therapy, got a long history, a lot of ways to do it. And it's recategorizing the pain or the other symptoms as non-dangerous. It's viewing them from a lens, which looks at it from a lens of curiosity, like what's going on here? Why did it go up? Why did it go down? Why did it shift? Why did it move? and what was I thinking about when it happened. Can't tell you how many times people have saying, well, pain wasn't there and then I thought about it and then it came. Like, okay, that explains it. Now you understand it better. And so it's kind of allowing yourself to lean into the sensation as opposed to fearing it and being scared by it.

1:01:20And we all have experience in leaning into a sensation. Nobody liked coffee when they first had it, when they were a baby. Nobody liked beer, whiskey. Nobody liked these things, lemons, dark chocolate. But we leaned into them and we learned to actually like them. If we can take these sensations and not fear them and lean into them a bit and tell our brains we're okay, as I was saying with that guy who was walking, tell ourselves we're safe, we're not in danger. This is not dangerous. I'll be fine. Even if I experience it now, I'm going to get better. And I'll just keep moving and I'll expand my life.

1:01:58Because as I think you said earlier, people with pain, they tend to, their lives shrink and they get smaller and smaller and they do less and less and less. More fear, more pain, more fear. It's a vicious cycle. And when they can reverse that and expand their life and do more and find joy and meaning and purpose in life, all of that is involved in pain reprocessing therapy. I love this. And it works. It's amazing. It's amazing that it actually works, right? And I've seen it firsthand. I've seen it firsthand.

1:02:32Shawn Stevenson:You know, just again, it's a shift in perspective because it takes it away from it being one problem and one solution only to internal investigation and self-assessment, the ability to be more aware of the potential information, the data, because pain is information as well. And we tend to just attribute it to like, I have this pain because this bad thing happened. And that's the end of the story, this bad physical thing. Right, right. And going back to one of the most important overarching messages from today is that emotional insults, emotional pain lights up from the knowledge that we now have today, it's the same parts of the brain that are associated with physical pain as well.

1:03:22Shawn Stevenson:And so we can have physical pain manifest by emotional input, by what we would consider stressful events taking place. And now I know sometimes, again, it could be something that we might see as a micro stressor. Like that wasn't a big deal, but it can be an accumulation, you know, the death by a thousand cuts type of scenario. Yeah, absolutely. And there are certain emotions that tend to be very inflammatory and also the accumulation of these things over time. And what I want to ask you about specifically, because some of these emotions, especially today and the way that we're conditioned societally, they are deemed to be dangerous, unnecessary, primitive.

1:04:11Shawn Stevenson:Yeah, yeah. Like we've got this full - They're bad, bad emotions. Bad emotions, right? We've got bad emotions. Anxiety is bad. Anger is bad. Exactly. But we've been blessed with this vast array of different emotions that we create names for that are means of us expressing ourselves and helping to process data. Now, of course, there can be, quote, bad anxiety. There can be quote, bad anger, but this can also be good anxiety. And as a matter of fact, one of my friends and colleagues who was sitting right in that chair, Dr. Wendy Suzuki, neuroscientist at NYU, good anxiety is what her recent book is and the work that she's been focused on and the value that can be found in these so-called bad emotions.

1:04:52Shawn Stevenson:So with that being said, we can, and I know coming from the conditions I come from, suppress certain emotions, especially, you know, once I learned how dangerous anger was and how I was expressing it in my environment, constantly fighting to just being like, I'm just not getting that angry anymore. Right. And not seeing the value in expressing if I'm starting to, again, taking all these insults, these micro things, and I'm just like, I'm not an angry person. And so I don't give myself permission to even feel that and how that can build up and potentially manifest as a physical symptom. It's so important, what you're saying is so important.

1:05:36So let's talk about anger for a minute. So one of the pain reprocessing therapy is one of our treatments, but the other main treatment is called emotional awareness and expression therapy that I developed with my colleague, my great, brilliant colleague, Mark Lemley. And emotional awareness and expression therapy is recognizing that there are no bad emotions, that emotions are there for a reason. If you get angry, there's a reason for it. You were hurt, you were slighted, and you were neglected, you were abused, you were disrespected. There's social injustice in the world that makes you angry.

1:06:12And we need anger to protect us. People religious say, God gave us anger to protect us. And it's true. We have this emotion. And we need anger if someone attacks us to protect us. If we're angry all the time about things in our lives and we take offense at every slight and we're holding in that anger all the time, year after year, that's going to be toxic to us. And that's going to cause our brain to turn on messages of pain, fatigue, anxiety, depression, whatever. So what do we do with anger? People are stuck because if they hold it in, they're hurting themselves. If they let it out in violence in the real world, they're going to jail.

1:06:59That's not good. So what do we do? This emotional awareness and expression therapy helps us to allow our anger to be expressed in a safe and healthy way. For example, one of the stories I like to tell is about three years ago, my hospital fired me. They didn't fire me, but they let me go. So they terminated by, they didn't renew my contract. Now I'm a doctor there for 20 years, esteemed doctor, right? What doctor gets fired? Like, and, but it's a budget crisis. And I, what do I do? Do I make money for the hospital? Not really. I talk to people. Doesn't make a lot of money. So they let me go. One month, gone.

1:07:43Okay. And then I get back pain. And I'm telling people, hospital, let me go. Hospital, let me go. And they were like, oh, yeah, everyone gets fired. I've lost jobs, too. And I'm like, OK, it's kind of funny. You know, I'm this well-esteemed doctor, supposedly. But we love you. Don't take it personally, right? And I have back pain. And so I'm in my car a couple weeks later. And I'm doing this pain reprocessing therapy, mind you. Like, it's OK, Howard. You're fine. Keep moving. Keep bending. Go to your classes. They're not working. Still got this pain limping around. And so I'm in my car a couple weeks later, and I'm like, you know what?

1:08:22It's not funny. Do you guys swear on this show? You have full permission. It's not fucking funny. It is not fucking funny. And I have anger about it, but I was just holding all that anger in. So I start screaming, yelling. And there's no one in the car. I start screaming, yelling. Fuck the hospital. Fuck this. Fuck that. Screaming, yelling. getting all this anger out in a safe and healthy way, right? I'm angry. Honor that anger, but don't take it out in the world. And then I could relax. I just let it all out. I didn't hurt anybody. I didn't go to, not going to jail, but I let it out in a powerful way.

1:09:04And sometimes that means imagining beating up somebody. Like if someone, you know, women who've been assaulted, you know, and they're holding all this anger in. There was a woman, one of the stories in my book is about a woman who was assaulted as a young girl and she had this back pain later in life and she imagined going back and beating up the assaulter, imagined tearing him off of her, you know, hitting him, punching him, throwing him out, knifing him, whatever, whatever the anger does, it doesn't matter, letting it all out and she took herself to safety and she gave herself compassion. and she came out of that experience, which was like 15 minutes, back pain gone.

1:09:51So for me, I could let all that anger out, and I just took a deep breath and let it go. So now I'm in a much better place, right? But I had another emotion, hurt, sadness. I'm kicked aside, you know? Like, who wants to be kicked aside? And I had to recognize that I had sadness that I hadn't expressed either. that I wasn't even acknowledging to myself. So I allowed that sadness to come in. Well, anger calls to protect. You want to protect yourself from anger. Sadness calls to connect. You need to connect. And who did I need to connect to? Myself. I needed to connect to myself. I needed to soothe that hurt with compassion and caring.

1:10:38And a friend just happened to call me, one of my doctor buddies he's like howard i'm so sorry you know being really kind and sweet to me and i allowed this compassion to come in to soothe the hurt and then i began to find compassion for the hospital like they put up with me for 20 years i never i never made any money for them and they gave me a place to do this work and i forgave them which is a powerful act right what happened to my pain gone and that's an example of working with them understanding and so often like you said a minute ago Sean really really wise what you said he said it's often the emotions that we don't recognize yeah that are the ones that are kind of eating us up

1:11:25Shawn Stevenson:inside yeah yeah wow thank you for sharing that story that's so powerful and you know thankfully your life is unfolded in a way that you had those tools, but a lot of people don't. And those 20 years that you were there, not making money for them, but changing a lot more lives than anybody else, it was just, it was a chapter. It was an important chapter. And now to be able to really expand this message in such a powerful way, and you've impacted the lives of so many people that I've already, that I know who were in my life, prior to even meeting you. And it's just really remarkable. And I just got to say this.

1:12:06Shawn Stevenson:I'm just going to say it like it is. The way that our system is constructed, this is what over$5 trillion spent in healthcare in the last, annually at this point, like 5.7 trillion, some crazy amount of money. And yet we're the sickest society in the world. We're just not getting better. And people are not living longer per se, they're dying longer. So we're great at like helping to subdue some of the symptoms, but the quality of life is just diminished so much. And what you are giving people is something that is already within them. And, you know, again, to say that this isn't making money for that system, you're generating incredible wealth for the economy by people getting back their quality of lives.

1:12:57Shawn Stevenson:and being able to contribute and being able to, you know, invest that back into society. And so. And it's and it's beginning to it's beginning to be noticed because of the research in part in the medical field. This change that's happening in society is not going to come from within medicine for the most part because it's probably too well entrenched. all these economic incentives, et cetera, are kind of going in the wrong direction. But, you know, including the pain reprocessing research, we also have some research, randomized controlled trials with emotional awareness and expression therapy, this emotional type processing work.

1:13:41And these randomized controlled trials have shown far better results with this method than the standard psychological treatments for pain, which is cognitive behavioral therapy. And so it's beginning to be recognized if you look in some of the publications. The AARP had a magazine the other day where they mentioned pain reprocessing therapy and emotional awareness and expression therapy as standard treatments. It's getting into the literature. And so So, you know, we're optimistic. We're optimistic that this change will, you know, gradually, it's a person-to-person thing, really. It's not, people just have to discover it for themselves and hear about it.

1:14:33Shawn Stevenson:Yeah. And this isn't, this again, just to summarize this, this isn't an investment in this multi-trillion dollar system in a monetary way, really. Again, this could be the cost of a book or the ability for a patient to come see you. And, you know, again, having these tools and being directed to a treatment that is already within them. And so I got to say this outright. It's the most valuable treatment that there is. And there isn't a price that you can place on that when somebody gets their life back or just to feel better, just to be able to do some of the things they want to do in their life.

1:15:10Shawn Stevenson:or just to reduce the volume of that pain or turn that pain off. And I appreciate you so much for doing this work and for, you know, really being a powerful leader, you know, to really get this message out there and more practitioners. Again, several of the people that you've helped that, you know, that I know they're MDs as well. And so they're being able to affect their patients in a greater way. When people do this work and they find it for themselves, the first thing they want to do is they want to tell somebody else. The first thing they want to do is they want to help other people. And that's the gift that keeps on giving.

1:15:53And that's why this work has been so great, because we've trained so many people. We're training people all the time. We're affecting people. And that's a person-to-person thing that's leading to a spiral of recovery. and nothing could be more gratifying than seeing that. Because it's the ideas. It's not me. It's not one person. It's not one research study. It's the putting it all together. And it's the ideas that make a difference. And there's nothing more powerful than a good idea whose time has come. Yes. And so that's what we're talking about. Is this the time? You know, what time is it? And is this the time that we should, we can begin to see this spreading and making a bigger difference?

1:16:46Yeah, it's time to wake up.

1:16:48Shawn Stevenson:Unlearn your pain. So what can people expect from the new book? Well, I try, I tried to not hold anything back. I tried to put everything we know about it. All the research that we have is in there. All the science is in there. The science of the brain, how the brain works. There's a whole chapter on placebo and nocebo effects. We kind of hinted about a little bit. There's sections on each of these processes that we talk about. There's a lot of myths that are exploded in there. There's four big myths about back pain. There's some myths about depression and antidepressants. So there's a lot of stuff in there.

1:17:32And then there's a whole sequence on treatment, on pain reprocessing, on emotional awareness. All that stuff is in there. So there's actually a recipe in there for people if they want to use the techniques for themselves. And a lot of times people don't need a doctor. They don't need a therapist. You know, they can really find what makes sense for them and use the model to get better. That's right.

1:18:01Shawn Stevenson:The model. Hell's show, baby. Where can people pick up a copy? It's, you know, it was published by The Open Field, which is Maria Shriver's imprint through Viking Penguin Life, which is Viking Press, which is Penguin Random House. So it's available everywhere. And we do have, I want to say one more thing, we do have a non-profit organization, the Association for the Treatment of Neuroplastic Symptoms. This is our non-profit, educational, 501c3, on the board. We've got a lot of great people, doctors, therapists, the public, anybody can join our organization. In a sense, it's kind of a movement of people who believe in this work and want to tell others about it.

1:18:46And, you know, we have an annual conference and we have lectures and all sorts of stuff that really trying to, you know, not profit off of this work so much, but spread it in a way that's educational.

1:19:04Shawn Stevenson:Yeah. I believe that this is going to be normalized, this information, this science, this treatment, because it works. And as you mentioned, there's nothing more powerful than an idea whose time has come. And people want to feel good. They want to live a full life. And just to go back to that sentiment, we don't describe what we see, we see what we describe. And we can start to describe a world that really works for us, a body and a sense of purpose that works for us and start to cultivate our life around that. But we're gonna have to take back control of our minds. you know, and really get this training, get this education.

1:19:47Shawn Stevenson:One of those first dominoes with unlearning your pain is the awareness. Right, right. And so you do such a great job of like, again, peeling back the layers, lifting the veil so we could see like, oh, and you start to inquire and, you know, it's really special. So everybody pick up a copy, unlearn your pain right now, everywhere that books are sold. Oh, it's such a pleasure, Sean. I appreciate you. Appreciate what you're doing. Thank you. Same, same. I appreciate you so much. The one and only Dr. Howard Schubiner, everybody. Thank you so much for tuning into this episode today. I hope that you got a lot of value out of this.

1:20:25Shawn Stevenson:If you did, please, you already know what to do. Share this with somebody that you care about. This is a very powerful and important topic to get more education on, as we discussed, awareness is one of the first dominoes with helping to ease and even cure. And I don't use a term like that lightly, but to be able to truly have an effective and sustainable treatment when it comes to pain. This resource with Dr. Schumacher is invaluable. so absolutely make sure to check out his new book unlearn your pain follow him check out his work through his other videos and he's actually a part of an incredible documentary and literally just going through and sharing the experience of patients who've gone through this therapy and when so many things failed them and they tried what they believe to be everything to reduce or to eliminate the pain that has debilitated them in their lives.

1:21:26Shawn Stevenson:And finally being able to find a solution, Dr. Howard Schubiner is truly, truly a pioneer and a leader in not just pain management, but finding real science-backed solutions. So please share this with somebody that you know this could be helpful for. And let's make good health. Let's make education. Let's make empowerment go viral. All right, and it happens just one person, one share at a time. So make sure to share your voice. You can share this on social media as well. And you can tag me, I'm at Sean Model on Instagram. Just share your voice. And again, you never know whose life you can touch, who are looking for solutions because tens of millions of people here in the United States alone are dealing with chronic pain every single day.

1:22:16Shawn Stevenson:And they are looking for a solution. and we have on today, this individual that you heard from, has published multiple well-constructed peer-reviewed studies in some of our most prestigious peer-reviewed journals in outperforming standard of care over six times in one of his recent studies, six times more effective utilizing his strategies versus standard of care. And so it's incredibly powerful and valuable. And again, I appreciate you so much for sharing your time with me today and of course, extending your ability, sharing your voice to help other people. We've got some amazing masterclasses and world-class guests coming your way very, very soon.

1:22:56Shawn Stevenson:So make sure to stay tuned. Take care, have an amazing day, and I'll talk with you soon.