Ep 24: "Navigating Shame and Pain in Chronic Illness: A Conversation with Lexi Gross LCMHC”

  • This is a rough transcript created with Artificial Intelligence technology. Any misspellings and sentence errors are a result of imperfect Al.

    Hi Lexi. Hi. Thanks for being back on the show. Of course. Thanks, Felix. Yeah, I'm excited to talk to you again today. Lexi was on another episode. Oh. I probably should know what episode it was before before we start talking, but that's okay. I'm not, I'm not a podcast professional yet.

    Bye. Yeah. Lexi was on a, a previous podcast. We talked a lot. The body and just how chronic illness kind of I think we talked a little bit about relationships, feeling like a burden that sounds like, like what our conversation was about. Yes. Yeah. And today we wanna talk about, we wanna talk about shame, specifically, how it comes up in the body when you start to feel better or when you start to kind of, Work on some of this stuff in therapy, especially through a somatic experiencing lens, which is known to help reduce physical pain in the body.

    It's not ever guaranteed, but, and it's not an outcome that we go in saying, you know, Hey, we're gonna reduce your pain. But a byproduct of se often is that your pain is is reduced. And so this can kind of sometimes throw you for a loop as the client, because you're kind of like, h how is this happening?

    Like, we're, we're just talking about this. You know, does that mean this is in my head? And and that, no, that's not what that means. So, Le Lexi and I are gonna talk about that today. Lexi do you wanna kind of take off? Sure. Yeah. When you reached out with this comment, it was like, really nice timing.

    I've been working with, I mean, a number of my clients on different, various types of pain or symptoms and. Often after spending time with the client session, we do some SE related work and maybe we're like really focusing on pain and it's available to pay attention to it and work with that. And how it shows up.

    And usually there's like a reduction in it in some way or like a different quality that comes up. And that's like a really interesting thing for my clients to experience. And then the next session will come up and be like, oh my God, I had a flare up and I couldn. Do any of this and it just stayed and it was X, Y, Z and I don't know where it came from and why didn't these things work?

    And usually when we like slow those things down there's like more to the story. And I think that's where the shame and like pain can get complicated is we have these. Single stories of what our pain is or what these symptoms are. And when we quote unquote fix it in one way, we think it's gonna apply and lead all these other ways.

    When like the body's nuanced, the pain is nuanced, the symptoms come out or nuanced. And so how we wanna like work with it also needs to be that way. So there's like flexibility around when it comes up and what it needs to, to like attach it. Yeah, you just mentioned the word single story. Can you kind of give us some context about what that means?

    Sure. So let's see. I use a lot of languaging around, like the story we tell ourselves, and it's usually attached to pain anxiety symptoms, anything that, a belief system that we have about ourselves. And so a single story usually might be like a snapshot or a thought that comes up, or meaning around why we are having.

    Pain or this symptom at this time, or why are anxiety is so bad at this time and this single story tends to be like, kind of like with like blinders on. And. Can be rigid when we're in that more activated place, there's less room for compassion, perspective taking flexibility. So the single story is, yeah, like maybe what we're attaching to this pain.

    That's usually from the past that we've maybe misapplied. Yeah. Like for example even, even as simple as I'm flaring up because I ate night shades yesterday. Yes. Or I'm flaring up. And it's not to say that different things don't impact your pain. Right. Don't get me wrong, but sometimes yeah, we attribute just this one cause or I'm a failure and that's why my pain is back.

    Yeah. So there's like the emotional piece, the physical piece, the environmental piece. We just have to blame kind of something. Yeah. Yeah. And a lot of Clients that I work with, and I'm sure you work with around like chronic illness, chronic pain, very skilled at meaning making, very skilled at finding what is the cause of this thing.

    And, and that is a, one of the ways that we regulate is having meaning around why something is happening. The challenge here is that it, it's not as helpful because it's overused and then we get attached to those meanings and if we know the meaning, then things will be okay when really. That's usually not how it plays out.

    That's not necessarily the equation and the fact that there's usually several causes. Absolutely. , right? Yeah. If you had nightshades yesterday, and maybe nightshades do cause like an inflammatory response in your body. Sure. But if you also were stressed and, you know, Anne had a bad day at work and absolutely, you know, drank alcohol the night before and like, and you were just doing all this stuff together.

    Mm-hmm. , the nightshades might throw you over the edge, but if you did none of those things or if none of those things happened to you mm-hmm. , then it might barely even affect you. Right. Yeah. And so this is a, what I was working on yesterday with client a couple weeks ago is one being like a food being a big trigger for a lot of challenges and, and digestive discomfort.

    And when we like slowed down to figure out, okay, well, what might have. Like actually added to this flare, like one we are around the holidays. Like that's a pretty intense time, whether it's like family dynamics of like your own family if you're visiting in-laws and those dynamics as well as food being like it's a major thing, but it's a part of the, this holiday that we just experienced and that can be challenging.

    And so really being able to like rewind, slow, slow down, and go back. It's like, wow, there was a lot of anxiety embracing, leading up to that event that it makes sense that afterwards there was a flare, not necessarily because of the food you ate. So that could be part of it just because there was so much tension, embracing of like worry and fear of what might happen on that day.

    Yeah. I have a, an Instagram friend, . We met on Instagram like five years ago and we've just, we've always stayed in contact through chat and he was telling me that he went into the cold like a couple days ago and there was just fear. There's fear around cold cuz he does have a disorder where Cold.

    Really? Yeah. Braces his it hurts him. So he went out into the cold and he was angry at himself about like the shoes he wore and like, it was just all these emotions and mm-hmm. . and then had a lot of shame. And he actually said that I could share this so . Yeah. But yeah, just the shame. And he, he even recognized like it actually wasn't the cold that caused this flare up.

    It was more so all of the fear and the shame that was kind of wrapped up around it. So the cold is an effect, but it's just not that only reason. Mm-hmm. . Yeah, and that's the thing also about shame is depending on, there's, so, like I, I love shame. It's like complex but also like simple and can be so many different things to work with.

    And if you. Are in a place where you're like well resourced and are able to be present with some of the shame and be curious of it, of like, well, what's another name for it? Or like, what might it be over coupled with? Or like what might it be in place of, because usually it pops up. In relationship to other emotions or sensations or unpleasant things that we experienced in the past and had, and, and were probably left alone with them and didn't know how to handle them.

    And so they were really scary and, and our nervous system and body and brain was like, I don't wanna do that ever again. So I'm just gonna avoid, avoid, avoid, and a level of shame of like, I didn't know what to do with it. Something's wrong with me. Again, that's coming more from like younger selves. Who?

    Yeah, like CH children, toddlers, teenagers. Cuz we don't have the skills to understand that stuff. And so when shame comes up around some of these symptoms, there is an opportunity to go. It's like a choice point, like we can. Explore the belief system that is showing up around it and start to unravel. It's like, is this my belief system?

    Is it my family's belief system around these emotions that's being passed down to me? Or like maybe we go in the other direction of like, okay, so it came up. How can we acknowledge it and what are we able to do in terms of like action to move towards or how do we want to address it? So there's a lot of different angles to go with it.

    And presents like really great opportunities for like incredible. Yeah, I think this is a concept too. I mean, I think a lot of people even struggle to start therapy cuz they're like, I already know, like what I should be doing. I don't, and you know, yeah. . Yeah. When you talk about the choice point, this is this is something we use in acceptance and commitment therapy and it's basically just a diagram that says like, you know, here are the options, here are the obstacles.

    Like, what do you wanna do? Which sounds really simplified, but. In order to move away from actions that don't align with our values in life and to move toward actions that do align with our values. There's a bunch of skills you have to learn in the middle. Mm-hmm. . Yeah. And that's kind of where, where we come in as therapists.

    It's the the mindfulness skills and, and not just this gets a little , even a little prescriptive. It really, the way that I work, and I, I'm pretty sure the way you work, Lexi, like we're not prescriptive and that's why therapy is so important. It's not, here's a mindfulness skill, go out and do it, and then you're gonna be able to then accomplish this goal that we're talking about.

    Yeah, yeah, yeah, yeah. Yeah. It's not that simple. And so in therapy we're always, you know, it is, it's very individualized, which, mm-hmm. , which sounds so vague, but we all have d. Childhood wounds. We all have different obstacles. We all have different skills that work with us or don't work with us. Mm-hmm. , you know, deep breathing sometimes sends some clients into a panic.

    So if we're working on that together and we're becoming aware of that together, then we know that that's not a skill to put on your, on your list of skills. Absolutely. Yeah. I, I love that you bring that up cuz that's like something that I. When I initially talked with clients, some of 'em would be like, yeah, I don't like journaling.

    I don't like, Yeah. Breathing exercises and I'm like, great. We're not gonna do those things. And like you are well versed in somatic like mind body interventions and experiential work for regulation or, or noticing what's coming up in the, in the body. And my guess is that similar to me is when we teach them and guide and, and do them with our clients in session.

    It's then afterwards of like, okay, this is how we can maybe fit it into your life of what the thing is and how to practice it and how to notice it, and setting up expectations for what to expect and not expect from it because. It's not gonna fix things, it's not gonna make the thing go away. It's gonna help you move through it while still having access to clearer thinking.

    That's usually the , the goal of it. , yes. Have a new experience in your body with set emotion or activation so that you start telling your brain like, oh I can handle this. Yes, yes. I love that. Proper expectations. Yeah. Cuz I think, you know, with social media especially, it's like. Five ways to like calm your nervous system.

    And it's like, oh, okay, so if I do these five things, my nervous system's gonna be calm. And it's like, yes, no, doesn't work like that. , maybe. Yeah. If you, you know, if you're in that head space and like you've already done a ton of work. Sure. Yeah. But yeah. Yep. Yep. Yeah. The same with the titles of like, here's a trauma release thing.

    I'm like, well, hold up. That's, you're not gonna release trauma just by doing this thing. There's a whole lot that goes with it. Best to do it in relationship with someone else. Yes. And I think that that's often missed of, yeah. We need connection for healing. We need connection for any sort of integration.

    And those tools are re can be really supportive and helpful. Yeah. And figuring out which ones break for you with again, the right expectations. And also knowing that doing this one stretch or this one breathing exercise is not going to unlock all of the trauma in your body. Yes. Unfortunately it doesn't work that way, unfortunately.

    That would be really intense. , right? Yeah. My thought was like, or what if you do this, you know, yoga pose that like touches this part of your body that did, was storing trauma and you're alone and you have no resources, and now you're like in a puddle of tears on the floor and you don't know what to do.

    And, you know, and that's, that's partly okay too. I mean, you know mm-hmm. , you know, it's all a part of the process. Sometimes we, we do, we have breakdowns and that's okay too. But like you said, healing happens in, in connection with. . So it's important to have someone you trust, and I think it's hard to find a therapist who you click with all, you know right away.

    You might mm-hmm. , you might go through several. And then it changes over the years too. Kind of their skillset and their personality might match where you're at mm-hmm. When you're 25, but not when you're 35. Right, right. And, yeah. Yeah. Well, and to bring that back in with like shame is this piece of, and this is, I think, Fortunately, I have the relationship with some of these clients if they come and share these experiences of these old belief systems, whether it's like chronic anxiety and beating themselves up for it, showing up and having a hard time working through it.

    But then once they. Share it with me. And I'm like, well, let's slow down. Like there's rigid thinking going on. Like this is bullshit what you're telling me. Like, you know that, which is fine, but like we're we, we know it together and let's go back to this unique situation of what might have like yeah.

    Triggered this response. And usually in that connection, the sharing of it. There, it's like easily diffused. I'm like, oh, right. Yeah, I totally understand now. Yeah, we, I was triggered on this like pretty major belief system around money that came up and I was surprised by it and then went into this spiral, but came out of it a lot quicker than typical.

    So it's being able to share shame, just like thrives in secrecy and being able to speak to it often resolves it more than anything. . Yeah. There's something so magical about you having like a, a secret thought where it's like too shameful to share, but you know, your therapist kind of helps drag it out of you a little bit.

    Mm-hmm. , you finally say it out loud and then they're just like, oh yeah. Like people have that thought. Now let's work through that . And you, there's no shame. There's no, it's like what? I'm accepted. I'm , I'm not an a terrible person cuz I had this song, . Yeah, absolutely. It's, it's so healing. Yeah, absolutely. I love it.

    Yeah. I'm wondering too, so going back to the piece about like pain and se kind mm-hmm. Somatic experiencing kind of Yeah. Helping with pain. Mm-hmm. , can you maybe speak to that a little bit and then kind of also going into how that might freak some clients out? Yeah. So let's see, in a. Maybe simplified form when working with, or like simplified, generalized form working with pain or symptoms related to chronic anything.

    After building, just like skills, awareness, resourcing, whether it's like. Sensation or imagery, all these different things start to help my clients goal and for myself, like building Vocabulary that works for different qualities, different types of sensations, which can be pain in our bodies and starting to learn the nuances of them.

    And that is part of my work is helping my clients and our brains learn that there's different levels of pain and different qualities of it. And each in that way, like often, like maybe we tend to it in different ways or we need different needs. Some of that being is. Some qualities and levels of pain we can be present with and we can actually notice and pay attention to some of it for a little bit and then go into a resource or go into a place that is less painful or has an opposite experience or something to, again, like this ululation piece of going between the hard thing into this thing that is more digestible.

    It helps, yeah, it slows down the process. Our, our nervous system usually can digest it and be present with the unpleasant thing a little bit easier. Yeah. Can I, can I, yeah, go ahead. Can I give an example of Yes, please. Like what? Yeah, so kind of when you're let's talk, just talk about joint pain for a moment.

    So you can have like achy joints, you can have shooting pains in your joints. There's, those are two different types of pains. And then on top of that, there's different levels of severity. Mm-hmm. , so, mm-hmm. , maybe your achiness is like, you know, it's barely even noticeable or maybe it's so bad that you literally cannot get out of bed that day.

    Mm-hmm. . When you're, especially when you're in that middle period, it's so hard to. Verbalize that to the people around you. Mm-hmm. . Mm-hmm. , because you barely understand it. Mm-hmm. , you don't have the language for it, and they've never even experienced it, so how can they understand it? Yeah. So when we're talking about getting specific and learning the nuance of pain in the body, that's what we're doing.

    It's not just like, oh, is this a level one or level 10? It's mm-hmm. . Okay, this is achy and it's hot. Mm-hmm. . And how big is that sensation in that spot? Is it the size of a softball or is it the size of, or is it a. Kind of, you know, superficial, like on the superficial part of your body. Mm-hmm. . And so in somatic experiencing, we get really good at, at describing the pain and, and doing that.

    It brings us awareness to your body that you're able to really trust yours. I think it comes down to trusting yourself more. Mm-hmm. , like, you're not confused about what's happening, and then even if someone doesn't understand you, or even quote, believe you, it's so much easier to handle because you have such a solid grasp on.

    Yeah. Yeah. And then you're able to know what you need to do with it. And that's the piece that we aim for is that with those different types of pain, both like whether it's like achy or shooting or stabbing or burning or like thro it, whatever, and the intensity we, if we can like touch into it peripherally at least, and know if like, Ooh, this is a type of pain I can, when I pay attention to it and do these things.

    It supports my, you know, system moving through it. I can handle it better or it like decreases it or I'm able to notice it and distract away, or it doesn't feel, you know, in the. Up in my face then great. That's incredible that we can work with that. And there's types of pain that we don't wanna pay attention to cuz we do, it doesn't feel contained or it feels too much and overwhelming and we're like, it can lead more into, I guess it really like an inescapable attack in a way of like, this piece of it is too much.

    I can't distract, dissociate, take enough of these supplements or medications to help other pain for it to go away. And so in those situations, we don. Pay full attention to it. We, we want to use different resources to support. And that is part of working with pain that way of being able to notice it, name it with whatever words make sense, and sometimes it's images or movement or whatever.

    So that, yeah, clients and ourselves have a better idea how to approach it, how to ask for what we need or do the thing that we need. Tend to it. Yeah. And when clients start to. Experience a reduction in pain, at least in my experience. Sometimes there's like an immediate, wow, this is amazing. And, and keep in mind too, for the audience when there's a reduction in pain in session, that doesn't mean you're gonna walk away from session and now that pain has gone, it just means

    Yeah. We've just had a brief experience with being able to reduce the pain a little bit and then the pain will rise back up and it will fall back down. And we're just learning how to feel it all so that we can. Be aware of, of the pieces that are, of the moments where our pain isn't as severe in that there's more shame and guilt.

    Mm-hmm. , that comes up a lot of times because it's like, wait, if my pain is lower, like. Is, this is what people are, are talking about when they're saying I'm, it's in my head or it's yeah. You know, they don't believe me and it's like, wait, wait, no, no. My pain is real. I have to like, and it almost keeps us stuck in that higher mm-hmm.

    higher level. Mm-hmm. . Yeah. Yeah. Then there's belief systems around our pain and our identity tied into someone with chronic pain and what that means for us. And having to like, yeah, that there are a lot of other barriers that can block that as well that show up when there is a reduction of pain is like, what does this mean?

    And then sometimes the hyper focusing and the guilt, the shame then it like leads to more intensity at different times and it. In the way of like, se we work a lot with like waves of knowing that there's always expansion, contraction happening at all times in our body of like our breath, like the like contraction of our heart, like the heart rate different things.

    And like same with like the electrical impulses of our Yeah. Nervous system sending out signals. There's activation and deactivation and these waves. And that's the same that happens with like, Everything basically, especially with pain, there's going to be times where it feels really good and there's less, and then there are times where it comes up and being able to ride and know that it will change, and looking for the small shifts that are letting us know that we are starting to like.

    Come down the wave or crest the wave can help us. Instead of continuing to ratchet up on this wave of this fear, this anxiety of like, oh, here's the faint, like this pain again after I've experienced no pain. What does this mean? And being stuck in that place can just continue to have us stuck in this like, I guess like escalating wave and when we're able to notice when we're in that place or like the, the crusting of the wave and notice the little cues of like, oh wow, maybe my breast started to like, feel a little bit more expansive as it's coming down and we can pay attention to that.

    Or like, oh, I'm able to like notice my feet more or I'm able to like be a little tiny bit more present. That can help us cue into like, oh, things are shifting and, and cool. And they're gonna shift again. . Yeah. And this is where, you know, again, therapy comes into play because this, this ties so much into kind of your family dynamics and the messages you heard growing up and you know, if no one believed you or if they minimized everything you said and did, your body literally has to respond with more and more signals to say, no, believe me, I'm in.

    Yeah. Pay attention. pay attention. Exactly. So it's, you know, again, this is where it gets tricky. It's like the pain is not in your head. It's a real physical thing. Mm-hmm. happening inside your body. You feel the pain, it's there, it's real. But again, if your body says, You know, no one believes me. The danger signals in your body say, turn them on higher.

    Turn them on higher. Like, see me, I'm here. Mm-hmm. and physically you're in more pain. So it's tricky because, you know, we, in therapy, all we can do with the individual is talk about what they have control over. And I think that that's a really, a really great tool. And at the same time, your environment, you know, It.

    We don't, we don't, it can't just control every aspect of how you feel. There has to be a level where you're able to deflect other people's judgments and criticisms. Mm-hmm. , but at the same time, your environment really does impact you. Yeah, absolutely. So, yeah, it's just figuring out what you wanna do with that.

    Yeah. And that's I think where with certain clients is this bringing, this se and actor are both. Bottom up, top down. So bottom up being like starting in sensation, the body, the physical things and how our bodies responding to things. Having a play through. And what does that mean in terms of like how it impacts the quality of our thoughts or yeah, like how we're responding to things.

    Things like that. Or like what we're the meaning making. And then the top down is like noticing our thoughts and naming them and addressing and being able to be present with them. And then noticing how. When we shift our perspective or maybe challenge them cognitively in these beliefs, how that impacts our body.

    So like that's more or less a simple I version of the bottom up, top down. But we're some of that these two can meet is with these, it comes back to the stories of like when we are in an environment, maybe home with a lot of our families or around coworkers that might be challenging or whatever. B, there can be these alarm systems, like these people don't believe me.

    They don't believe me. Going into those old beliefs of like, I must be making this up, or This isn't right, or I have too many needs, like, I'm always asking for things. Any of those types of things and being able to come in with challenging thoughts and, and some self-compassion for self of. Kind of like your adult self.

    This is some like part sw of like adult self and child self of like, okay, I, I got you. I can take care of this. Yes, they're telling me these things aren't real or aren't as intense, and I know that what is happening is real, and with that, this is how I'm gonna take care of me. This is how I can take care of myself.

    These are the tools that I have. Like I believe you kind of to yourself and that. Isn't gonna be a quick fix. It's not gonna mean things are gonna shift right away, but it starts to develop this relationship with self of like, yeah, I got you. Like I got it. We don't need to be protecting ourselves all at the time.

    This situation right here isn't as dire as like my brain is telling me and like, I got it. Yeah. And I think, you know, when we talk about the conversation around beliefs, a lot of times the question is like, especially on social media and whatnot, you'll see a lot about like, what are your beliefs? And let's look at them.

    And I think that's helpful. But what's, I think, even more helpful is when you think about where you learned them from. Absolutely. Yeah. Then you start to, to actually be able to reflect and be like, is this something I believe or is this something that I was taught to believe? Mm-hmm. , what does the rest of society believe?

    Is that in alignment? Mm-hmm. with how I feel and. And then to even answer like, is that in alignment with how I feel? That's where the somatic work comes back in too. Mm-hmm. . Because in order to know how you feel, you have to be able to pay attention to be aware of the nuances of these different sensations.

    So yeah, it's all, it all works together. And that's why individualized care is so important. Mm-hmm. . Yeah. Yeah, yeah. Absolutely. And I think. It's been this timing of this podcast. It's great. We're just going through like themes with so much that's been coming up in a lot of my like own reading and work with clients around these belief systems and where we come from and a lot of it being like generational trauma, generational I guess styles of parenting or generational relationships with shame.

    And, and probably a lot of it's just more on the forefront of it being the holidays. We're all spending more time with our families, anticipating that, myself included, of like, Ooh, what's gonna play out this time? And. When we're able to, yeah, be curious and go into those interactions with, huh. I wonder where my parent got that from, or I wonder what it was like when I was like a little one and experienced that reaction that I just saw now when I was younger of like, I wonder how that might have impacted.

    How I felt about this or wh what I might have needed. And that's a lot of the se is like what would've been helpful in that moment? Like what did I really need? ? Mm-hmm. and, and being able to, yeah, just ask the question. You may not know it right away, cuz that's also part of the development of knowing what we need.

    But just putting it out there, it starts to open up the possibility for your brain and body to be like, oh, right, you're gonna listen to me? Cool. Here's an opening. I'll try and show you what you. Yeah. Yeah. Just building that the question helps you build that curiosity muscle. Mm-hmm. , which then helps you kind of look for the answer in different places in your life.

    And yeah, a lot of times, you know, clients will say like, you know, I, I, my parents did the best they could, which is true. They did. Mm-hmm. . And you know, they, I, I totally understand now why, you know, why they couldn't do better, you know? And I actually think that's a big part of growing and learning is being able to understand and see your parents as human and knowing that they didn't have the resources and the skills.

    And also your inner child did. , this is like what, this is what you were saying earlier. Your inner child did not care or know, and that part of you is still alive and well. Mm-hmm. in your body. Mm-hmm. . So we wanna integrate what we know now as an adult with that inner child inside of us, by giving it, not by just telling the inner child , they, they did the best they could.

    They don't care what the inner child needed. . Yeah. They don't, they don't care. They needed nurturing and they needed somebody to believe them and to tell them that they're good because we internalize our parents' beliefs about themselves. So if your parent also thought the world was bad, they were bad, you were bad.

    Your five year old self believes you all, you were bad. And there's still a part of you that believes that. Mm-hmm. . Yeah. And coming on this topic of shame. And I think why I like it so much or I've developed to like working with it and reading more about it and how it plays out in the different ways is shame is what happens when we are left alone with things that we don't yet know how to deal with.

    And so that is where, when. And, and you know, whether it's like a really big emotion or being a sensitive kid and having all of these feelings that come up and it's not, you know, if someone were to look at it, it's like, it's not that big of a situation, but for that little. One, not knowing how to deal with frustration or disappointment or a minor loss of like a toy being broken or whatever it might be, or being left out and not having the proper like caregiver to help guide through that, and we instead are left alone or maybe even punished for something, but we don't know why it then.

    For that brain, for that development, that unfortunately what? Usually like the meaning that comes out of it, like the equation of like, this must mean that I'm wrong, that I did something like that, I did something wrong, that I'm not good enough in this way rather than having an adult. Like, oh yeah, you're feeling really frustrated right now.

    That's really hard. Like, do you want me to just sit with you with it and like, do you need a hug? Do you, can we go for a walk? Or like what? Just being able to tend to it without trying to change it, but helping name it and helping normalize and not be alone with it. And that's, Usually where shame comes from.

    Yeah. And you know, for the parents listening, that is, it's not easy. It's not easy when you're, you know, you've got work to get to and you've got schedules and you've got Yes. Yeah. Like, it's not easy and at the same time, you know, it's just, it's unfortunate. Our society, we don't live in a society in a communal society where, you know, other people.

    Even, even to the point of like other people disciplining your kids. You know, if you live in a society where everyone kind of agrees on one style of parenting mm-hmm. , then you trust the other adults in that kid's life to to say mm-hmm. No, don't do this. Or to, you know, correct them in a, in a gentle way.

    Which is really, really healthy for kids. Mm-hmm. to learn that people can correct them and love them and that is literally what the child. To support, as support and to grow. So it's not your fault if you can't figure this out. That's again, where therapy comes into play. Cause you know, it's just so individualized and so to you and your situation, since we don't have a communal way of living mm-hmm.

    Yeah. Yeah. It's, it's hard. It's so hard. it is very hard. But, you know, it's . It's all a learning process. I think that's the biggest part of this too. We're talking about frustration and fr you know, little kids getting frustrated and then how you respond to them or how you were responded to when you were a kid.

    Mm-hmm. . Which means that when you feel frustration now mm-hmm. , you still tend to respond with that inner child. Mm-hmm. . And if that inner child was taught that frustration means I'm about to get reprimanded, or I'm about to be punished in some way, then. As an adult, frustration feels unbearable, and you do everything you can possible to minimize frustration in your life, but then when it pops up, it feels like the whole world is crushing it around you.

    Yeah. Yeah. And so maybe the question is like, well then how do we work with that? It's like, well, there's, there's a lot of ways to start to like un like we, and language of se is like uncoupling these and experiencing them as separate rather than when frustration comes up, shame comes in and shuts you down.

    Or looking at nervous system response. Usually it's more of like collapse, going in the disconnect maybe. Negative thinking, maybe like more fatigue, lethargy, like the, when there's like a lot of shame that comes in. There's a huge shift in posture in how, and it's even really obvious when it starts to show up with clients of like the head going down, maybe the eyes being downturned.

    There's it, it's pretty obvious. I'm sure you've noticed it too. And so it's trying to work with the right amount of the. You know, emotion, sensation that is unpleasant, that is with shame and helping to unine like yeah, get them out of being connected so much so that yeah, you have a different relationship and a different or develop an ability to.

    Trust yourself that you can be with these feelings or these unpleasant sensations or these unpleasant thoughts and make it through it and it not mean that you are bad or that like the world is ending or that like you were gonna get in some major trouble. Maybe you can tolerate it. Yeah. And I think the message sometimes that people will hear is like, okay, so shame is bad.

    Stress is bad. And something I've been working on a lot with my clients is, is helping them understand the no feeling. No feeling in and of itself is bad. Mm-hmm. . And even stress and even trauma traumatic events. Mm-hmm. , they are not inherently what causes like post-traumatic stress responses. It's the inability to move that energy through your body.

    Mm-hmm. , when you feel the shame, the guilt, the trauma. The fear and then it gets stuck in you. And then we, you know, we keep showing up with these patterns of defensiveness and resentment and, and frustration and everything we're talking about that kind of stunts our ability to take. Action in our life that mm-hmm.

    You know, is in the direction of, of how we wanna live. So we work a lot, and that's where somatic experiencing comes in too, is learning how to move, move the, the feelings and the sensations mm-hmm. Through your body so that they don't just stay stuck in one place. Right. Yeah. Yeah. I, I think what comes up as I was thinking about this interview is thinking about some.

    The work around shame that I've like either watched as demos by like Peter Levine or other practitioners. And I think one of my favorite comments and things like languaging that he used in a demo is, Sometimes when shame comes up, it is, we don't wanna touch it, we don't want to work with it because it's going to collapse us.

    It's going to like immobilize us, how you said, and kind of like start to slow everything down. And so he said like, yep, there's shame there. We're gonna put that aside. We have other work to do. And it's, that's exactly what it is. He's like, sometimes we don't wanna go into it because it's getting in the way and halting being able to be present with the energy of the frustration, the anger, the like Like, yeah, your autonomy, your ability to do something, your action.

    And that is this balance of when do we go into it and when do we like, name it, acknowledge it, put it aside. We're like, we'll come back to that. And often after we've like, Done the things that the body wanted to do in response. Like it's not even like we can go back to it and be like, yeah, I don't need to look at it anymore.

    Like that's kind of resolved on its own and doesn't mean that you're never gonna feel shame again. It's just like that piece of it in that interaction is no longer a big deal or necessarily a. Yeah, it doesn't shut you down. It's just, oh, there's shame. Hello, goodbye . And it just kinda like comes and goes and it, the wave that shame is on, instead of it being like a tidal wave now, it's just a small little mm-hmm.

    wind wave in the water. Which is hard, you know, it's, it takes work and practice and therapy to get to a place . Mm-hmm. , where you know, you're able to feel shame and then not. I'm gonna say, let it shut you down. But even in that language, l letting it, like, I think that just really gets to people. It's like, Ugh, I'm let, I'm letting this happen.

    And that just, again, that's just shame. Like right there. Yeah. Is shame doing its job. Right, right. And yeah, and I, and , and I think that's where the education of like, yeah, it shuts you down because whatever thing that you were feeling was too intense and overwhelmed. So like you didn't have the tools yet, so like, yeah, your brain shut you down.

    That's fine. Which is protect. Right. And and this kind of, I guess like leads into like other ways of like, how, how do we move through the shutdown of shame is like, well we were with it. And I've been working with some people on this is like to be in that shutdown and freeze's response and not try and jolt out of it.

    And so like, how can we be in. In that response without like floating away or completely disappearing. And I use those terms because often when we are completely disconnected or shut down, like we sometimes feel like we are, there's no gravity or we're like on the ceiling. Sounds weird, but if you ever had that experience of like, I'm not present and I'm observing things from above, you're like, I feel like I'm invisible, or like I want to disappear.

    That is that sense of, it's like, yeah. You're really kind of disconnecting. And so when we notice that start to happen, how can we stay somewhat connected to someone else or our present moment? And ideally it's like with someone else, we wanna do this in community. How can I, like if someone else is in the room, can I make physical contact?

    We'll, also noticing this other thing happening, can I. Notice the sounds or a texture of something that in my hands, like what? Is there a little bit of movement available while this like kind of shutdown moves through so that it doesn't take over ? Yeah. It's kind of like learning how to feel two things at once.

    Yeah. Which, mm-hmm. , I think a lot of us are, so, you know, we, we all kind of multitask to a certain extent. Mm-hmm. Which multitasking can be really it can hinder a lot of productivity. But my point is that it feels like we're able to do multiple things at once, but when it comes to feelings and emotions, most of us, like, I mean, that's why shame shuts us down.

    We feel this anger, we feel shame about it because mm-hmm. Shame. And then shame does its job. It, it shuts down the anger and we just feel shame. Mm-hmm. . So we wanna learn how to hold the hand of shame mm-hmm. , and also feel our anger while also holding onto something that, that grounds us and resources us, so that we can, we can move through those two really hard feelings.

    Mm-hmm. . Mm-hmm. . Yeah. And that's what SE is about. . . Yeah. So simple. And it's so simple, guys, don't you, you understand Now, Oh yeah. It's, it's so not simple. And I mean, I even, I struggled so much. I, I saw an SE therapist. Myself and we had seven sessions and I was like, I'm gonna, I'm just gonna stick it through.

    I'm gonna keep, keep going. Cause I hadn't been able to find a therapist that I really clicked with since grad school. Mm-hmm. . And after seven sessions she fired me, . Oh no. . And I was like, oh no. Like am I never gonna be able to, you know, be a somatic therapist. Like I had all of this stuff come up right.

    and I share this willingly and openly because yeah, I just think it's so important for people to know, like, one, it's not just about some magic technique that is gonna like, it just, it doesn't work for everyone and it also doesn't work if the relationship with you mm-hmm. and the therapist isn't, isn't there.

    And sometimes it's not there because you just don't get along with. and you don't know right, who the therapist is when you're calling them. And yes, we do a 15 minute consult call mm-hmm. , and, and we hope to do the best we can in that, but sometimes it takes a few sessions before you learn like, this is not, it's not the right fit.

    Yep. And that can be confusing too cuz you know, sometimes we have a tendency to flee or to run. So then you're like, is this a bad fit or am I just running mm-hmm or am I just uncomfortable and needing to, wanting to not feel the uncomfortableness. Yeah, yeah. . Exactly. Yeah. Absolutely. Absolutely. But yeah, and I think, I don't know if I made the point clear earlier, I just wanted to circle back along to like, Feeling shame when there's a reduction in pain.

    Mm-hmm. just, just for, I really want people to hear and to know that everything we just talked about over the last, you know, 20, 30 minutes about shame still relates. It relates back to this because yeah, we have to learn how to feel shame. Let it, let it kind of move it aside, like feel it, let it go, mm-hmm.

    so that we can then, Honestly feel, feel that reduction in pain without kind of moving back into a higher level of pain and getting stuck in it again, knowing too that sometimes it's not just about, again, like maybe you work really hard on, on shame and you're doing really good at this, you can feel the pain, reduce.

    It doesn't mean your pain isn't gonna increase again, like it ebbs and it flows just like shame does and other emotions, so mm-hmm. , that's really we're talking about accept. Yeah, I am essentially like normalizing that that's a, a normal thing to, to feel, to experience, to think, to question when starting to, yeah.

    To notice reduction or shifts in pain or symptoms. Yeah. And yeah, everything has cycles and seasons and. , you know, our body, our body does too. Everything comes and, and goes. And if you study Nature, which is the founder of Somatic Experiencing, that's really how he, he started all this was by studying animals and studying nature and noticing that there's all these rhythms and cycles in nature.

    Mm-hmm. There's a really good book called Braiding Sweetgrass that she just talks about. Really just nature and like in, in her stories about nature, she's a Native American woman who just truly has such a depth of knowledge around plants and, and how they grow. And, and she has all these stories about w womanhood and motherhood and family mm-hmm.

    and community and it's such a beautiful book. So I really recommend if you're not like a, a sciencey type person, but you wanna kind of get into like this concept that's a really good book to. And then I think there's also another one, it's called Rhythms and I'm gonna look it up. Rhythms in therapy, rhythms in nature.

    If I can't, like if I can't find it in Google right now, I'll put it in the show notes, but have got it on my, on my shelf somewhere. But there's one that's a little more sciencey for people to kind of learn about. So, yeah. What other thoughts? Anything else come up for you, Lexi? I think the one last piece that was just thinking about this, that usually goes hand in hand with shame, and it goes back to some of our belief systems around it, is usually it's like very common for my, for people who experience chronic pain or illness or chronic anxiety or whatever and have shame.

    It's perfectionism tends to. Like go hand in hand. And a lot of the perfectionism is a level of protectiveness from shame. So we don't, so we try and find ways to not feel it because, you know, shame doesn't feel good. We don't like that. And so often where our brain goes, which logically can make sense, but in application doesn't, is if I do everything right, if I do X, Y, Z, if I show up in this way, if I don't have any needs at all, then.

    I will like, everything will be fine. I won't have to feel shame or have to feel really anything. And so the perfectionism can often be a part of it and sometimes is a more accessible, available thing to start working with rather than the shame itself or help kind of. be an avenue to look to help clients or ourselves identify like where did this come from?

    What belief systems is supporting this perfectionism? Cuz sometimes we talk about shame, that's like feels too intense and too much for people. So if we can work with something that is more or like less intense sometimes perfectionism. Tends to be that. Yeah. I like what you said too, just if I can learn to not have any needs, , , and I won't, I won't ever feel disappointed by people.

    Not, I mean, you didn't say this last part, but that's kind of where my brain goes. Yeah. Mm-hmm. , and I won't feel disappointed by the people who don't provide the needs that I'm looking for, or if I don't myself meet those standards. Right, right. . I think it's just interesting to go back to again, like where did we learn this?

    Cuz this is a societal thing. America is very mm-hmm , perfectionistic and my therapist in undergrad to gave me something that just stuck with me for, for . And it was a story about how, not a story, but it was the fact that, and, and. Kind of pre-industrial revolution. It was commonplace and normal for men, women, anyone to cry in public.

    And if somebody was crying in public, people kind of rallied around them. And what this meant was when we were then working in industrialized kind of offices and factory, if you're crying over something, Whether it's real, you know, it doesn't matter what it is, like something horrific or something you stubbed your toe, like mm-hmm.

    people would come and rally around you, which meant people stopped working and stopped productivity. So then managers were told by the, you know, owners of these companies, don't let that happen anymore. Mm-hmm. . And so societally we started to learn. Don't, don't cry. Don't cry in public, don't cry in front of people.

    And shame is what helps us shut all, shut down our emotions. So, mm-hmm. , that's kind of, that's what happened. So we learned, don't have emotional needs, don't care about anything so that you don't get hurt and that you don't stop producing. So, , luckily, just, just a little anecdotal kind thing to, to keep with you as you think about.

    Why do I care so much if things are, are perfect and I don't feel anything, like, why are we shameful about these emotions? And for me, I look at it through this capitalist lens of, mm-hmm. , it, it reduces productivity. So is that, is that what is most important to you? Do you want that to continue to be most important to you?

    Mm-hmm. ? Mm-hmm. Some, some food for thought. Yeah, . I like it. Just some light conversation. . Mm-hmm. . Mm-hmm. . Oh man. Well, I really appreciate your time, Lexi, as always. Yeah. Anything else you wanna leave people with today or, no, I think, I think that's, yeah, I think I talked a lot about it. All good things, things , I think we're, I think I'm all good.

    I appreciate you being here. Yeah. Thanks so much for having me again. Absolutely.

Episode Summary and Notes

Shame and the Healing Journey:

In our conversation today, Lexi and I are going to navigate the murky waters of shame and its connection to healing, especially through the lens of somatic experiencing (SE). Somatic experiencing is a therapeutic approach known to help reduce physical pain in the body. While it's never a guarantee, one of the byproducts of SE can be a reduction in pain. However, this can sometimes leave clients perplexed.

They might wonder if their pain was all in their head, and this is precisely what Lexi and I aim to explore today.

The Complexity of Pain Reduction:

Lexi shares her insights from working with clients who experience chronic pain and other symptoms. Often, after a session where they've focused on their pain and engaged in SE-related work, there's a noticeable reduction in their symptoms. This experience can be incredibly enlightening for clients, but it's not the end of the story.

In subsequent sessions, clients may report a flare-up of pain or symptoms. They might feel like they've regressed and question why the previous strategies aren't working anymore. Lexi points out that this is where the shame factor often comes into play.

Single Stories and Pain:

Lexi introduces the concept of "single stories" in the context of pain and symptoms. A single story is essentially a rigid belief or narrative that we create about our pain. It's often a snapshot in time, a thought, or a meaning we attach to why we're experiencing pain or symptoms at a particular moment. For instance, a single story could be as simple as believing that a flare-up of pain is due to eating certain foods or that you're a failure because your pain has returned. These single stories can be limiting, inflexible, and laden with shame. They overlook the nuanced nature of our bodies and our experiences.

Flexibility in Healing:

Lexi emphasizes the importance of understanding that healing isn't linear. Our bodies are complex, and pain and symptoms can stem from various sources. While specific strategies may work at one point, they might not be effective at another.

It's essential to have compassion, perspective, and flexibility in our approach to healing. This includes acknowledging that setbacks or flare-ups are a natural part of the process. They don't indicate failure or that the previous progress was meaningless.

Understanding the Roots of Meaning-Making:

As our conversation continues, Lexi and I touch on the human tendency to seek meaning when faced with pain, discomfort, or challenging emotions. We have an innate need to pinpoint a cause or source for our suffering, which often results in the creation of a single story. This single story is a rigid belief or narrative that we construct around why we are experiencing pain or discomfort at a particular moment.

This process of meaning-making is a coping mechanism, a way for us to regulate our emotional responses. However, it can become unhelpful when we become overly attached to these meanings. Lexi points out that many clients she works with are skilled at attributing a single cause to their pain or symptoms, which can lead to a narrow perspective on their condition.

The Pitfalls of Single Stories:

Single stories can be limiting and inflexible. When we believe in a single narrative for our pain or symptoms, we often miss the complexity of our bodies and experiences. For example, attributing a flare-up to a specific food we ate might disregard the various other factors, such as stress, emotions, or environmental triggers, that contributed to the discomfort.

Flexibility in the Healing Process:

Lexi emphasizes the importance of acknowledging that healing is not a linear process. Our bodies are intricate, and multiple factors can influence our pain and well-being. It's crucial to adopt a compassionate and flexible approach to healing, allowing for setbacks or flare-ups without attaching shame or self-criticism.

For instance, Lexi shares an example of a client who experienced digestive discomfort during the holidays. Instead of immediately attributing it to food choices, they slowed down to explore other contributing factors, such as family dynamics and heightened anxiety during the festive season. This shift in perspective helped them understand that their pain was not solely caused by dietary choices.

Exploring Shame with Curiosity:

Shame often arises as a response to difficult emotions or sensations. It can be particularly challenging, as it stems from earlier experiences in life when we lacked the skills to cope effectively. Shame can lead us to avoid or suppress these uncomfortable feelings, which can ultimately worsen our symptoms.

However, when we are resourced and can approach shame with curiosity, it presents an opportunity for growth and healing. We can unravel the belief systems connected to shame and explore its origins. It may be our own beliefs or those passed down through our families.

Additionally, we can choose to acknowledge shame and consider how to address it constructively, rather than allowing it to dictate our actions or self-perception.

The Choice Point in Healing:

Felix introduces the concept of a "choice point," often used in Acceptance and Commitment Therapy (ACT). It represents the moment where we can choose to move away from actions that don't align with our values and move toward those that do. However, between these two points lies a vast array of skills that need to be developed.

Therapists play a vital role in helping clients acquire these skills, especially in mindfulness and self-compassion. Therapy is not about providing a one-size-fits-all solution but tailoring a path that aligns with each individual's unique experiences and values.

Exploring Somatic Experiencing and Pain Management:

In the final part of our conversation, we explore the role of somatic experiencing (SE) in managing pain, particularly in the context of chronic conditions. SE is an approach that focuses on the mind-body connection and aims to reduce physical pain by addressing the emotional and physiological aspects of pain.

Building Skills and Vocabulary:

Lexi explains that when working with clients experiencing pain or chronic symptoms, it's essential to start by building skills and awareness. This includes developing a vocabulary that helps clients describe the different qualities and levels of their pain. By doing so, clients can better understand and differentiate their pain experiences.

Navigating Different Qualities and Levels of Pain:

Lexi emphasizes the importance of recognizing that not all pain is the same. Pain can manifest in various ways, such as achy sensations or shooting pains, and it can vary in severity. Understanding these nuances is crucial in helping clients develop coping strategies.

For example, if someone experiences joint pain, they may encounter different levels of discomfort on different days. On some days, the pain may be barely noticeable, while on others, it could be debilitating. Lexi suggests that clients often struggle to communicate these differences to others, as they might not fully comprehend the nuances themselves.

The Challenge of Articulating Pain:

The challenge of articulating pain is a common experience for individuals dealing with chronic conditions. When pain falls between barely noticeable and incapacitating, it can be challenging to convey its complexity to others who have not experienced it. This communication barrier can lead to feelings of isolation and frustration.

SE and Developing Presence:

SE can help clients become more present with their pain and discomfort. Lexi explains that clients can learn to pay attention to different qualities and levels of pain and develop strategies for shifting between the discomfort and more manageable states. This movement between sensations is akin to an undulation process that allows clients to be present with unpleasant sensations while also accessing resources to support them.

Conclusion:

Our conversation with Lexi sheds light on the intricate interplay between shame and the healing journey, particularly in the context of chronic pain and symptoms. By recognizing the limitations of single stories and embracing flexibility in our approach to healing, we can navigate the ups and downs with greater understanding and compassion.

Remember, healing is a complex, non-linear process, and setbacks are not a reflection of your worth or effort. It's a journey, and along the way, you're learning, growing, and discovering what works best for your unique body and experiences.

Contact Lexi for individual and group therapy if you’re a resident of Oregon or North Carolina.

https://lexigrosscounseling.com/

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Ep 23: Dr. Hannah Khadem: Bridging the Gap Between Mind and Body