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Today I have a special guest, a leader in the field of Mindbody medicine and President of the ATNS (Association for Treatment of Neuroplastic Symptoms, formerly PPDA), Dr David Clarke.Dr Clarke practiced Gastroenterology in Portland from 1984 to 2009, treating over 7000 patients whose symptoms were not explained by diagnostic testing. In this episode, Dr Clarke summarizes Pain relief Psychology. With research based methods teaching patients to take their focus off the symptom, shift attention to brain, and feel the emotions or deal with life stressors. Responding to chronic pain or symptoms this way rewires the brain, so that symptoms can be eliminated instead of just managed.Listen to hear more! Find Dr Clarke and the 12 question quiz on the ATNS website- https://www.symptomatic.me/ Dr Clarke's challenging patients course https://ppdassociation.org/online-course For fresh content on healing chronic pain or disease, follow Betsy on Instagram https://www.instagram.com/bodyandmindlifecoach/ Youtube https://www.youtube.com/channel/UCvXZSYYGL2cfJl-oEOzqspA Website https://bodyandmindlifecoach.com Transcript- Automatically Generated: This is Betsy Jensen, and you are listening to Unstoppable Body and Mind, Episode 135, Treating Neuroplastic Symptoms with Dr. David Clarke.In this podcast, we learn to upgrade our brain and understand the power of our thoughts, to heal and to create the results we want in our life. Become the person in control of your healing and make peace with your life. Become Unstoppable Body and Mind.All right. Hi, everyone.Welcome.We have a special, special guest today. This is Dr. David Clarke. Welcome.Great to be with you, Betsy.Well, we are so glad to have you here. So Dr. Clarke is one of the pioneers and leaders in this field. The head of the PPDA, which is now the ATNS, we can talk about what all of these initials mean and acronyms.But why don't we start with a little bit about your story, coming from being a Western physician to what you do now?Yeah, I didn't know anything about this. The first seven years of my formal training and education, you know, it's kind of embarrassing to admit as a physician that nobody ever mentioned the idea that your brain could cause serious pain or illness in your body, in the complete absence of anything wrong structurally or with your organs. But then I encountered a patient, I didn't know the first thing about diagnosing or treating.In year eight of my formal training, she was referred to us at UCLA where I was in training by another university because they couldn't find anything wrong to explain her symptoms. She was actually averaging one bowel movement per month, despite taking four different laxatives at double the usual doses. We did some specialized testing on her that also was normal.I was doing her exit interview and basically telling her she was just going to have to live with this because there wasn't anything more we could do. But just so the conversation wouldn't be over in two minutes, I started asking her about stress. She didn't really have any.You know, her current day life was really going just fine. But when I asked her about stress earlier, she started talking about having been molested as a girl by her father. Unfortunately, not just once or twice, which would have been bad enough, but hundreds of times.And I had never heard anybody say that before. I didn't know what to do with that information. I had no formal training in how to respond to that.But I fell back on basic instincts as a doctor, which is to try to get the story. When did it start? How often did it happen?When did it stop? Those kinds of things. And she was telling me the story in a perfectly calm tone of voice.It didn't look like she was distressed by this at all. If you didn't know better, you would think that, and I didn't know better at the time, you would think that she had completely processed this information and had moved on. And yet she has this terrible physical symptom with no explanation for it.So I didn't think the two things could possibly be connected, but they were both very striking. So I had vaguely heard of a psychiatrist at UCLA that was interested in conditions like this. And I thought maybe it'll help her to live with this a little better.So I connected her up with Harriet Kaplan, who was a psychiatrist and forgot all about her. Until I ran into Harriet in an elevator three months later, and I've told this story many times before, but this was the elevator ride that changed my career. Because in making conversation with Harriet, it turned out she had cured this patient with less than three months of counseling.And the idea that you could alleviate a serious, real physical symptom just by talking to somebody, that was nowhere in my medical education or training. And I thought, you know, if I'm going to be a complete doctor, I should know a little bit about this. So I got Harriet to teach me how she thought about these things.And I thought, you know, maybe I'll see a couple of patients a year that have this concern or this issue, and I'll be able to use this information, and get the patient over to whoever the Harriet is in my medical community. And I was, you know, started practice in Portland, Oregon a few years later. And I was wrong on multiple counts.First of all, there weren't any Harriots in Portland. I would send patients to mental health, they would get cognitive behavioral therapy, it wouldn't help them, and they would come back and they say, you know, now what do we do? And so I did, you know, I tried to help them by trial and error.And I'm confident I wasn't very good at it in the beginning, but even as a bumbling beginner, I was helping people. They were having improvement that they weren't getting from the rest of the healthcare system. So, you know, that was back in the 1980s.Today, it's been 7,000 patients I've treated like this. It was 250 or 300 every year, which was another shock for me, one out of three of my patients. And I just got better and better at it as time went on.My first book, which is called They Can't Find Anything Wrong, came out in 2007. And then I started getting invitations to speak. And then I met other people who were doing this work, which I'd never met before.And we founded a nonprofit in 2011, which is now the Association for Treatment of Neuroplastic Symptoms. And you came to our conference in Boulder just six weeks ago.Yeah. That's where we met officially. And I realized how tall you are in real life.I look a lot shorter on Zoom.Yeah. You said it's your superpower to look short on Zoom. And yeah, that I have to say was such a cool conference.It was really, really amazing just being around all of these people who we've read their books, we've followed podcasts and done research and read a lot of works and studies that people have put out. And a lot of those big name people were there. It was kind of the everyone who's anyone of this world, the mind body world.It's really true. Yeah. The speakers we had were tremendous.I mean, I've been doing this all these years and I learned a lot from them. And the research is something we haven't had before. Just in the last mainly three years, there has been gold standard randomized controlled trials of the treatment methods that we recommend at the ATNS.And they've been getting stunningly good results at universities across North America, everywhere from Halifax to Los Angeles is showing the power of first of all, focusing on relieving people's symptoms like that first patient, not just helping them live with it, but actually relieving it and focusing on stress in people's lives, trauma, the long-term impact of adversity in childhood, other life challenges. When you do that, people actually get better.Yeah, yeah. And it's not just digestive issues, as we know. Like that can be a main one.That's what brought me to the work was ulcerative colitis and irritable bowel.Yeah, absolutely. That's how I started. But when people found out that I was doing this kind of work, they started sending me mysterious cases with symptoms from head to toe.You know, I didn't, I have to say, I didn't see that many with migraines, but all kinds of things, dizziness, itching of the skin was one, back pain was a big one, fibromyalgia, pelvic pain, pelvic pain was very common in my practice. I had a whole slew of gynecologists that would send me patients that they couldn't find anything wrong with the pelvis, and yet it was very painful for people. Some of them had genital or bladder pain as well.So, you know, joints, skin issues.Genital urinary problems, like incontinence could have a mind-body component, right?It should be checked for, that's the thing. What we emphasize is, you know, we're not going to have this mind-to-body connection in every single case, obviously, but there are a lot of people it should be checked for to get a complete evaluation.Yeah, I personally know that because I had incontinence issues during a super stressful time, and I also just had four kids. So I thought, well, this is just my life. I'm just going to have this now.But turns out I don't have that anymore. So, but I read Dr. Sarno's book when I first, because I found out about this stuff kind of like 2019, I think, 2018-19, a little before, I think, Cureable came out. I didn't really know about the PPDA.I kind of found Sarno first, and he did say genitourinary issues. So I just got curious, and I started noticing some patterns with incontinence that I was like, oh, it's only certain times. It's right at the end of a conversation, right when I get home in the driveway.Not the whole ride home, just right when I get home.No, it's good that you had the insight to figure that out. That's what a lot of practitioners call gathering evidence, that it's not an organ-based or structure-based condition. For example, if the symptom moves from place to place, or if it's not always triggered by the same thing, if you can sit at home for a long period of time and your back is okay, but you sit at the office for the same period of time and your back is not okay, you know, your back doesn't know the difference, but your brain definitely does.One of my early patients, he had daily low back pain except two weeks out of the year. And you know, no prize for guessing what he was doing in the two weeks out of the year, he was on vacation and he was not resting carefully on a warm beach, you know, taking good care of his back. He was fly fishing in British Columbia, which involves a lot of motion of the spine.And at the end of the day, he would help the lodge owner clear brush from behind the lodge. Did any of this cause problems for his back? Not a bit.As long as he was on vacation, he was fine. But when he was back from vacation, he was a workaholic and it manifested in back pain.The thing is too, I've seen where people on vacation they don't have the pain, they do all these things, maybe on the plane ride back or once they get back, they do have pain, but they don't attribute it to coming back to work or the stressors they're putting on themselves. They think, oh, I must have overdone it three days ago when I did that ATV riding. And they attribute it to something they did several days before, or even I've heard of people up to two weeks before.Oh, my, my chiropractor said it was probably what I did on vacation two weeks before. And that's why I had the pain two weeks later.Yeah, no, I hear that too. When you believe that all pain and illness is connected only to organ disease or injury, as a clinician, you will bend over backwards trying to make it fit into that box. If you don't have the training or the capability to assess somebody for a brain-to-body condition or what we today call a neuroplastic condition, you're not going to be thinking of it.And so you have to try to make the patient's condition fit into something else. And what we see a lot is people trying to make it fit into things like long COVID or Ehlers-Danlos syndrome, which is stretchy connective tissue, or mast cell activation syndrome, or chronic Lyme disease. I mean, there's a whole long list.Chronic fatigue is another one, a whole long list of conditions that are being blamed for this. Systemic candidiasis, another one, being blamed for this without any real reason to blame it. And what we encourage people to do at the ATNS is to become aware of how you assess somebody.Look at the stress in their life right now. One of my patients only got his pain when he was driving to work. When he was driving home from work, he was fine.But none of the doctors who had seen him before me thought to ask him about that, to get that detailed story of when and where his symptoms were happening. But a really big one is, if you went through experiences as a child, that you would never want for a child of your own. And that can be just about anything.You know, anything from, you know, the sexual abuse that I mentioned in the first patient. But it can also be just lack of support, lack of being made to feel good about yourself, being made to feel like a second rate or a worthless person. That can have profound long-term impacts on people.And we can't change the past, but those long-term impacts can make you physically ill. And we can change those long-term impacts. We can successfully treat those.And when we do, the symptoms start to alleviate.Yes, yes. That's one thing I'll always remember about you is that question to ask yourself is, if I had my own child and was going through the exact same things that I went through as a child, are there any things that I wouldn't want them to have to go through? And maybe it's even a bully in third grade or something, right?Even those kinds of things can have an impact on that fear base, your nervous system, and then later in life, something similar comes up and you develop that. So it could be not a direct correlation of the symptoms don't just start at the time necessarily.That's right.Right? And then the other thing I find is that a lot of times people may not acknowledge the stressors that they are under currently, a lot of times people tell me they don't have a lot of stressors. That's not always the case.But sometimes pain has become its own stressor or illness, or the lack of a diagnosis has become its own stressor, but they minimize or don't realize how stressful that is. Could you speak to that?Yeah. My patients are very strong people, and they are capable of carrying levels of stress that most people cannot. And so when they look at their life, they're going like, no, it's really not that huge an amount of stress.Or they'll say the same thing about when they were kids, that it wasn't that bad. Other people have been through worse. You know, I think I'm over it now.But they are like Olympic weightlifters who are carrying 50 pounds more than the world record for their weight class. And they just don't know it. So their bodies are breaking down.And you know, they're feeling that physical impact of this weight of stress that they're carrying without recognizing just how much is going on. Until, you know, as you point out, asking them to think about what it would be like to watch their own kid and try to cope with the same childhood issues that puts a completely different spin on it, helps people to recognize much more accurately. Or to, you know, imagine if a friend was carrying all the stress that they are.One of my patients was, let's see, she was working full time. Her husband was working full…
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