Published May 2022 on YouTube

661: Rachel Zoffness | Managing Pain In Your Body and Brain

1. Introduction

Dr. Rachel explains the science behind pain, how it affects the brain, and what modern medicine gets wrong about pain treatment. This episode offers hope and a better path forward for those who suffer from chronic pain.+

2. Gut-Brain Connection

Stomach Pain:Jordan and Rachel discuss their experiences with stomach pain as children and how it is often dismissed as a way to avoid school. They also touch on the pain caused by bullet ants and how it relates to chronic pain experienced by some individuals.+
The Gut-Brain Connection:Rachel explains how emotions can manifest as physical symptoms in the body, particularly in the gut. Jordan shares his personal experience with psychosomatic pain during a difficult time in his life. The speakers discuss the negative connotations associated with the term "psychosomatic" and the importance of recognizing the mind-body connection in healthcare.+

3. Pain Education

The Somatic Experience:Rachel explains how emotions are somatic and how emotional health is connected to physical health. She discusses the lack of pain education in medical schools and the false divide between physical and emotional pain.+
Understanding Pain:Rachel discusses the lack of pain education in medical schools and the limitations of the biomedical model of pain, which only focuses on physiology and leads to over-reliance on pills and procedures. She introduces the metaphor of a pain dial and explains how stress, mood, and attention can affect pain volume.+

4. Understanding Pain

Understanding Pain:Rachel explains how emotions, attention, and distraction affect the experience of pain. She also talks about the neuroscience of pain and how it's not discussed enough. Jordan shares a personal anecdote about using distraction to help his child during a painful experience.+
Understanding Pain:Rachel explains that pain is not just a biomedical problem, but that it is constructed in the brain. She discusses the three parts of the central nervous system that process pain and emphasizes that pain is both physical and emotional.+

5. Understanding Pain

Rachel Zoffness, a pain psychologist, explains that pain is both physical and emotional and lives in the brain. She discusses the concept of a "pain recipe," which is the sum total of all the factors that amplify pain, including biological, psychological, and sociological components.+

6. Sponsors

Dr. Rachel shares insights on how the mind-body connection can be used to manage pain and boost pain relief. She explains how the brain processes pain and how mindfulness and meditation can help alleviate it.+

7. Hacking Pain

Hacking Pain Recipe:Rachel explains how to hack the pain recipe by understanding pain neuroscience and putting together a cocktail of things such as moving your body, connecting socially, and treating depression and anxiety. She also emphasizes the importance of pain education and understanding chronic pain.+
Hacking Chronic Pain:Rachel explains how chronic pain can lead to central sensitization and shares a story of a teenager who had been in bed for four years due to chronic pain. She discusses the importance of understanding pain and using tools like cognitive behavioral therapy and biofeedback to manage it, even though they are not reimbursed by insurance.+

8. Pain Pathways

Pain Pathways:Rachel explains how the brain works and how practicing pain can sensitize the pain pathway in the brain, causing the brain to interpret non-dangerous sensory information as dangerous.+
Chronic Pain Brain:Rachel explains that chronic pain can cause the brain to become extra sensitive and alarm when it doesn't need to, leading to stress and amplification of pain. Desensitizing the brain is key to treating chronic pain.+

9. Perception of Pain

Pain Perception:Jordan and Rachel discuss how pain perception is subjective and can be influenced by context and the reactions of people around us. They share personal experiences and insights on how the brain processes pain.+
Overcoming Chronic Pain:Rachel Zoffness shares her experience treating a teenager with chronic pain using cognitive behavioral therapy. She explains how desensitizing the brain little by little can help overcome chronic pain and how context matters in the brain's interpretation of sensory messages from the body.+

10. Overcoming Chronic Pain

Overcoming Chronic Pain:Rachel shares a success story of a patient who overcame chronic pain through biopsychosocial treatment. She discusses how big pharma profits from pain medicine and how it's not the answer for long-term chronic pain. The brain's construction of pain in context also matters.+
Pain Perception:Rachel discusses the neuroscience behind pain perception, explaining how the brain processes information to determine whether or not to make pain and how much. She uses an example of a construction worker who experienced pain despite the absence of damage to his body to illustrate how pain perception can be influenced by various factors.+

11. Sponsors

Justworks simplifies business management for remote and in-person teams. Their platform handles everything from onboarding to payroll and provides expert support. Check out to learn more.+

12. Pain and Amplification

Pain Amplification:Jordan and Rachel discuss how attending to pain can amplify pain volume and make it feel worse. Science shows that ruminating about pain will also make it worse.+
Pain and Harm:Rachel explains that pain and harm are not the same thing and that Western medicine often assumes that pain means the body is in danger. Chronic pain is not necessarily a sign that your body is in danger of harm and treating pain as a biopsychosocial problem is necessary to understand the whole pain recipe.+

13. Understanding Chronic Pain

Treating Chronic Pain:Rachel explains that trauma and sensitization are connected and can amplify pain. To treat chronic pain, it is important to address past trauma and other hard topics that may be connected to the pain.+
Understanding Pain:Rachel explains how pain manifests physiologically and how mirror neurons in our brain work. She also talks about the gate control theory of pain and how touch can help alleviate pain.+

14. Pain Relief Insights

Pain Relief Insights:Rachel explains how touch therapy can interrupt pain messages and reduce pain volume. She also reveals that emotional pain can hurt physically and that pain relievers can treat the pain of social rejection and ostracization.+
Opioid Sensitization:Rachel explains that opioids sensitize the brain to pain over time and harm pain patients. Chronic pain requires a biopsychosocial treatment, including cognitive-behavioral therapy and biofeedback, but doctors are not trained in this area.+

15. Understanding Pain

Rachel Zoffness explains how pain is biopsychosocial and how context matters when interpreting sensory input. She also discusses the importance of recognizing the "pain voice" and not identifying with it. Jordan Harbinger and Rachel Zoffness also discuss the practical techniques found in her workbook for managing pain.+

16. Outro

Jordan shares about his free Six-Minute Networking course and how he uses his resources to give back to those in need. He also encourages listeners to share the show with others and offers to buy a book for anyone dealing with pain who cannot afford it.+