Full Transcript 0:01 The question that I want to answer 0:01 The question that I want to answer today, which is often posed by some
Questioning the Trauma-Pain Link 0:04 today, which is often posed by some 0:04 today, which is often posed by some individuals, is whether emotional trauma 0:06 individuals, is whether emotional trauma 0:06 individuals, is whether emotional trauma can cause physical pain right away. I 0:09 can cause physical pain right away. I 0:09 can cause physical pain right away. I want to answer not really, but it gets 0:12 want to answer not really, but it gets 0:12 want to answer not really, but it gets complicated. So, I want to get into this 0:14 complicated. So, I want to get into this 0:14 complicated. So, I want to get into this topic. 0:22 Just to review, I'm I'm a physician 0:22 Just to review, I'm I'm a physician trained in psychiatry as well as pain
Background and Clinical Perspective 0:26 trained in psychiatry as well as pain 0:26 trained in psychiatry as well as pain medicine and addiction medicine. and I 0:28 medicine and addiction medicine. and I 0:28 medicine and addiction medicine. and I used to direct the chronic pain rehab 0:30 used to direct the chronic pain rehab 0:30 used to direct the chronic pain rehab program at the Cleveland Clinic and 0:32 program at the Cleveland Clinic and 0:32 program at the Cleveland Clinic and continue to see chronic pain patients 0:34 continue to see chronic pain patients 0:34 continue to see chronic pain patients that with psychiatric and mental health 0:37 that with psychiatric and mental health 0:37 that with psychiatric and mental health concerns as well as addiction in my 0:39 concerns as well as addiction in my 0:39 concerns as well as addiction in my current clinic and I've drawn from that 0:42 current clinic and I've drawn from that 0:42 current clinic and I've drawn from that experience various lessons. I've also 0:44 experience various lessons. I've also 0:44 experience various lessons. I've also done some research on this topic the 0:47 done some research on this topic the 0:47 done some research on this topic the relationship between for instance trauma 0:49 relationship between for instance trauma 0:49 relationship between for instance trauma and physical pain. So getting back to
Trauma as a Risk Factor for Chronic Pain 0:52 and physical pain. So getting back to 0:52 and physical pain. So getting back to the question, emotional trauma doesn't 0:55 the question, emotional trauma doesn't 0:55 the question, emotional trauma doesn't really cause physical pain, but it's 0:58 really cause physical pain, but it's 0:58 really cause physical pain, but it's important. It's related. It's what we 1:00 important. It's related. It's what we 1:00 important. It's related. It's what we call a risk factor. If individuals have 1:03 call a risk factor. If individuals have 1:03 call a risk factor. If individuals have had trauma, not just emotional, but 1:06 had trauma, not just emotional, but 1:06 had trauma, not just emotional, but physical trauma of any sort in their 1:09 physical trauma of any sort in their 1:09 physical trauma of any sort in their early adulthood, in their early 1:11 early adulthood, in their early 1:11 early adulthood, in their early development, and that impacted them 1:14 development, and that impacted them 1:14 development, and that impacted them sufficiently, it can be a risk factor 1:16 sufficiently, it can be a risk factor 1:16 sufficiently, it can be a risk factor for later developing chronic disabling 1:18 for later developing chronic disabling 1:18 for later developing chronic disabling and complex pain. So if you think about
Other Risk Factors and the Bigger Picture 1:22 and complex pain. So if you think about 1:22 and complex pain. So if you think about it, this is something that actually 1:24 it, this is something that actually 1:24 it, this is something that actually shapes somebody's not just psychology 1:27 shapes somebody's not just psychology 1:27 shapes somebody's not just psychology but actual nervous system. 1:35 We've seen that those individuals who 1:36 We've seen that those individuals who unfortunately go through a car accident, 1:38 unfortunately go through a car accident, 1:38 unfortunately go through a car accident, a surgery, some other injury, and then 1:41 a surgery, some other injury, and then 1:41 a surgery, some other injury, and then develop chronic disabling pain have had 1:45 develop chronic disabling pain have had 1:45 develop chronic disabling pain have had often, not always, but often 1:47 often, not always, but often 1:47 often, not always, but often pre-existing risk factors. One of those 1:50 pre-existing risk factors. One of those 1:50 pre-existing risk factors. One of those risk factors is trauma. That could be in 1:53 risk factors is trauma. That could be in 1:53 risk factors is trauma. That could be in childhood, early adulthood, or even just 1:57 childhood, early adulthood, or even just 1:57 childhood, early adulthood, or even just a traumatic psychological experience of 2:00 a traumatic psychological experience of 2:00 a traumatic psychological experience of the event itself. 2:02 the event itself. 2:02 the event itself. So, as we meet individuals with chronic 2:05 So, as we meet individuals with chronic 2:05 So, as we meet individuals with chronic pain that's very difficult to treat, 2:08 pain that's very difficult to treat, 2:08 pain that's very difficult to treat, that doesn't get better with standard 2:09 that doesn't get better with standard 2:09 that doesn't get better with standard treatments, we ask ourselves, what were 2:12 treatments, we ask ourselves, what were 2:12 treatments, we ask ourselves, what were the risk factors in this individual? We 2:14 the risk factors in this individual? We 2:14 the risk factors in this individual? We ask ourselves if you got a hundred 2:16 ask ourselves if you got a hundred 2:16 ask ourselves if you got a hundred individuals and they have the same or 2:19 individuals and they have the same or 2:19 individuals and they have the same or similar car accident, injury, surgery, 2:22 similar car accident, injury, surgery, 2:22 similar car accident, injury, surgery, not all of them are going to have 2:23 not all of them are going to have 2:23 not all of them are going to have chronic disabling pain. In fact, the 2:25 chronic disabling pain. In fact, the 2:25 chronic disabling pain. In fact, the majority of humans are going to bounce 2:27 majority of humans are going to bounce 2:27 majority of humans are going to bounce back thankfully and they're going to 2:28 back thankfully and they're going to 2:28 back thankfully and they're going to heal. But there are a select few that 2:31 heal. But there are a select few that 2:31 heal. But there are a select few that are going to have certain risk factors 2:33 are going to have certain risk factors 2:33 are going to have certain risk factors aside from trauma. We'll revisit that in 2:35 aside from trauma. We'll revisit that in 2:35 aside from trauma. We'll revisit that in a second. There are other risk factors. 2:38 a second. There are other risk factors. 2:38 a second. There are other risk factors. We call it genetics or genetic loading. 2:41 We call it genetics or genetic loading. 2:41 We call it genetics or genetic loading. Maybe there's a family history of 2:42 Maybe there's a family history of 2:42 Maybe there's a family history of neurologic disease or chronic pain. 2:45 neurologic disease or chronic pain. 2:45 neurologic disease or chronic pain. There are aspects of the injury or 2:47 There are aspects of the injury or 2:47 There are aspects of the injury or medical process that are risk factors. 2:50 medical process that are risk factors. 2:50 medical process that are risk factors. For instance, if somebody has other 2:52 For instance, if somebody has other 2:52 For instance, if somebody has other medical conditions that contribute to 2:54 medical conditions that contribute to 2:54 medical conditions that contribute to things like inflammation, poor healing, 2:57 things like inflammation, poor healing, 2:57 things like inflammation, poor healing, that can influence if somebody develops 2:59 that can influence if somebody develops 2:59 that can influence if somebody develops chronic lasting complex pain. So there 3:03 chronic lasting complex pain. So there 3:03 chronic lasting complex pain. So there are a whole host of other factors to 3:05 are a whole host of other factors to 3:05 are a whole host of other factors to think about but for the question posed 3:07 think about but for the question posed 3:07 think about but for the question posed if we were to focus on trauma it is
Parallel Pains and Mind-Body Connection 3:09 if we were to focus on trauma it is 3:09 if we were to focus on trauma it is important but it's not alone the thing 3:12 important but it's not alone the thing 3:12 important but it's not alone the thing that causes chronic physical pain. 3:21 I I do want to talk a little bit about 3:21 I I do want to talk a little bit about my work in this space. Um in uh 2019 I 3:26 my work in this space. Um in uh 2019 I 3:26 my work in this space. Um in uh 2019 I published a paper called parallel pains. 3:28 published a paper called parallel pains. 3:28 published a paper called parallel pains. It's an article that you can read if 3:30 It's an article that you can read if 3:30 It's an article that you can read if you'd like, uh, where I talk about how 3:33 you'd like, uh, where I talk about how 3:33 you'd like, uh, where I talk about how trauma doesn't really cause physical 3:35 trauma doesn't really cause physical 3:35 trauma doesn't really cause physical pain, but it sort of coexists with 3:37 pain, but it sort of coexists with 3:38 pain, but it sort of coexists with physical pain in many individuals. And 3:40 physical pain in many individuals. And 3:40 physical pain in many individuals. And it's important to attend to both. We 3:42 it's important to attend to both. We 3:42 it's important to attend to both. We want to get away from splitting up the 3:44 want to get away from splitting up the 3:44 want to get away from splitting up the mind and the body and thinking trauma 3:47 mind and the body and thinking trauma 3:47 mind and the body and thinking trauma causes physical stuff, physical stuff 3:49 causes physical stuff, physical stuff 3:49 causes physical stuff, physical stuff causes mental trauma. It's all very much 3:52 causes mental trauma. It's all very much 3:52 causes mental trauma. It's all very much more connected than we normally 3:55 more connected than we normally 3:55 more connected than we normally appreciate. And instead of thinking them 3:57 appreciate. And instead of thinking them 3:57 appreciate. And instead of thinking them as separate or one causing the other, 3:59 as separate or one causing the other, 3:59 as separate or one causing the other, it's very important to treat them both 4:01 it's very important to treat them both 4:01 it's very important to treat them both equally and balance them out. This is 4:03 equally and balance them out. This is 4:03 equally and balance them out. This is why I use the term parallel pains. And 4:06 why I use the term parallel pains. And 4:06 why I use the term parallel pains. And in the article, I I talk about how 4:10 in the article, I I talk about how 4:10 in the article, I I talk about how different individuals with trauma and 4:12 different individuals with trauma and 4:12 different individuals with trauma and ongoing stressors, meaning things that 4:14 ongoing stressors, meaning things that 4:14 ongoing stressors, meaning things that are really challenging in their life, 4:16 are really challenging in their life, 4:16 are really challenging in their life, have these kind of parallel pains to 4:18 have these kind of parallel pains to 4:18 have these kind of parallel pains to their physical pain. I have three 4:21 their physical pain. I have three 4:21 their physical pain. I have three examples in the article of individuals 4:23 examples in the article of individuals 4:23 examples in the article of individuals with real life chronic disabling pain 4:26 with real life chronic disabling pain 4:26 with real life chronic disabling pain and parallel 4:29 and parallel 4:29 and parallel psychological or social pains that are 4:32 psychological or social pains that are 4:32 psychological or social pains that are also important to attend to. These can 4:35 also important to attend to. These can 4:35 also important to attend to. These can be stemming from trauma or other 4:38 be stemming from trauma or other 4:38 be stemming from trauma or other hardships. It's important to balance 4:40 hardships. It's important to balance 4:40 hardships. It's important to balance this out if we're going to have any 4:43 this out if we're going to have any 4:43 this out if we're going to have any fighting chance in helping individuals 4:45 fighting chance in helping individuals 4:45 fighting chance in helping individuals with chronic disabling pain. And this is
Intrapersonal and Interpersonal Dynamics 4:48 with chronic disabling pain. And this is 4:48 with chronic disabling pain. And this is how I actually leverage my identity as 4:51 how I actually leverage my identity as 4:51 how I actually leverage my identity as not just a pain physician but also 4:52 not just a pain physician but also 4:52 not just a pain physician but also psychiatrist in helping individuals with 4:55 psychiatrist in helping individuals with 4:55 psychiatrist in helping individuals with both of these tasks at once. 5:06 One thing that I represent in that 5:06 One thing that I represent in that article that' be important for 5:08 article that' be important for 5:08 article that' be important for individuals to think about is how each 5:10 individuals to think about is how each 5:10 individuals to think about is how each of us have brains but each of us also 5:13 of us have brains but each of us also 5:13 of us have brains but each of us also have minds. And in those minds we have 5:15 have minds. And in those minds we have 5:15 have minds. And in those minds we have inner psychologies. They're very 5:17 inner psychologies. They're very 5:17 inner psychologies. They're very complex, right? Everything we've been 5:19 complex, right? Everything we've been 5:19 complex, right? Everything we've been through, our development, our traits, 5:21 through, our development, our traits, 5:21 through, our development, our traits, our tendencies, what we like, what we 5:23 our tendencies, what we like, what we 5:23 our tendencies, what we like, what we don't like, all of that psychological 5:26 don't like, all of that psychological 5:26 don't like, all of that psychological mumbo jumbo, if you will, is really 5:28 mumbo jumbo, if you will, is really 5:28 mumbo jumbo, if you will, is really critical to try to understand. In the 5:31 critical to try to understand. In the 5:31 critical to try to understand. In the article, Parallel Pains article that I 5:33 article, Parallel Pains article that I 5:33 article, Parallel Pains article that I mentioned, I delve into what we like to 5:36 mentioned, I delve into what we like to 5:36 mentioned, I delve into what we like to call dynamics. Dynamics are kind of 5:39 call dynamics. Dynamics are kind of 5:39 call dynamics. Dynamics are kind of psychological forces or, you know, 5:42 psychological forces or, you know, 5:42 psychological forces or, you know, variables that kind of, you know, play 5:45 variables that kind of, you know, play 5:45 variables that kind of, you know, play off of each other. So for instance, 5:47 off of each other. So for instance, 5:47 off of each other. So for instance, somebody may have a lot of anxiety about 5:49 somebody may have a lot of anxiety about 5:49 somebody may have a lot of anxiety about something, but then they have what's 5:51 something, but then they have what's 5:51 something, but then they have what's called a defense. A defense means a 5:53 called a defense. A defense means a 5:53 called a defense. A defense means a coping strategy or a way to deal with 5:55 coping strategy or a way to deal with 5:55 coping strategy or a way to deal with that anxiety. Anyway, these dynamics 5:58 that anxiety. Anyway, these dynamics 5:58 that anxiety. Anyway, these dynamics which are very complex are important to 6:00 which are very complex are important to 6:00 which are very complex are important to try to understand in an individual who 6:02 try to understand in an individual who 6:02 try to understand in an individual who has chronic disabling pain. And the 6:05 has chronic disabling pain. And the 6:05 has chronic disabling pain. And the dynamics fall into two different 6:07 dynamics fall into two different 6:07 dynamics fall into two different categories which are represented by two 6:08 categories which are represented by two 6:08 categories which are represented by two different triangles, a red one and a 6:11 different triangles, a red one and a 6:11 different triangles, a red one and a blue one. We have intrapersonal dynamics 6:14 blue one. We have intrapersonal dynamics 6:14 blue one. We have intrapersonal dynamics that means things within our own 6:16 that means things within our own 6:16 that means things within our own psychology right so our own tendencies 6:19 psychology right so our own tendencies 6:19 psychology right so our own tendencies traits coping mechanisms but then we 6:22 traits coping mechanisms but then we 6:22 traits coping mechanisms but then we also have interpersonal 6:24 also have interpersonal 6:24 also have interpersonal dynamics that means kind of how we dance 6:27 dynamics that means kind of how we dance 6:27 dynamics that means kind of how we dance or what our dynamic is with other people 6:30 or what our dynamic is with other people 6:30 or what our dynamic is with other people it's really important interpersonal 6:32 it's really important interpersonal 6:32 it's really important interpersonal dynamics this is where for instance 6:35 dynamics this is where for instance 6:35 dynamics this is where for instance early relationships might have been very 6:37 early relationships might have been very 6:37 early relationships might have been very important and they shape how you see the 6:39 important and they shape how you see the 6:39 important and they shape how you see the world how you see future relationship 6:41 world how you see future relationship 6:41 world how you see future relationship relationships, how you see your doctor, 6:43 relationships, how you see your doctor, 6:43 relationships, how you see your doctor, how you see the health care system at 6:45 how you see the health care system at 6:45 how you see the health care system at large. These are dynamics or dances if 6:49 large. These are dynamics or dances if 6:49 large. These are dynamics or dances if you will, interactions, relations that 6:51 you will, interactions, relations that 6:51 you will, interactions, relations that are really important to attend to to 6:53 are really important to attend to to 6:53 are really important to attend to to understand how individuals navigate 6:57 understand how individuals navigate 6:57 understand how individuals navigate health care or just seeing their chronic 7:00 health care or just seeing their chronic 7:00 health care or just seeing their chronic pain doc for instance. Intrapersonal and 7:03 pain doc for instance. Intrapersonal and 7:03 pain doc for instance. Intrapersonal and interpersonal dynamics are really 7:04 interpersonal dynamics are really 7:04 interpersonal dynamics are really important to understanding those 7:07 important to understanding those 7:07 important to understanding those parallel pains. So where does trauma fit
Central Sensitization and Chronic Pain 7:11 parallel pains. So where does trauma fit 7:11 parallel pains. So where does trauma fit into all of this? As mentioned, if 7:12 into all of this? As mentioned, if 7:12 into all of this? As mentioned, if somebody has had early trauma, that's 7:15 somebody has had early trauma, that's 7:15 somebody has had early trauma, that's going to shape them not just 7:17 going to shape them not just 7:17 going to shape them not just psychologically and being afraid of 7:19 psychologically and being afraid of 7:19 psychologically and being afraid of something that for for instance 7:21 something that for for instance 7:21 something that for for instance resembles something scary from the past, 7:23 resembles something scary from the past, 7:23 resembles something scary from the past, but also at a level that they may not 7:26 but also at a level that they may not 7:26 but also at a level that they may not even appreciate or be aware of. It may 7:28 even appreciate or be aware of. It may 7:28 even appreciate or be aware of. It may shape their neurological system. So 7:30 shape their neurological system. So 7:30 shape their neurological system. So here's where we get into the 7:31 here's where we get into the 7:32 here's where we get into the neurobiology of chronic pain. 7:40 It turns out that individuals with 7:40 It turns out that individuals with chronic pain that's lasting for years 7:42 chronic pain that's lasting for years 7:42 chronic pain that's lasting for years and only getting worse with time and 7:45 and only getting worse with time and 7:45 and only getting worse with time and doesn't respond to any treatments, they 7:47 doesn't respond to any treatments, they 7:47 doesn't respond to any treatments, they typically have something called central 7:49 typically have something called central 7:49 typically have something called central sensitization. 7:50 sensitization. 7:50 sensitization. That's fancy speak for your central 7:52 That's fancy speak for your central 7:52 That's fancy speak for your central nervous system being kind of on high 7:55 nervous system being kind of on high 7:55 nervous system being kind of on high alert, sensitized. 7:57 alert, sensitized. 7:57 alert, sensitized. Central central nervous systems are 7:59 Central central nervous systems are 7:59 Central central nervous systems are composed of our brains and spinal cords. 8:01 composed of our brains and spinal cords. 8:01 composed of our brains and spinal cords. If you look at how pain circuitry 8:03 If you look at how pain circuitry 8:03 If you look at how pain circuitry operates, it's not just your hand or 8:05 operates, it's not just your hand or 8:05 operates, it's not just your hand or your belly or your back that's hurting, 8:08 your belly or your back that's hurting, 8:08 your belly or your back that's hurting, it's actually a complex circuit or a 8:09 it's actually a complex circuit or a 8:09 it's actually a complex circuit or a loop that's going from those areas up 8:12 loop that's going from those areas up 8:12 loop that's going from those areas up the spinal cord into the brain and then 8:15 the spinal cord into the brain and then 8:15 the spinal cord into the brain and then back down. So, it's a complex circuit 8:17 back down. So, it's a complex circuit 8:17 back down. So, it's a complex circuit with a lot of moving parts. And it's 8:19 with a lot of moving parts. And it's 8:19 with a lot of moving parts. And it's important for patients to appreciate 8:20 important for patients to appreciate 8:20 important for patients to appreciate that as you navigate the health care 8:22 that as you navigate the health care 8:22 that as you navigate the health care system and you have chronic pain, the 8:25 system and you have chronic pain, the 8:25 system and you have chronic pain, the natural tendency is to go see a 8:27 natural tendency is to go see a 8:27 natural tendency is to go see a gastroenterenterologist if your belly 8:29 gastroenterenterologist if your belly 8:29 gastroenterenterologist if your belly hurts, a spine doctor if your back 8:32 hurts, a spine doctor if your back 8:32 hurts, a spine doctor if your back hurts, an orthopod if your leg hurts, 8:35 hurts, an orthopod if your leg hurts, 8:35 hurts, an orthopod if your leg hurts, etc. And that's all good and you should 8:38 etc. And that's all good and you should 8:38 etc. And that's all good and you should not discard that. But if you don't 8:41 not discard that. But if you don't 8:41 not discard that. But if you don't attend to that central nervous system, 8:43 attend to that central nervous system, 8:43 attend to that central nervous system, you might be missing a big part of the 8:44 you might be missing a big part of the 8:44 you might be missing a big part of the puzzle, particularly with chronic 8:47 puzzle, particularly with chronic 8:47 puzzle, particularly with chronic complex disabling pain. So, back to 8:49 complex disabling pain. So, back to 8:49 complex disabling pain. So, back to trauma. Trauma actually has been has 8:52 trauma. Trauma actually has been has 8:52 trauma. Trauma actually has been has been shown to centrally sensitize 8:55 been shown to centrally sensitize 8:55 been shown to centrally sensitize individuals. What does that mean? That 8:56 individuals. What does that mean? That 8:56 individuals. What does that mean? That means that unfortunately there are 8:58 means that unfortunately there are 8:58 means that unfortunately there are hormonal changes at the time of early 9:01 hormonal changes at the time of early 9:01 hormonal changes at the time of early trauma or worse chronic trauma that 9:05 trauma or worse chronic trauma that 9:05 trauma or worse chronic trauma that impact how that nervous system then 9:07 impact how that nervous system then 9:07 impact how that nervous system then adapts over time. And so now you have 9:10 adapts over time. And so now you have 9:10 adapts over time. And so now you have years later a very sensitized nervous 9:13 years later a very sensitized nervous 9:13 years later a very sensitized nervous system. Unfortunately, that sensitized 9:16 system. Unfortunately, that sensitized 9:16 system. Unfortunately, that sensitized nervous system can be quietly simmering 9:19 nervous system can be quietly simmering 9:19 nervous system can be quietly simmering and then when an incident occurs, a car 9:22 and then when an incident occurs, a car 9:22 and then when an incident occurs, a car accident, a surgery, an injury, suddenly 9:25 accident, a surgery, an injury, suddenly 9:25 accident, a surgery, an injury, suddenly it sort of explodes if you will erupts 9:28 it sort of explodes if you will erupts 9:28 it sort of explodes if you will erupts and now you have severe pain that is not 9:31 and now you have severe pain that is not 9:31 and now you have severe pain that is not behaving or responding to treatments 9:34 behaving or responding to treatments 9:34 behaving or responding to treatments like most pain and it can transition 9:36 like most pain and it can transition 9:36 like most pain and it can transition into chronic disabling pain.
How Trauma Shapes the Nervous System 9:45 So, trauma is relevant. It's important. 9:45 So, trauma is relevant. It's important. Does it cause it alone? No. But it sort 9:48 Does it cause it alone? No. But it sort 9:48 Does it cause it alone? No. But it sort of sets up a template of risk, if you 9:50 of sets up a template of risk, if you 9:50 of sets up a template of risk, if you will. And mixed with other factors can 9:53 will. And mixed with other factors can 9:53 will. And mixed with other factors can result in chronic disabling pain. Not 9:56 result in chronic disabling pain. Not 9:56 result in chronic disabling pain. Not attending to that trauma. Although we 9:58 attending to that trauma. Although we 9:58 attending to that trauma. Although we can go back in time machines, but we 10:01 can go back in time machines, but we 10:01 can go back in time machines, but we can't we we can't ignore the residue of 10:04 can't we we can't ignore the residue of 10:04 can't we we can't ignore the residue of that, the effects of trauma. So this is 10:05 that, the effects of trauma. So this is 10:06 that, the effects of trauma. So this is where again going back to the parallel 10:07 where again going back to the parallel 10:07 where again going back to the parallel pains part, we need to understand how 10:10 pains part, we need to understand how 10:10 pains part, we need to understand how people are sort of built 10:11 people are sort of built 10:11 people are sort of built psychologically. That's also stemming 10:13 psychologically. That's also stemming 10:13 psychologically. That's also stemming from the trauma and development that's 10:15 from the trauma and development that's 10:15 from the trauma and development that's early on. We can do something about 10:17 early on. We can do something about 10:17 early on. We can do something about that. That's where therapies, 10:20 that. That's where therapies, 10:20 that. That's where therapies, counseling, and other strategies might 10:23 counseling, and other strategies might 10:23 counseling, and other strategies might help unlock the sort of mental and 10:26 help unlock the sort of mental and 10:26 help unlock the sort of mental and psychological mystery that is at play in 10:29 psychological mystery that is at play in 10:29 psychological mystery that is at play in the chronic pain patient. 10:32 the chronic pain patient. 10:32 the chronic pain patient. So, in summary, to answer the question, 10:34 So, in summary, to answer the question, 10:34 So, in summary, to answer the question, emotional trauma cannot by itself cause
Summary and Closing Thoughts 10:37 emotional trauma cannot by itself cause 10:37 emotional trauma cannot by itself cause physical pain. However, emotional trauma 10:41 physical pain. However, emotional trauma 10:41 physical pain. However, emotional trauma or really any significant trauma can 10:44 or really any significant trauma can 10:44 or really any significant trauma can shape our bodies, our nervous systems, 10:47 shape our bodies, our nervous systems, 10:48 shape our bodies, our nervous systems, and our psychologies to then emerge from 10:51 and our psychologies to then emerge from 10:51 and our psychologies to then emerge from acute pain to lasting chronic complex 10:55 acute pain to lasting chronic complex 10:55 acute pain to lasting chronic complex disabling pain. So, trauma is important 10:57 disabling pain. So, trauma is important 10:57 disabling pain. So, trauma is important for us to attend to as well as the 11:00 for us to attend to as well as the 11:00 for us to attend to as well as the psychological effects of trauma. 11:03 psychological effects of trauma. 11:03 psychological effects of trauma. I'm Dr. Javier Jimenez or Dr. X. Follow 11:07 I'm Dr. Javier Jimenez or Dr. X. Follow 11:07 I'm Dr. Javier Jimenez or Dr. X. Follow me for more conversations about 11:09 me for more conversations about 11:09 me for more conversations about emotional trauma and physical
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