Latest / The Brain Dump / What Pharmaceutical Research Taught Me About the Power of the Therapeutic Relationship | Episode 28

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What Pharmaceutical Research Taught Me About the Power of the Therapeutic Relationship | Episode 28 · The Brain Dump

• 0:00
  SPEAKER_00: Hi, I'm Sandy Boone, therapist, coach, and nervous system educator with 30 years in healthcare and mental health.
• 0:06
  SPEAKER_00: I built two practices, got diagnosed with ADHD at 50, and learned the hard way that healers need healing to.
• 0:12
  SPEAKER_00: I help female therapists and healers regulate their nervous systems, reclaim their lives, and stop being everyone's everything.
• 0:18
  SPEAKER_00: Welcome to the Braind Dump with Sandy Boone.
• 0:31
  SPEAKER_00: Before I became a therapist, I spent 12 years in pharmaceutical research.
• 0:35
  SPEAKER_00: I want to tell you about that because I think it explains more about why I practice the way I do than almost anything else in my background.
• 0:43
  SPEAKER_00: It's also where I first encountered the brain-body connection, not as a concept, not as something I learned in a textbook, but as something I watched happen in real time in real people over and over again.
• 0:54
  SPEAKER_00: The thing that I learned in pharmaceutical research was this the relationship between the clinician and the patient was doing more healing than the compound being studied, not sometimes consistently.
• 1:05
  SPEAKER_00: The industry had a name for it.
• 1:06
  SPEAKER_00: They called it my placebo rate.
• 1:08
  SPEAKER_00: Multiple people told me over the course of those 12 years that I had a really high placebo rate.
• 1:14
  SPEAKER_00: What they meant was that the people in my studies who were receiving the inactive compound, the sugar pill or the inactive control, were getting better at a rate that was inconvenient for the data.
• 1:25
  SPEAKER_00: What I heard was something completely different.
• 1:27
  SPEAKER_00: I heard you are healing people through presence and relationship and attunement, and we are measuring it as a confounding variable instead of recognizing it as the mechanism.
• 1:38
  SPEAKER_00: That realization sent me back to school.
• 1:40
  SPEAKER_00: That realization is the foundation of everything I do now, and it's what this episode is about.
• 1:45
  SPEAKER_00: Let me back up and tell you how I ended up in the pharmaceutical research in the first place.
• 1:50
  SPEAKER_00: I often joke that no one lands in pharmaceuticals on purpose because that's been my experience.
• 1:55
  SPEAKER_00: My son was born and I needed work that made sense for that season in my life.
• 1:59
  SPEAKER_00: Clinical research fit.
• 2:01
  SPEAKER_00: At first, it was really meaningful work.
• 2:03
  SPEAKER_00: I was building relationships with patients, providing access to care that may not have otherwise been available.
• 2:09
  SPEAKER_00: And this was before the Affordable Care Act, when the landscape of healthcare access looked very different than it does now.
• 2:15
  SPEAKER_00: The people who participated in clinical research came in for different reasons.
• 2:19
  SPEAKER_00: Some were motivated by something bigger than themselves.
• 2:22
  SPEAKER_00: They wanted to contribute to science, leave something behind, to be a part of an answer to a disease that had affected them or someone they loved.
• 2:30
  SPEAKER_00: Some found it interesting.
• 2:31
  SPEAKER_00: They liked learning about their own bodies, being on the inside of something most people never see.
• 2:37
  SPEAKER_00: Others came because they didn't have insurance, and clinical research provided screening procedures and healthcare access that simply wasn't available to them in any other way.
• 2:46
  SPEAKER_00: All of those motivations were valid and all of them were real.
• 2:49
  SPEAKER_00: In the early years of that work, I felt the weight and the privilege of what I was doing every single day.
• 2:54
  SPEAKER_00: But something shifted when pharmaceutical drugs started being advertised on television.
• 2:59
  SPEAKER_00: Maybe the profit motive had always been there.
• 3:01
  SPEAKER_00: It probably had.
• 3:02
  SPEAKER_00: But once those commercials started, something that had been operating in the background became impossible to ignore.
• 3:08
  SPEAKER_00: The industry I was a part of was, at its core, a for-profit enterprise.
• 3:13
  SPEAKER_00: For-profit enterprises have a particular relationship with healing that I found increasingly difficult to reconcile because real healing is not always the most profitable outcome.
• 3:24
  SPEAKER_00: In fact, when it's done right, it's not at all.
• 3:27
  SPEAKER_00: Over the course of those 12 years, I learned something I've never been able to unlearn.
• 3:31
  SPEAKER_00: The relationship cured more than the drug did.
• 3:34
  SPEAKER_00: Not every single case, of course.
• 3:36
  SPEAKER_00: A lot of times the drug helped, but with a consistency that was undeniable to anyone paying attention.
• 3:42
  SPEAKER_00: The quality of the human connection between the person receiving care and the person providing it was doing something that the compound alone could not do.
• 3:50
  SPEAKER_00: I was really good at that connection.
• 3:52
  SPEAKER_00: I built real relationships with the people in my studies.
• 3:55
  SPEAKER_00: I showed up for them as humans, not as data points.
• 3:58
  SPEAKER_00: I knew their names, their families, what mattered to them, and what scared them.
• 4:02
  SPEAKER_00: My placebo rate reflected that.
• 4:05
  SPEAKER_00: When the people around me said, you have a really high placebo rate, they were describing the measurable effect of a therapeutic relationship.
• 4:12
  SPEAKER_00: They were watching the body respond to being truly seen and cared for by another human being.
• 4:18
  SPEAKER_00: They were watching the nervous system relax in the presence of someone who was really consistently present, authentically present.
• 4:26
  SPEAKER_00: They were watching the brain-body connection in action.
• 4:29
  SPEAKER_00: They just weren't calling it that.
• 4:30
  SPEAKER_00: And I was watching it too.
• 4:32
  SPEAKER_00: What I was seeing made me increasingly unable to stay in an industry that treated that connection as a variable to be controlled for rather than a phenomenon worth understanding.
• 4:41
  SPEAKER_00: So I went back to school, I got my master's degree, built to practice, and I've spent every year since trying to understand and apply what I first witnessed in those research studies, that the body responds to relationship, that healing is not a passive process that happens to a person, and that the brain and the body are not separate systems that happen to live in the same organism.
• 5:02
  SPEAKER_00: They are one system, and treating them as anything else is always going to produce incomplete results.
• 5:07
  SPEAKER_00: Let me get really specific because I think this concept gets talked about in ways that are true but not always useful.
• 5:14
  SPEAKER_00: When we say brain-body connection, we're not talking about the mind being positive or the body following suit.
• 5:21
  SPEAKER_00: We are not talking about visualization or intention or any of the things that get lumped into wellness culture and stripped of their actual science.
• 5:28
  SPEAKER_00: We are talking about a bidirectional communication system that operates constantly, below the level of conscious awareness, between your brain and every single organ, tissue, and system in your body.
• 5:41
  SPEAKER_00: Your gut communicates with your brain through the vagus nerve, and roughly 80% of those signals travel from the gut up to the brain, not the other way around.
• 5:51
  SPEAKER_00: Which means what's happening in your gut is directly influencing your mood, your cognition, your emotional regulation, and your sense of safety in the world.
• 6:00
  SPEAKER_00: This is not a metaphor, friends.
• 6:01
  SPEAKER_00: This is anatomy.
• 6:03
  SPEAKER_00: Your gut produces 90 to 95% of your body's serotonin.
• 6:07
  SPEAKER_00: Nobody told us that in graduate school.
• 6:09
  SPEAKER_00: Your adrenal glands respond to signals from your brain's threat detection system and release cortisol, which then travels back through the bloodstream and affects the brain function, immune function, digestive function, and the body's ability to produce the neurotransmitters that regulate mood and motivation.
• 6:26
  SPEAKER_00: One system talking to another constantly in a loop that doesn't have a clean beginning or end.
• 6:32
  SPEAKER_00: Your autonomic nervous system is running beneath every interaction you have, every clinical session you hold, every relationship you're in.
• 6:40
  SPEAKER_00: It is tracking safety and threat, regulating your heart rate, and breathing and digestion.
• 6:45
  SPEAKER_00: And it's sending signals up to your brain about whether this moment feels okay or whether it doesn't.
• 6:51
  SPEAKER_00: None of this is happening only in your mind.
• 6:53
  SPEAKER_00: All of it is happening in your body, and it is affecting what you think, what you feel, and what you're able to do.
• 6:59
  SPEAKER_00: That is what nobody explained to most of us in graduate school.
• 7:02
  SPEAKER_00: We learned about cognitive distortions and attachment styles and diagnostic criteria.
• 7:08
  SPEAKER_00: We did not learn that the vagus nerve is the highway between the body and the brain, and that the state of that highway determines a great deal about how a person is able to experience their own life.
• 7:18
  SPEAKER_00: When I understood this, and I mean really understood it, not just intellectually, but in terms of what it meant for the people sitting across from me, it changed how I practiced.
• 7:27
  SPEAKER_00: If the brain and the body are one system, then treating only the brain through conversation, through insight, through cognitive restructuring is always going to be partial work.
• 7:37
  SPEAKER_00: It is working on one part of a system while leaving the rest of it unaddressed.
• 7:42
  SPEAKER_00: Think about the person who has done years of therapy and still can't shift the pattern.
• 7:47
  SPEAKER_00: Think about the person who understands their trauma, can articulate it clearly, has done the work, and whose body is still responding as if the threat is present.
• 7:56
  SPEAKER_00: Think about the healer who's burned out, has tried all the self-care, and still feels flat.
• 8:01
  SPEAKER_00: In every one of those cases, the question worth asking is, what is happening in the body that the mind level work hasn't been able to reach?
• 8:10
  SPEAKER_00: Sometimes it's the nervous system needing body-based intervention, somatic work, movement, breath work, neurofeedback.
• 8:16
  SPEAKER_00: Sometimes it's the gut brain axis, what's happening in the digestive system that's contributing to anxiety, mood instability, and cognitive fog.
• 8:24
  SPEAKER_00: Sometimes it's the mineral status, the raw minerals the brain needs to produce the neurochemicals that make regulation and connection and joy possible.
• 8:32
  SPEAKER_00: The functional medicine lens is not a replacement for good clinical work.
• 8:36
  SPEAKER_00: It's the missing layer.
• 8:37
  SPEAKER_00: It's the part of the picture that explains why good clinical work sometimes hits a ceiling and it can't break through on its own.
• 8:44
  SPEAKER_00: To work with me and explore what that layer looks like for you, check the show notes.
• 8:48
  SPEAKER_00: I want to come back to that placebo rate for a moment because I think it contains something important that I didn't fully understand until years later.
• 8:56
  SPEAKER_00: What the research was measuring when my placebo rate was high was the effect of a therapeutic relationship on physiological outcomes.
• 9:03
  SPEAKER_00: People were getting better, measurably objectively better, in response to being in relationship with someone who showed up for them consistently and with authentic care, even when they weren't getting the real drug.
• 9:16
  SPEAKER_00: That is the brain-body connection in its most human form.
• 9:19
  SPEAKER_00: The body responds to being seen, the nervous system responds to the presence of a calm, attuned other.
• 9:25
  SPEAKER_00: The physiological systems that regulate mood, immunity, digestion, and stress response all respond to the quality of the relational environment we're in.
• 9:34
  SPEAKER_00: This is what Peter Levine means when he talks about co-regulation.
• 9:38
  SPEAKER_00: This is what Stephen Porgius means when he talks about the social engagement system.
• 9:42
  SPEAKER_00: This is what decades of attachment research has been pointing towards.
• 9:46
  SPEAKER_00: The presence of a safe, regulated other changes the physiology of the person with them.
• 9:52
  SPEAKER_00: Folks, that's not soft science.
• 9:54
  SPEAKER_00: That is one of the most well-documented phenomena in the relational neuroscience literature.
• 9:58
  SPEAKER_00: My placebo rate was high because I was good at relationship.
• 10:02
  SPEAKER_00: Relationship is a physiological intervention, whether we call it that or not.
• 10:06
  SPEAKER_00: I want to say something directly to the clinicians and healers listening because this matters for how you understand your own work.
• 10:12
  SPEAKER_00: You are a physiological intervention.
• 10:15
  SPEAKER_00: Every session you hold, every relationship you build, every moment of authentic presence and attunement you offer, it is not just psychological support.
• 10:25
  SPEAKER_00: It is a direct input into another person's nervous system.
• 10:28
  SPEAKER_00: It's co-regulation and it's biology.
• 10:31
  SPEAKER_00: That is an enormous responsibility and it's also an enormous privilege.
• 10:35
  SPEAKER_00: The reason your clinical relationship matters so much is not just because connection feels good or because people need to feel heard.
• 10:42
  SPEAKER_00: It is because a regulated, attuned human presence literally changes what is happening in another person's body.
• 10:48
  SPEAKER_00: It shifts their autonomic state.
• 10:50
  SPEAKER_00: It creates a physiological condition in which healing becomes possible.
• 10:55
  SPEAKER_00: You knew this intuitively probably, or you wouldn't be in this work.
• 10:59
  SPEAKER_00: What I want to give you is the language and the science to understand what you've already been doing.
• 11:03
  SPEAKER_00: The brain-body connection is not a concept to add to your continuing education credits.
• 11:08
  SPEAKER_00: It's the mechanism by which everything you do as a healer actually works.
• 11:13
  SPEAKER_00: Twelve years in pharmaceutical research taught me that the relationship cured more than the drug did.
• 11:18
  SPEAKER_00: Graduate school taught me the language of the mind.
• 11:20
  SPEAKER_00: Somatic experiencing in functional medicine taught me the language of the body.
• 11:24
  SPEAKER_00: Thirty years of clinical practice taught me that you cannot separate them and expect complete healing.
• 11:30
  SPEAKER_00: The brain-body connection is not a wellness trend.
• 11:33
  SPEAKER_00: It is not an alternative to evidence-based practice.
• 11:36
  SPEAKER_00: It is the foundation that evidence-based practice has been slowly and perfectly building toward for decades.
• 11:42
  SPEAKER_00: Nobody explained it to most of us when we were trained.
• 11:45
  SPEAKER_00: We learned about the mind and then we learned about the body, and nobody told us they were running the same operating system.
• 11:52
  SPEAKER_00: Now you know.
• 11:53
  SPEAKER_00: Thanks for being here.
• 11:54
  SPEAKER_00: If something today resonated with you and you want to explore what the brain body connection looks like in your own physiology, check the show notes.
• 12:02
  SPEAKER_00: You'll find information about booking your root cause roadmap with me at sandyboon.com, where we look at what is actually happening in your body and build a plan that addresses the whole system, not just the parts that show up on a standard lab panel.
• 12:14
  SPEAKER_00: That's where we start.
• 12:15
  SPEAKER_00: Thanks for being here.