Latest / 🎙️ Rebuild & Fulfill Real conversations on burnout, rebuilding, and becoming stronger than before. / When Your Brain Gets Too Good at Protecting You | Dr. Sam Tyriver & Hayley DiMarco | Episode 36
Transcript
- Kelsey Dunbar: What if the thing holding you back isn't that your body is broken, but that your brain has gotten too good at protecting you? Pain is real, anxiety is real. The fear you feel when your body tells you something isn't safe Marc Rogala: Also, it's often a difference. Kelsey Dunbar: is absolutely real. But what if the alarm and the actual danger aren't always the same thing? And what happens when the system designed to keep you safe starts making your world smaller? Today we're talking about pain, fear, avoidance, the nervous system, and how we begin teaching the brain Marc Rogala: Thank Kelsey Dunbar: that it may finally be safe to live again. Welcome back to Rebuild and Fulfill, where we have real conversations about what it takes to rebuild when life doesn't go according to plan and become stronger on the other side. I'm Kelsey Dunbar, joined as always with my co host and Suffer to Tougher co founder, Marc Rogala, and we have two guests today whose work immediately caught our attention because there is a lot of crossover between what they're teaching and conversations Marc and I have all the time. Dr. Sam Tyriver is a physical therapist and Doctor of physical therapy and certified wellness coach who has spent more than a decade working with patients with particular focus on chronic pain, mental health, and the connection between the brain and body. Sam developed the physical therapy curriculum and programming for a comprehensive intensive pediatric pain program in Milwaukee, working closely with specialists across mental health, trauma, and chronic pain. He's worked alongside psychiatrists, psychologists, Counselors, social workers, trauma specialists, and eating disorder professionals, and he's lectured at universities, wellness organizations, the Milwaukee VA, and professional associations. He's also the creator of the Certified Mind Body Trained Therapist Program, which trains physical and occupational therapists across the country to approach chronic pain, anxiety, and trauma through a neuroscience informed mind body framework. And then there's Hayley DeMarco, who has been translating complicated ideas into words people can actually use for a long time. Hayley is a best-selling author with more than 50 published titles and is the founder of Hungry Planet, a content and design studio. Her work has reached readers across a wide range of topics. Marc Rogala: I'll stop this. Kelsey Dunbar: But this book that we are talking about today is different Marc Rogala: possible. Kelsey Dunbar: because she isn't approaching it simply as a writer. She lived it. Haley's own nervous system remained on high alert long after the original threat had passed, and she eventually found herself sitting across from Sam, not as his future co-author, but as his patient. Together, they've taken Sam's years of clinical experience and Haley's ability to translate complex ideas through the lens of her own experience and turn it into their upcoming book. Marc Rogala: Okay. Okay. Kelsey Dunbar: The overprotective brain. And we're also excited that Sam and Hayley will be joining us as speakers at the upcoming Transformation Gap Summit, where they'll be taking this conversation even deeper. We'll tell you a little bit more about that later. But today I want to go back to where this partnership actually started. Because Sam didn't go looking for Hayley because he needed a co-author. Hayley originally came to Sam because she needed help. So that's where I want to start. So, Hayley, take us back to the beginning. What was happening in your life and your body that eventually put you in Sam's treatment room? Marc Rogala: Yes. Hayley DiMarco: Wow. Okay. I I came to Sam and I told him I felt like my grandmother instead of myself and that had been going on for like twenty years. I just I could barely get out of a chair and I was unable to do most of the things that I enjoyed doing because I had migraines and a lot of other st other things. I had chronic anxiety, I had just a lot of pain issues. I went to Sam because we'd moved to Wisconsin and his office was right across the street and I Marc Rogala: Okay. Hayley DiMarco: thought, well I'll go here. I I I didn't know anything about him. Marc Rogala: Okay. Hayley DiMarco: But within the first three visits, he changed my life. He literally changed my life. We started to work on it. And I don't know, in a few months I was back to being my well, probably younger than my age. I felt so much better. I was able to do so many things. And I think there Sam, there's probably a lot of times when I was saying, Well, do you have a video on this? You gotta get this out there. People need to know this. But I do remember, maybe I don't know, six months later I said, Have you ever thought about writing a book? And he's like, I don't know. I don't know how to write a book. I mean, I'd like to. And I said, Well Let me help you. That's what I do. And so that was it. He was ready. He was like gung-ho. And we just started in. Marc Rogala: So Hayley, said you were dealing with this for over 20 years. At that point, what were you thinking? Something in my body is broken and somebody needs to figure out what it is? Hayley DiMarco: I was yeah, I you know, I'd tried everything. I tried medical doctors, I'd tried naturopaths, I tried chiropractors, I tried PT. And you know, you you come back, you feel like, there's a day or two where I'm kind of normal and then I'd get hit again with another flare up and yeah, I felt like my body was attacking me. I felt like what's something's wrong that my body just hates me. It just must hate me because there's so many things happening. So yeah, it was it was it was a losing battle that I'd fought for mu really longer than twenty years. Most of my life, really, I'd say. Kelsey Dunbar: So Sam, I I'd love to hear the same story from your side. So when Hayley first came to see you, what did you think that perhaps she couldn't see yet? Dr. Samuel Tyriver: she came in, I remember I think in the original diagnosis of the script said maybe headaches or migraines, and those can come from a lot of reasons. but after a couple of visits, it really became clear that the the root cause for the the the headaches, the migraines, there was just there's more to it. It wasn't just because her traps were tight. she said something about you know, I'll reach overhead and I'll I'll have a headache or a migraine for days afterwards. And that like that physiologically, if it's a tension headache or a migraine. doesn't fit that's not consistent it follows one of the the rules of acute versus chronic what we used to call acute versus chronic pain and it just none of it fit and so I realized that I had seen Hayley before I had seen her many times before names are different the diagnoses and the details are different but the root problem the cause the overprotective brain that was causing all of these issues that was the same and that's what we need to deal with. presenting it to Hayley You're always on the fence. You know, do is she gonna is she ready to start looking at her symptoms in a different way? than just saying, no, no, the issue's my neck, it's my back, it's my tummy, it's my elbow, it's my shoulder, whatever. And and you never know. And so I presented, hey, you know, there's a different way that we can look at this. And if we kind of step through a a process, I think you'll understand kind of how this this works. And it's not the issue isn't lying in your neck or your shoulders. And she was on board. She was receptive. She was open-minded. and it's really it's because of her. Like the the patient makes the progress. I can show them or explain, but the difference between treating Haley's underlying issues and just tight muscles in the neck is Can't fix it. You have to present it to the patient, and then the patient has to be on board with it. And fortunately for everyone, Hayley was. And then after that. Hayley DiMarco: I d I just have to say, Dr. Samuel Tyriver: she had mentioned she was an author and you know, you're focused on like I'm a one track mind, like let's let's help Hayley get healthier or whatever first. And then she's like, Have you ever thought about writing a book? And a couple of years ago I had I Googled it, like how to write a book. And I'm like, I'm nobody and like I've never written a book. I've written papers, I've you know, published clinical guidelines, but like I don't know, first thing I w and I just got overwhelmed. I'm like, it's gonna be one of those things that I guess I just will have always wanted to do. And then the miracle of Hayley happened and she if it weren't for her, there's no book. Hayley DiMarco: I do remember that when when he started to present all this information to me, it was like a light went on and I said, Why has no one told me this? Why have I lived this long? And now I'm starting to understand, I I literally did, like you asked, Marc, I really felt like my body was trapping me. And there was really no answer. Like I could get a massage and maybe it'd go away, I'd get a little PT, it would go away. But I didn't know there could be an end to chronic pain until Sam came along. Kelsey Dunbar: Yeah, I love stories like this where the relationship goes from clinician and patient to the two of you writing a book together. It's just awesome to see collaboration. Dr. Samuel Tyriver: Yeah, I agree. It was, you know, a patient comes in and what Hayley said, to go back to what she said about, you know, why wasn't I ever told this? Is I I the I think there's a lot of reasons for it because the way to treat an overprotective brain, everything you do, I mean, technically, yes, insurance has to pay for physical therapy, but the way to help people with overprotective symptoms, pain, anxiety, it's free. There's no pill, there's no like system, there's nothing that you have to pay for. And so, you know, why don't you hear about it more? Why aren't why aren't teenagers taught this? Why aren't kids taught this in college or in school? I was like, well, nobody makes money off of it. You know, like it's it's these things live inside your body and learning how to tap into those and access those, that's where the treatment lies. And that's what I try to show Hayley, and that's what Hayley did for herself. I was, yes, she came to see me, but she did the things to make her brain heal and her nervous system heal. Marc Rogala: So I got a question. So obviously there's tenseness in this particular area here, in the neck, So you're having headaches, you're having like neck and back pain as well? Hayley DiMarco: No, no. I mean, the headache was in the neck. I think the the interesting part is that it was just if I raise my hands over my head, instant headache for forty-eight hours. It was always forty eight hours. And it was always Marc Rogala: Okay. Hayley DiMarco: a headache if my arms went over my head. What what Sam told me is that's not physically something that should happen. That is a heightened alarm. You know, we all have video those video doorbells in the front of the ho our houses and those can have settings where you can have them really sensitive, like I want to know everybody that comes to my door. Or you can turn it down and say, I don't want to know animals. I don't want to know about leaves. Right. You in fact, I don't want notifications at all. And what Sam was showing me was that my my ring doorbell, my alarm was set to sensitive. So everything that came along, my body said, this is bad. This is bad Marc Rogala: Thanks everybody. Hayley DiMarco: news. And that it it's it's reminds me of a story. My dog, Marc Rogala: Thank you. Hayley DiMarco: I have a dog and we used to live in Eugene in Marc Rogala: Okay. Hayley DiMarco: an old house that had a really overprotective smoke detector. And every time I would do anything in the kitchen, I boil water, the smoke detector would go off. And my dog would freak out. You know, it's so loud. He would run and hide in the living room. Well, we moved to Wisconsin and now we have a healthy smoke detector. Doesn't go off. Really, I it hasn't gone off once Marc Rogala: Thank Hayley DiMarco: since we've lived here. But every time I cook, even if I open up the oven, my dog runs and hides. Because his system has learned, that's dangerous. I don't, I want, I know what's coming next. Marc Rogala: Thank Hayley DiMarco: And that's where I was. My system was like, One time you raised your hands over your head, you happened to get a headache and it thought, Well, we can't do that anymore. And so that was to me, that's the big picture. That's the overprotective brain is it's really struggling to keep us safe when really what it's doing is keeping us trapped. Dr. Samuel Tyriver: And that really is the that's the premise for the book. Hayley came up with this analogy of you know, our brain should really be a fortress. You have all the trappings of a fortress, you've got sentries, guardians, walls, you've got amenities, you've got all these drugs that live in your brain, these chemicals that make you feel amazing, but we don't know how to access those things. And when that fortress, the analogy in the book that we use, starts to become a prison, your world just gets smaller, just like being a prisoner in a cell. suddenly you can't leave your bed. You're not gonna go on that trip. You're not gonna go out with your friends. And your brain becomes overprotective. Just like an overprotective parent or a spouse, it becomes anticipatory. No, no. If you go to that concert, you're gonna do drugs or get in trouble. Or your brain says, no, no, if you raise your arms over your head, if you exercise, if you go back to work, go back to school, you're gonna pay for it for days. And then when you do those things, your brain knows that it's trying to protect you. And so it sounds the alarms. It it fires off all the warning size. So you go Marc Rogala: Okay. Thank Dr. Samuel Tyriver: And you ride an exercise bike for 10 minutes. Great. That's that's a good thing. That should be very healthy. But just like an overprotective spouse or parent, the the very thing that's supposed to be good for you, that makes you healthy, is the thing that's gonna set you free. The brain doesn't want you to do that and it punishes you for that. It creates pain. It creates when we get down to the neuroscience of it, when your brain is being used up by anxiety, pain, depression, trauma, or stress, you can insert any of those words, those neurons can't fire in your brain. They're not being used for their original purpose. Marc Rogala: I'll Dr. Samuel Tyriver: movement, thought, math, dribbling a basketball, exercising, controlling your heart rate, blood pressure, your digestive system, your reproductive organs, you name it, your brain is responsible for it. And when Marc Rogala: speak. Dr. Samuel Tyriver: those neurons are being used up by something else that is not the intended purpose, we lose all this function. And that's where when I have patients that come in and they've got, say I've got ulcers, I've got IBS, I've got anxiety, I've got splotches, I've got a heightened heart rate, but dropping blood pressure. It's all explained by the neuroscience behind pain, anxiety, trauma, depression, and stress. And that's the nature of the book. That's the the whole analogy that Hayley came up with. Marc Rogala: Yeah, so here's a question for both of you. When did each of you realize there's something bigger here that we need to get out to other people? Dr. Samuel Tyriver: So I left when I left Children's and Rogers in 23. that was a program for teenagers 13 to 18 years old. And then they had to commit to that program. And it was the children's way, which is fine, and the Rogers Way, which is also fine, but it was a blanket approach. So if you're 13 to 18 years old and you can commit to eight hours a day, five days a week, four to six weeks, awesome, good. You're gonna do great in this program. And then when you leave the program, Sorry, good luck. We there was no step down. There was no there was nothing for anyone else. And so when I left that in twenty-three, I said, Where can people go that are maybe not thirteen to eighteen years old that can't commit to five days a week, eight hours a day? Where's a fifty year old go? Where's a twenty-five year old go? Where do these kids and teenage go after that program? And then they need ongoing therapy, maybe not every day, maybe once a week or once every other week or twice a week. And so that's when I created the mind body program. And I was able to pitch it at Doctors of Physical Therapy, I saw a need for it outside of an intensive program. I had no idea. I had to plan on doing it in Wahuatosa. And that was it was gonna be good. It was gonna be my thing in Wahuatosa. And then one of the leadership mentors in the doctors of physical therapy was like, Have you thought about maybe expanding this? And so we piloted and expanded the program. Marc Rogala: . Dr. Samuel Tyriver: wider and wider to train other therapists. And that's that was it. Like that's all I saw is it's gonna be a thing that I can teach other therapists to do. And then it you just kind of grew within doctors of physical therapy and now it's opened up to you know people outside of doctors of physical therapy. And then Hayley came in and Hayley, this is where you should pick it up and just talk about what this concept of okay, mind body program, but now it's become a book and it's become more than just a this is what Sam does in TOSA. Hayley DiMarco: Well, I can remember the first time that we sat down to kind of plot out what's this about, what's this idea and what is a book, because that's really my my job. Sam said to me, You know, your body's a fortress. And I said, What? Wait, just stop, just stop there. I I really got chills because I was like, My body's a fortress. Now that's a pretty good visual. And I said, But mine feels like a prison. Marc Rogala: Thank you. Hayley DiMarco: So What's the problem here? It should be a place where I feel safe, where I'm protected, where I can go about my day and I'm not getting all these alerts and alarms and the dogs are set out barking and the gunmen have their guns out and I'm and I'm constantly in some kind of a threat mode. And that that was to me, that was huge. And that's when I said, you Marc Rogala: Okay. Hayley DiMarco: know what this really is? This is an overprotective brain. And all all through well, even at the beginning, Sam, when you first started telling me about this, you said, Okay, you have chronic pain and you have acute pain. Now I'm not a PT. Marc Rogala: She's in that one. Hayley DiMarco: I was like, what's acute pain? I don't know what's acute pain. It's not a normal thing that lay people like us talk about. And so he explained to me. And I thought, okay, there's gotta be another expression for this. And so as we started to work on it, we started to recognize, you know what? There's actually helpful pain and there's overprotective pain. And what I was experiencing, I had no damage to my system. There was no, Marc Rogala: After After Hayley DiMarco: right, Sam, you can talk more about this, but I didn't have any problems with my x-rays or anything. I had overprotective, not helpful. Because it wasn't pointing to damage and overprotective pain. And I think a lot of people, I know a lot of people who struggle with this kind of pain that they can't, the doctors can't tell you what it is. They don't know. They call it fibromyalgia, they call it, I don't know, what are some of the other terms? they they have these ideas and they can tell you, we know you're in pain, but we don't know why. And Sam told me why. And that was when I said, people need to know this. Marc Rogala: I mean, I'm just thinking about my personal story. And I don't know if you know much about my personal story, Hayley, but I'm an opioid addict in recovery. And I was introduced to prescription pain medicine as a result of a neck and back issue that they really never could figure out. They're having me do MRIs, they're having me do EMGs. My personal doctor couldn't figure it out. The surgeon couldn't figure it out. He referred me to a surgeon. The surgeon referred me to a pain doctor close to where I live. He introduced me to prescription pain medication and that was it in the five or six year period. I ended up losing my career, losing my marriage, my relationship, my kids, a number of overdoses. Came out on the other side though, okay. Living a life of recovery completely changed my lifestyle, my diet, my mindset, my body movement and doing a lot of work in the recovery community. And that's kind of how Kelsey and I came together. But I can totally relate to this and understand this. And for the audience, I just want to get this out there. Sam works at the same company that my girlfriend Tiffany works at. And she was part of that program initially. And she was sharing some of that material with me when you guys were doing the meetings virtually. And she had, she would take pictures of the actual slides and send them to my texts. Be honest with you, Sam. And I'm reading this and I'm like, man, this is like speaking to me because I totally understand it. Because when I was in the weeds of my addictions, then I started working with the actual clinical therapist. And I found out that I had PTSD, general anxiety disorder, panic disorder, major depressive disorder. So everything was kind of working its way, you know, to the pain that I was feeling in my body. I never had my back touched surgically. never, I mean, it hasn't bothered me since I got into recovery and I started living my life in a much healthier way. But I've been able to keep my mental health in check with coping skills and daily structure and so forth. And it's been an amazing journey that Kelsey and I have been on, but this speaks to me. So I appreciate you giving this information out there for sure. Hayley DiMarco: You bet. I'm I'm happy. I'm I'm glad to hear that. Kelsey Dunbar: Yeah. So Sam, when you talk about, the healthy protection system versus an overprotective one, for that person that's listening right now going, Wait, is this me? What are s some of the signs that their alarm system may be responding to perceived danger rather than current danger? Dr. Samuel Tyriver: So overprotective pain, it follows certain rules. So usually the pain that you're experiencing is not it's not coherent with a certain tissue issue. So we use tissue issues, someone comes in with a rotator cuff, we ask describe your pain, we have specific tests that it's diagnostic, it follows rules. We know what's causing the pain. Is your ro is your shoulder pain a rotator cuff issue? Is it a labral tear? We can do things that tell us what causes the pain, what hurts, what kind of pain it is. Overprotective pain doesn't, it anticipates it, it tries to keep you withheld from doing the thing. So sometimes just thinking about doing an activity can cause pain. And people, I I want to make sure that like I want to really highlight a point that when we say overprotective brain, I think a lot of people hear that and they say, You're telling me it's all in my head. This is mind over matter. And the Marc Rogala: . . Dr. Samuel Tyriver: The truth, the literal truth is that because your brain is in your head, yeah, technically it is all in your head. If your brain was in your elbow, I'd tell you it's all in your elbow. But all pain is in your head. If I get a cut, a scrape, a bruise, a broken bone, that pain is still in my head. If you remove my brain, and this is one of the way that pain medications work, they work in two ways. One is it just dumbs your your it numbs your brain cells, so you become less functional. Well, you can't use a functional heavy machinery if you're under opioids. So opioids work that way, subs illicit drugs work that way. Marc Rogala: Okay. Okay. Dr. Samuel Tyriver: and so all pain is within your head, but overprotective pain, it becomes this anticipatory. I do this thing, and my pain is preventing me from living my life. It's holding me a prisoner. Helpful pain should be should be helping you. It literally keeps you alive. It's an evolutionary response. Helpful pain helps us figure out where the problem is so we can fix it, and then you can live your life and do the rest. Overprotective pain keeps you back. So that's a hallmark difference, but I want to be like Marc Rogala: Okay. Okay. Dr. Samuel Tyriver: crystal clear that when people come in with overprotective pain, you may still have a tissue issue, but that overprotective pain is keeping you from living your life. Like Marc had neck and back pain. All pain happens for a reason. It never happens for no reason. And you can do fMRI studies where you put fMRI on people and you can see the pain in real time. You can see the light up on the fmri. And so we know that when someone hurts it's real, but what's causing the hurt? And when that pain was keeping Marc from living his life, well the pain medications certainly weren't helping. If they were Marc Rogala: Thank you. Dr. Samuel Tyriver: Marc would have had no problem. He would have been fine. He would have been living his life. But it doesn't work that way. So to sum it up, helpful pain keeps you alive. It guides you to where the problem is so you can fix it. Overprotective pain, it keeps you from living your life. It holds you a prisoner. Both are real, both hurt and both suck. Marc Rogala: Thank you. Hayley DiMarco: Yeah, and I they do. And I wanna reiterate that so that we're perfectly clear. We are not saying overprotective pain isn't real. You feel the pain. There there's no question I I can testify. You feel the pain. It's as Sam said, it's not all in your head, but yet it is. Marc Rogala: Sam, here's a question for you. Why doesn't the brain simply recognize, okay, the original threat is over. We can stand down now. Dr. Samuel Tyriver: in so in America we have this backwards view of pain tolerance. The more pain I feel, the tougher I should be. and you can look at a boxer like that, but we have to understand what pain is. We assume pain is because of a tissue issue or something that's wrong with our bodies, our muscles, our bones, our skin. And that's not always the case. You can have emotional or that's not always the case. You can have emotional pain. So if you ever experienced loss of a loved one, I I lost a my one of my dogs a few years ago. My stomach hurt, my chest hurt. The pain was very real. The pain in my chest, the pain in my tummy. There was nothing wrong with my chest or my tummy. What was wrong? Was the emotional damage of losing something, a creature that I loved and cared about. So the pain is always real, but it's the circumstances that surround the pain that will dictate whether you feel the pain or not. So consider a boxer. Boxers get punched all the time, they're very tough, they have a high tolerance for pain. Okay, boxers train every day to get punched in the face and punched in the stomach. All right. So when that happens, especially when they're in a fight setting, their their brains don't register it as a problem. There's no reason to sound the alarm. If pain is a warning sign, they're not doing anything wrong, they're just living their life. And trying to beat up the other person that's trying to beat them up. But you can take the same boxer and let's say they have a phobia of needles or a fear of dogs. And you put that boxer in a chair and you try to give them a flu shot, and what do they do? Full-blown panic attack. And all this is just a little bitty needle. This is a big tough boxer. So circumstances will dictate whether your brain perceives the threat. A hot shower in the winter in Wisconsin for me feels great. A hotch that same hot shower in the summertime after I've been at the beach and I've got sunburn now, now is very, very painful. The circumstances don't change. How our brains perceive those circumstances change. And that's what will dictate pain for you. You can have a tissue issue and no pain at all. You guys have everyone on this call has probably had a so I got a bruise here, or I've got a cut here. I didn't realize I got that. Well, there's damage. The damage is real, but your brain isn't registering pain. And yet we can have pain without damage, or we can have damage and pain. So all three of those things can be real. And if you stick fMRI, functional MRI, on someone's head. You cannot you cannot tell the difference between which of those sick or circumstances it is. All we know is that they're in pain, which is I think I think that is very validating for people that have invisible pain. Fibromyalgia, CRPS, functional neurologic disorder, CRPS is complex regional pain syndrome, or they have what we call psychosomatic symptoms where their heart's race or their blood pressures drop, or they get a tremor, but there's no neurological damage. It's all very real. and I think it's important to validate those and research now. Imaging validates that. Hayley DiMarco: I want to also add that this idea that we've kind of been focusing on chronic pain, actual physical pain. What what this this is bigger than just physical pain. It can also be anxiety, it can be depression, it can be all Marc Rogala: Thank Hayley DiMarco: kinds of other emotional kind of symptoms that happen from this over-protective brain. And Marc, you asked, you know, why does it just keep going? Why does the alert keep going after the threat has passed? And I I like to think about the idea of Rabbits. I have I don't know if you guys have noticed, but in for some reason in Wisconsin, when I walk my dogs, there's a rabbit in every yard. And they're eating and they as they sense us coming, usually from like a couple houses away, they stop. They just stop eating because right they're on alert. They're like, here's a threat. And then as we get closer, they take off. I just see their little tail running. And that's the life of a prey animal. And what happens, I I know from experience, not everyone who suffers from pain or anxiety or depression. Marc Rogala: Okay. Okay. Hayley DiMarco: Is the same story. But I feel like for many of us, there's this sense that we are prey animals. And so I got wounded by someone, someone made fun of me. I got hurt when I stepped funny off that curb. And your brain says, that's a threat. I the brain's main job is to survive. It wants you to survive. So it thinks about those threats and categorizes them as predator and keeps a hold of them unless you teach it that. You know, it's okay if I step off here by by doing by stepping off something again. Like if you know the old adage, if you fall off a horse, get right back on. If you if you don't get right back on the horse, your brain learns, horses are dangerous, and you're not gonna ride horses anymore. So I really think it has to do with that sense that we've trained ourselves through fear, partly, through this d idea that we want to survive, that we're we're like prey animals. So we're in a constant state of threat management. Kelsey Dunbar: I love that. And Dr. Samuel Tyriver: That's Kelsey Dunbar: I can see why you guys work together so well, because you throw all the jargon out there, Sam, and then Hayley just cleans it all up for you and makes it so that everybody can understand it in a in a much easier way. So I I love the dynamic between you guys. Dr. Samuel Tyriver: Yeah. Marc Rogala: Okay. Dr. Samuel Tyriver: From a scientific background too. Hayley DiMarco: Yeah, that's how the book works. He's he's a genius. I think you're a genius, Sam. He really is. He has this stuff down and he really understands Marc Rogala: Okay. Dr. Samuel Tyriver: Thanks, Adelie. Maybe I don't know about that. Hayley DiMarco: our bodies and our minds and what's happening. And Marc Rogala: and I'll Hayley DiMarco: I just like to throw in, you know, a little stuff for the the lay person that doesn't quite understand what all you PT people are talking about. So it works really well. Dr. Samuel Tyriver: It works well, Hayley, because I think you make it so that anybody can pick it up and understand it. And I what I want to make sure that people, when they read the book too, is like none of this is like I didn't think of any of this. This is this is the way our neuroscience works. And one of the reasons I love working with mental health and chronic pain, I don't love those two things, but I love I love mental health. I don't love pain, I don't love anxiety or depression. But But they just fall back to your nervous system. And your nervous system falls back to physics, physics fall back to math, math is universal. So there are certain constants as human beings and as mammals that we've evolved. And one of those is it's in your DNA. Everyone, all four of us on this call, it's in our DNA to get stressed out and to shift into a fight or flight autonomic state. That that's in your DNA. You don't have to practice it. You're born with that skill, and that's evolutionary. If you just like Marc Rogala: . Dr. Samuel Tyriver: laid around while your village was being attacked and you're like, I don't really care. You know, you're not going to survive to make more babies that also don't care about their village being plundered. So we've evolved this trait. What we don't evolve, what is a skill, is to shift out of that anxious, hyper anxious, hypervigilant state. And that takes practice. And if you don't practice it, like riding a bike, doing a dance move, juggling, whatever, you will never learn it. And so many of us go through our entire lives, we're bombarded with more things that get us stressed out, more social media, stress, jobs, work. Marc Rogala: Okay. Dr. Samuel Tyriver: politics, all these things, and yet none of us practice the way to get out of it, to to calm ourselves down. And you're not born with it. And so you have to seek out those things. And I think that that that evolutionary neuroscientific trait makes it makes your story about the rabbits, Hayley, it's just spot on. Because the rabbits, did you ever did you ever chase after any of those rabbits, Hayley? Like, no. But they just like it's in their DNA. They just want to get out of there. They're that they're prey animals and they want to survive. And we're built with those same Marc Rogala: . Hayley DiMarco: No, never. I don't think anybody does. Yeah. Marc Rogala: Thank Dr. Samuel Tyriver: natural instincts. So we just we swim with the stream if we're trying to get hyper anxious. I think another point you made too, Hayley, that I want to go back to is the the idea of anxiety and depression. And if we follow the theme of helpful and overprotective, you can have helpful and overprotective versions of anxiety and depression. And people say, well Sam, how was depression ever helpful? Well there's the stages of grief. So when you grieve, if you experience loss of a loved one, about 30% Marc Rogala: Okay. Dr. Samuel Tyriver: Of Americans do not grieve appropriately and properly. But if you do grieve appropriately and properly, you actually come out cognitively more emotionally resilient and mature than before that grief occurred. Grief is important to our growth cognitively and emotionally. And I don't think a lot of people see it that way. We experience grief and we think, no, it can only be bad. But a lot of these things have a beneficial component, but we're just too too far into the overprotective stages of them. Marc Rogala: Okay. Kelsey Dunbar: Hayley, I wanted to ask you about this. There's a there's a story in the book that really caught my attention. You were helping Marc Rogala: Thank Kelsey Dunbar: launch a teen publishing imprint. It was this huge professional undertaking, constant deadlines, constant problems to solve, and one morning you woke Marc Rogala: . Kelsey Dunbar: up and you couldn't stand up straight. You continued going to meetings for about a month, basically folded at the waist. So what was happening at that time? Hayley DiMarco: Well, I wish I would have known what was happening at that time, but you know, so this is in retrospect. But looking back, my brain was so occupied with again, I I'm gonna say, because this is my psyche, but I think it's a lot of ours, my brain was occupied with the threat, the threat of can I launch this? Am I gonna be successful? being a woman and a man's job, you know, how are they gonna look at me? And so there really were a lot of angles that my body was dealing with and my brain Marc Rogala: Thank Hayley DiMarco: was trying to manage that were threatening. And because of that, as Sam pointed out earlier, your brain only only has so much attention span, we'll call it. It can it can pay attention to, you know, this threat, but it's not also going to pay attention to this joy at the same time. They're just kind of you pick Marc Rogala: Thank you. Hayley DiMarco: one. And I I was focusing on the threat. And because of that, there were just, I believe, and and Sam, you could talk to this more, but that my body was was so consumed with threat that it had it's my heart rate was up, I wasn't getting proper digestion, I wasn't getting sleep. My body, I believe there are certain, you know, parts where your body's kind of like almost telling me, I can't do this anymore. I'm crumbling. You know, I wasn't getting the picture that it was it was just too overwhelming. And I think that I'm certain that was over protective pain because it went away as soon as the launch was done. Kelsey Dunbar: Alright, so this may be one of the most important distinctions in the entire book. Hurt does not automatically equal harm. And we need to be careful here because we're certainly not telling someone to ignore an injury. Marc Rogala: Thanks Kelsey Dunbar: You guys touched on this before. So what does hurt does not equal harm actually mean? how do we distinguish between pain that's not appropriately warning us about damage and then an alarm system that has become overly sensitive? Dr. Samuel Tyriver: So it kind of falls back to our three assumptions about pain or the I assumptions I'm and when I deal this in the clinic I call them the sort of the three tenets that you have to be on board with if you're gonna turn off your alarm system or at least reduce your arm s your alarm system. And one of those is that the pain is created in your brain and it's an interpretation. Your brain is trying to tell you that there's something wrong. So your brain your all the pain that you have is in your brain, no matter what. whether that's something wrong is a cut, a broken bone, a tumor that needs to be addressed, or that something wrong is a stressful presentation that's adding a lot of stress and trauma to your life right now, it's still manifesting in the same way. The second man second assumption is that there is a such thing as overprotective pain. You can have pain without that tissue issue. And the last is that in order to treat overprotective pain, It's different than the treatment for helpful pain. With helpful pain, if we consider the cognitive behavioral therapy informed physical therapy model, the CBT informed PT model, think, feel, do, it's a triangle. You have to feel better before you start to think better and do better for helpful pain. If I have a broken foot, I have to think, it's starting to feel better. Then I can go for a run. Maybe I try it. Maybe it starts hurting again. So I take time off. If I had the flu, I don't feel very good. I gotta wait till I feel better before go back to work. With overprotective pain, and this is the suckiest part for everyone. Is the do has to get better first because overprotective pain will not heal over time. In fact, it usually gets worse because more things add up. and the patient has to start doing better before they will ever start to feel better. And oftentimes they'll start doing better. They say, okay, I'm gonna take those first steps toward exercising, I'm gonna Marc Rogala: I'll see you later. Dr. Samuel Tyriver: book that trip in February or whatever to Italy. I'm gonna do this thing. And then they do, they take little steps and we do it intelligently, and then they start to think, okay, I did that. I think I can do it again, or maybe I can do a little more. And they think and do and think and do. And they're like, Well, Sam, when do I start to feel better? And that's that's the million-dollar question. And that varies for everyone. But if you start doing better, your thinking starts to improve, and then the feeling starts to go away. You're training your brain that this thing that I knew I shouldn't do before. Marc Rogala: So. Dr. Samuel Tyriver: is gonna start to get better. And so your brain, like a dog learning a new trick, it starts to learn, this is actually okay. Maybe if Hayley spent time feeding those rabbits, they wouldn't run away from her and her dogs. They would learn, Haley's, this is actually okay. And sh they we could beat that overprotective Marc Rogala: So. Dr. Samuel Tyriver: response. Marc Rogala: Okay, Sam, there's an incredible example in the book about a construction worker who lands on a nail sticking through his boot and he's in excruciating pain. They sedate him, cut the boot away and discover the nail went between his toes. He wasn't injured at all. What does a case like that teach us about the relationship between pain and perceived danger? Dr. Samuel Tyriver: So Hayley actually found that study, which is a really good study. So credit where it's due to Hayley. Marc Rogala: Okay. Dr. Samuel Tyriver: I deal with this a lot though in clinic and not on the grand scale of a construction work and jumping down and putting a nail through their boot. you deal with you all the time that you know they might have a slip disk at L4, L5. And they'll be sitting there in the chair and they'll get shooting pain coming up through the rest of their body, you know, 10 out of 10 pain. And they're just sitting there, and you think, well, that's not consistent with the slip disk at L4, L5. But the pain is very real. you know, or they'll have an old injury. You know, they we had a young EMT, she hurt her hurt her wrist in an ambulance accident, and went through all the process of healing, casted the thing, and then six months later, after the thing is all healed, suddenly she started getting wrist pain again. Her arm was it was kind of like a posture, like a flexion response. It's almost like she had a stroke. So of course neural workup and everything. There's no brain damage. There's no tumor. A lot of wrist pain. Her words were, my my wrist doesn't feel like my own. My hand doesn't feel like my own. So she starts seeing one of our board certified hand therapists. They're working through it. Marc Rogala: Thank you. Dr. Samuel Tyriver: And they're really not getting very far because they're looking at the hand, and the issue is not here, the issue is this overprotective response here. Her brain has learned that there's a problem, and the way to get its attention is to manifest in the arm and the hand. And so we say, okay, maybe she needs more of mind-body type therapy, where we're talking about okay, maybe this is over more of an overprotective sign and symptom. We also refer to a psychologist, a sports psychologist that works really, really well with young people in teens and 20s. Marc Rogala: So . Dr. Samuel Tyriver: And so we go that route. And then about a week or two into treatment, she's still working with the OT. And she I saw her walking across the floor. And this poor young woman, her foot was kind of turned inwards, and you think almost as if she had had a stroke. So again, back to neural, back to the medical workup. And Nope, it's all clean, no stroke, no brain damage, no TBI, nothing. It's all because, as Hayley mentioned, the neurons up here are being used. So her primary motor cortex couldn't do its job. That's the part that's responsible for voluntary decision making. And so if we can fix what's going on up here, if we can turn down the alarm, the symptoms start to go away. Patients will always do better in physical and occupational therapy before they do as before they do better in mental health therapy. But she eventually we discharged, Marc Rogala: Okay. Dr. Samuel Tyriver: she got back to function. I got an email from the psychologist just a few weeks ago. Marc Rogala: . Dr. Samuel Tyriver: weeks ago that she had gone back, she had done her firefighters exam and is now a firefighter. And that was one of her original goals. She has basically returned to function, but had we not involved the psychologist to to get at what was going on up here that was manifesting in these physical symptoms, that she'd probably still be walking around with her arm bent up. Kelsey Dunbar: Yeah, so Hayley, the story that you gave earlier about the, you know, you fall off a a horse and you're like, I'm never riding a horse again. So how much of our behavior can eventually and this is actually a question for both of you, so feel free to both chime in, how much of our behavior can eventually become organized around avoiding something that isn't actually happening anymore? Marc Rogala: Okay. Okay. Hayley DiMarco: can speak from experience, all of it. I have literally because how do I put this? I'm a chicken. I have struggled with anxiety and fear. I will be honest with everyone, my entire Marc Rogala: Thank Hayley DiMarco: life. I mean, since I was six. So I have built my life around this idea that life's not safe. And so avoidance is I mean, that's the best policy, right? If you avoid, you just figure, well, nothing can get me. What I found out though is when I talked to Sam is avoidance was what got me into the Marc Rogala: So. Hayley DiMarco: pain. So We can avoid things thinking it's gonna save us from pain, but in the end, it just adds more to that pain because we're our bodies were made to move. That's just that's how how how we're built. It's like if you put a car in your in your garage and you say, I'm not gonna drive that for a year. You come out in a year and Marc Rogala: Okay. Hayley DiMarco: you're like, What happened? The tires are flat, what the battery's dead, don't you're gonna call your you're gonna call your your garage and say, What's wrong with my car? No, it's it didn't move. Marc Rogala: Thank Hayley DiMarco: It's made to move. And we are made to move. But this avoidance can feel really great. Like my couch feels really great. I'm not only scared, I'm also an introvert. So Marc Rogala: you. Hayley DiMarco: double whammy. I I'd rather stay at home on my couch with none of y'all. I don't want anybody around me. I feel like it's safer. But ultimately, I don't want to say this for everyone. Ultimately that keeps you trapped on your couch and that turns that fortress that we talked about earlier into Marc Rogala: I'm going to start with PowerPoint. Hayley DiMarco: a prison where you're thinking, I can't even get out. You know, you've kind of moved into the to the center where there's not even windows anymore because I I mean I won't even answer my doorbell. If somebody rings and I didn't invite I'm like, hide, everybody hide. There's somebody at the door. So it's it's natural for a lot of us in the world in which we live, the things we see on the news, the experiences we had in in in our childhood, the trauma we've experienced, but avoidance is just safest. And that's wrong. Marc Rogala: Okay. Okay. Dr. Samuel Tyriver: And you're right, Hayley. And I science v all the research validates it and the more that gets pumped out, it validates it. And we used to say, Well, come on, Hayley, answer that door. You know, mind over matter. Just you know do it. Don't avoid it anymore. There's nothing wrong with you. It turns out when if you look at blood chemicals, neurotransmitters, neurophysiology, now we can measure it, we can objectify it, we can calculate how much of this this chemical neurotransmitter her body's producing in brain. You know, is this nerve being active? And then they're not. There's there's physical, tangible, measurable stuff that's happening that's keeping you from doing these things. It's not just to simply mind over matter. Marc Rogala: Is Dr. Samuel Tyriver: But how can we what can we do to rebalance those chemicals? And it the good news, and I think we we go over this a little bit more in the book and more of a step-by-step process, but the good news for people that are struggling with this is there's a phenomenon in science and research in statistics and biology Marc Rogala: that okay? Dr. Samuel Tyriver: called regression to the mean. So if you have this sort of average level of function, this average level of strength, and you're an Olympic athlete, you're way up here. In order for you to get from here. Marc Rogala: . Dr. Samuel Tyriver: To here, which is like just to make a teeny tiny improvement, you got to work and train and work hard and eat just right. And if you don't, if you just slough off for like two weeks, boop, you come right back to this. If you've been stuck in your prison for a long time, that average level of function and strength is here. But here's the silver lining: is you're down here. Okay, you're at a below Marc Rogala: Okay. Dr. Samuel Tyriver: average level of function. And this is the good news: is that you gotta really try, you gotta really isolate and go out of your way to not move to go from here. Marc Rogala: Okay. Dr. Samuel Tyriver: To even worse. But if you just start taking a few steps, like just a few things, your body, your brain, your neurological system, it wants to get back up to this. And those are the messages that we kind of put out in the book. And none of those are like, you know, well, Sam thinks this or Hayley thinks this. These are things that have been tried and true for as long as humans have been humans, but the research supports it. The all the most current neurological research supports Marc Rogala: . Dr. Samuel Tyriver: it. Hayley DiMarco: and I I waft I have to say this because to me this is the this is the golden nugget at the center of that which is the book. It's the most important thing to me. And that is that the idea of that we all have inside of us an inner pharmacy. That that to me, that's the most important thing for everybody to get out of this. Your body can make drugs. We go to the we go to the pharmacist and say, I need drugs. We got already. We have drugs that can help with pain relief. We got drugs that can motivate us, calm us down. And w you know, you think about when you go to Walgreens, where's the pharmacy? Where's what where's pharmacy? At the back, right? Right. You have to Marc Rogala: You're back. Yep. Hayley DiMarco: go through everything to get to the back. Like in the grocery store, the bread, the the milk, all the stuff you need, they put it way in the back. Marc Rogala: Thank Hayley DiMarco: in our bodies, nobody tells us where the pharmacy is. We know where the greeting cards are, we know where the Photoshop is, but we haven't gotten to the back because we haven't been taught that we have this pharmacy. We haven't even gotten back there to it. And what we teach in the book is how to access this pharmacy so that you can get access to all the drugs that you need. For what we're talking about here, overprotective pain. And Marc Rogala: Perfect. Hayley DiMarco: Sam has formulated that the best word, Sam, these six keys to the inner pharmacy that open up kind of your prescription pad so you can start to write these. And I'm talking about things like you've heard it, serotonin, dopamine, endorphins, oxytocin. Those things really, really, those are really what did it for me. Those really benefit a body that's struggling with overprotective, what we used to call Marc Rogala: Thank Hayley DiMarco: chronic pain. Because it opens up your life, as Sam was just saying, he was doing all his here to Marc Rogala: So, that's my question. Hayley DiMarco: here. That's what moves us, you know, from if we're at this level and we want to get up get up higher, we have to start practicing these six keys to the pharmacy. Marc Rogala: it's interesting because, you know, when I was in the middle of my crisis, I was on this quest for education. And I learned about those feel good chemicals in the brain. And once I had a certain stretch of sobriety and was passed my post acute withdrawal syndrome, I wanted to basically create structure that accelerates my every, every one that you just mentioned, my serotonin, dopamine, oxytocin, and endorphins. So body movement became very important. I really cleaned up my diet because you know, 90 % of your serotonin was made in your gut and it communicates to your brain through the vagus nerve. I basically wanted to replace the fake dopamine or cheap dopamine with real dopamine. And then, know, oxytocin, I really gave back to the community. I give back to the community by speaking at the hospitals and visiting patients and detox and things like that. So my whole daily ritual is designed from the diet to the exercise, to the giving back, to drive that brain chemistry. And really I do that really for my mental health, it obviously affects my physical health as well. So I love the way that you just said that because it speaks to me personally. And it's some of the messages that we send to our audience as well and other podcasts. Kelsey Dunbar: one of one of our most watched episodes of our podcast was actually our brain chemistry episode where we kind of go into those things in depth. And I always give Marc the credit for the fact that 30 years as a personal trainer and honestly, very little of the curriculum that I've been through in 38 different certifications that I have actually talks about brain chemistry. I learned more in one conversation with Marc about brain chemistry. than I learned in thirty years in the fitness industry. So he definitely taught me a lot about that. And then since then we've really gone in deep on it. Hayley DiMarco: Yeah. Well, as someone who's not a PT and who who's not in the, you know, Dr. Samuel Tyriver: The brain chemistry is Go ahead, Hayley, go ahead. Marc Rogala: Thanks Hayley DiMarco: medical realm, when when Sam first wrote down these prescriptions, these six keys, it was like he just made it it's like no duh. Like he has six different things, and I'll just give you them. The first one is w this is easiest, hobbies. If if you're pr when I'm talking about you're a prey, you feel like you're there's predators all around. Marc Rogala: So, thank you. Hayley DiMarco: When you're being chased by a predator, you don't have time Marc Rogala: Thank Hayley DiMarco: for a hobby, right? Your brain is like, I can't I can't work on my puzzle right now. So when we do that, when we when we practice hobbies, our brain goes, well maybe there's not maybe I'm not being chased. Right. It gives you that sense that you're okay. You can relax. And it doesn't seem like it should be important, but it is. And then movement, I'll let you talk about that in a minute, Sam, but obviously movement's important. But he didn't ask me that, you know, you need to get out there and start running. It wasn't that. The first thing I did was that what's that, that hand bike thingy? Right? I was scared Dr. Samuel Tyriver: Yeah. Yeah. Hayley DiMarco: to death of it. I'm like, I can't do this. It's gonna hurt. And it was I f I'm embarrassed. I'm embarrassed now, but it's okay. I use my embarrassment for for the good of humanity. I thought that it was really gonna wound me and it didn't because he started really slow on movement. And then laughter, that's one of my favorites. I love laughter, but there's a lot of studies that we could talk about, you know, and how laughter fills kind of that prescription out for you. And then relaxation, prayer, meditation, anything that it is that you that you can do because a person that's being chased is again not meditating, not not in a in a position of prayer and that. that feeds your body as well. And then as you said, Marc, good nutrition. You can't build these, these drugs if you don't have the nutrition to build them and then positive social connection. So those six keys we talk about more in the book Marc Rogala: Thank Hayley DiMarco: and I and I find them to be really not hard. Like every day I can say, I'm feeling a little anxious. What do I need to do today? Well look at my six keys. And then bam. Dr. Samuel Tyriver: There Marc Rogala: It just becomes habitual and then it becomes a lifestyle. Once it becomes a lifestyle, you get that mentality that it's not hard because it's it's a non-negotiable. It's something that your brain automatically goes to. But it takes practice. Dr. Samuel Tyriver: Yeah. If I if I was just listening to Hayley go through the h laughter, hobbies, exercise or movement, positive social interaction, you know, you we say these buzzwords all the time. But when you really you look at the people that live the longest, happiest, healthiest lives, the people that are not addicted to substances, the people that don't suffer from you know type two diabetes, congestive heart failure, they're getting these six things. And there's there's entire books and college courses written on each of those six things. So I didn't make those up. Those are the words we use in the book, those are my words and Haley's words for these things, but these things have existed forever. And when you when you really iron out the neurophysiology of it, what happens when you laugh? How much laughter do you need? What happens when you don't do this? What happens? When you isolate, when you have social anxiety, so you don't go out with your friends, what happens to your nervous system? Then you realize holy crap, like there's all these problems. And if you do these six things, you get these chemicals in your brain. And so what if you could do that for yourself? And we can, So it sounds cheesy, but when you iron out the neuroscience behind all of it, it holds up. Kelsey Dunbar: I really appreciate how humble you are to say these things have all been out there and like we didn't make these ideas and stuff like that. And it's extremely humble by you because honestly, there's a difference between we should know this or we do know that, but to put it in a system and in a book where people actually have an action plan is a whole different thing. So don't sell what you put together short in its brilliance because Simplifying things and giving people an action plan is is where it's at. That's that's the genius. Dr. Samuel Tyriver: I appreciate that, Kelsey. I just I like all these things are free. You know, food, yeah, you technically gotta pay for, but exercise maybe you need a gym membership, but you don't really. but they're all free. And it's like if if we could just do these, I mean the pharmaceutical industry would just go, but yeah. Marc Rogala: That's another conversation. Dr. Samuel Tyriver: Yeah. Marc Rogala: So I work at a behavioral health facility during the day and people coming in struggling with substances, people coming in struggling with... you know, anxiety, depression, everything we just talked about. And we got to do an intake and there's a couple of questions on the intake, but the one question on the intake that, that, that, cause I do those, talks about what do you do for fun? What do you do for leisure? What do you do for recreational activities? And they'll say, well, I used to do this or I used to do that. I used to do a lot of fishing. but they're not doing it anymore. And that's one of the things that we encourage them to is go back to those hobbies, go back to things that you love, go things that gave you joy, as opposed to relying on alcohol, substances, gambling, things like that. That's just getting you deeper into a rut, you know, with the anxiety and the depression and so forth, you know, and then the diet thing, my favorite quote, you know, is, I eat your food like medicine, don't eat it for pleasure. You know, and that's the mentality that I've taken in my recovery world. When I eat something, is it going to give me cheap dopamine? Am going to have a high sugar diet? Is it going to increase my cortisol levels and increase my anxiety when I come down off of it? Is it going to drive my serotonin? Is it going to deplete my serotonin? I I got in a really good habit of asking myself these questions and getting my diet straight. You know, but I got it straight because I mean, if I didn't get it straight and get it sobriety, I was going to end up dead. I mean, it was a matter of life or death for me. I appreciate all this. really do, especially in the format that you put it in, because it's so important for the general public to have access to. Hayley DiMarco: Yeah, and I I to as just being the general public, I I found it really important that it was just so simple because it can be really daunting when you're suffering with chronic pain, overprotective pain, Marc Rogala: Yes. Hayley DiMarco: and you've tried everything. People said, Try this and try that and the PT might say you need exercise. It's daunting. You think, Why am I gonna do all this? But you know, the way we've laid it out, it's it really is simple and it's rewarding. It's instantly rewarding. Kelsey Dunbar: So so I'd like to talk about a part that you have in the book where you stop waiting to feel ready. And I think that's hugely important. That really jumped off the page for me because it applies to almost everything Marc and I talk about. Most people operate, in the the feel think do. You know, you talked about that before, you know, I'll do it when I feel better. I'll exercise when I feel motivated. I'll go back out when I'm less anxious. I'll start when I feel ready. But then you flip that in the do do think feel. So you you talked about a little bit before, but you know, I'm gonna give this one to Hayley. why is it that waiting until we feel ready sometimes exactly what keeps us stuck? Hayley DiMarco: Well, I think that this we have this Marc Rogala: Thank Hayley DiMarco: glamorized idea of what it'll feel like to be ready. And you know, there like coming to this podcast, I I could be nervous beforehand and say, Well, I'm not ready because I feel nervous. But th those aren't mutually exclusive. You can feel nervous and still be ready. You can likewise feel pain, you can feel like you have a headache, you can feel like your muscles ache, you have anxiety, and still be ready to start doing something about it. Because every day that you decide I'm not going to do something about it, you become less and less ready. And so I think for for me it's been it it's kind of a mantra I keep telling myself, I'll lay down on the couch and be like, I'm just too tired. I know I should work out at least, you know, five days a week. That's what I do. I should I should, but I just don't feel I feel too tired. I I don't wanna do it. And I remember Sam, Sam, you're probably gonna walk this back because you're embarrassed. But you said, unless you're throwing up in the toilet, you should get up and move. And Marc Rogala: Okay. Okay. Hayley DiMarco: My brain doesn't think that way. My brain's like, poor baby, you feel like you had a big day today. It's three o'clock. You're getting groggy. You should take a nap. It's like a it's that overprotective parent that really wants me to stay home and not do anything. I know its goal is to try and protect me, but by telling me I'm not ready, it's taking away my life. And I just won't let it do that anymore. So now I'm trying to treat my brain like a toddler and say, no, come on, kid, we're getting up, we're moving. It's really important that if you want your life to change, you cannot wait till you feel ready because you are ready. If you're in pain and you're tired of it, you're ready. Marc Rogala: Sam, question for you. From the nervous system side, what happens when somebody acts safely while the alarm is still going off? Dr. Samuel Tyriver: So I tell people that if you accommodate your overprotective symptoms. So we've ruled out you don't have a tumor, you don't have damage or broken bone or anything like that. It's overprotective pain. Then when you accommodate that, it's like giving the dog a treat for peeing on the floor. So saying good doggy, that's what you do. So your nervous system learns. Your nervous system is very smart, it's built to learn. So that's what it's doing is it's learning. And so when we have to unlearn, like when Hayley started and she did three minutes on the arm bike. We no, she selected that amount of time and that falls back to the C B T informed PT is we do intelligently. And and you're right, Hayley. If I un I say unless you you're you puke, pass out or die, you're not gonna stop, but you're gonna do the three minutes. If you feel terrible, I don't care, finish the three minutes. If you feel amazing afterwards, you I got three minutes, I might think I could do more. Or if we're getting distracted because we're talking, I set a timer. No, we're done. Because Hayley is now taking charge of her nervous system and not letting the feeling, the emotion, the overtective pain dictate. Hayley is taking charge of her life. She made the decision when to start, she made the decision when to stop, and she didn't based on how she feels. And your nervous system learns that. It's like, okay, well, you know, we made it through the bike three minutes. I didn't die. I didn't puke or pass out. I'm okay. So maybe I can do three and a half minutes or four minutes. But if we if Hayley was like, you know what, this is starting to get a headache at two minutes in, it's okay, okay, let's stop. That's good job, doggy. You peed on the floor. Congratulations, do it again. We're rewarding the overprotective symptom. We're saying thank you. You protected me from something that was potentially dangerous. So Marc Rogala: Thanks. Thanks. Dr. Samuel Tyriver: Please keep that remember that and next time I'm about to do something dangerous, warn me again. Marc Rogala: So follow up question on that. So essentially the brain doesn't need another motivational speech. It basically is looking for new evidence. Dr. Samuel Tyriver: Yeah, you're retraining the brain. It has to relearn. There was a study done, and I won't cite the author because the author is embarrassed about these studies from the nineteen seventies, the learned helplessness where they put dogs in a cage and they would zap them when the dogs would try to leave the cage. And so They would zap them, zap them, zap them. So eventually the dogs learned that they they couldn't leave the cage. And so even when they stopped the zapping, the dogs would not go. And so the the only way to get the dogs out was someone had to pull the dogs manually through the doors of the cage, and then they would learn. And then eventually the dog would go. And so what we're trying to do with the book, and what I try to do with the certified mind body trained therapist program is help people pull the dog through the cage, at least to start. But after that, like the person has to do it. And each time you do it. you retrain and that dog becomes more comfortable and eventually you can retrain those dogs and it's safe to leave the cage and they can go just like it's safe for you to leave your prison or to retrain your prison or renovate that thing back into the fortress it's supposed to be. Kelsey Dunbar: Yeah, so I I wanna kind of go to another concept in the book, and that's rebuilding trust. So something Marc and I talk about consistently is that rebuilding usually doesn't happen through one huge breakthrough. It's small promises kept repeatedly. So your book describes recovery in much the same way. Giving the nervous system safe repeated experiences until it begins changing its prediction. So for someone listening who's thinking Marc Rogala: next week. Kelsey Dunbar: This is me. My world has gotten smaller. I've stopped trusting my body. What's the first step? And that could be for both of you guys. Why don't I each give your own version of the answer there? Marc Rogala: That's it. Dr. Samuel Tyriver: You go first, Hayley. Yeah. Hayley DiMarco: Me. Okay. well, I think it goes back to the idea of being ready. I think you have to realize you can be ready or you can live. You gotta pick one. And I I wanted to live, I just didn't know how. And so when Sam started giving me these just do these kind of small activities, just doing the bike, and then I remember him telling me, Okay, now you're gonna go to the gym and you're gonna do these things. And then you're gonna call me and tell me how you feel. If it hurts, we'll work through it. And I I remember my head going, If it hurts, are you kidding me? There's a potential what you're telling me might hurt. And my brain is thinking, That's no no no no no. I don't want anything to hurt. But him telling me, Call me and we'll take care of it set me free. It told my brain, Marc Rogala: Okay. Hayley DiMarco: We'll take care of it means it's probably okay. Can I just tell myself, it's probably okay instead of I know it's awful. I know it's gonna be terrible. And I i i that that kind of I'm a pessimist again. Marc Rogala: Okay. Hayley DiMarco: You're learning so so many great things about my wonderful personality, but I'm also a pessimist by nature. So I assume that pain is a horrible thing that I can't live through. But recognizing that you know, that old adage, no pain, no gain. Or I used to work for Nike, you know, and our our motto was just do it. If you don't just do it, you're not gonna get anywhere. It's just like lifting weights. The the when you lift weights, which which repetition is the most important one? The last one. Marc Rogala: Okay. Hayley DiMarco: The last one, the one that hurts the most, the how far you push it. And if we are not willing to push it a little bit, it doesn't have to be a lot of pain. This little thing wasn't a lot of pain. I thought it was gonna be, but if we aren't willing to push it, then we're not gonna get out of that, I'm not ready, and get into living. Marc Rogala: Okay. Dr. Samuel Tyriver: Yeah. The neurological system in the human body is a lot more resilient than we give it credit for. So often I see people that feel here, but their capabilities are here. And we just learn and learn and learn. It's like the abused spouse. Why don't you just leave? Why don't you just stand up to this person? Or, you know, if it's the the person that's being abused is even bigger than the abuser. Well you're bigger than this person. Just stand up to them. It's not that easy. We get this learned helplessness. And so taking those first steps is really, really hard. But those first steps are can be different for everyone. but it we use a lot of really great analogies in the book. Haley's come up with some really fantastic ones where Treating over protective pain, treating overprotective symptoms, taking those first steps can sometimes be painful. sometimes there's what we call an extinction burst, where if you think of like a yapping puppy or a crying child, it gets louder, louder, louder, louder, and then finally it shuts up. Sometimes your pain gets worse before it gets better, or sometimes the anxiety gets worse, or the depression gets worse, or the grief, or the reliance on substance late. And that's that's that really sucks. And that's really hard for people to get over. But they can, and I've seen it. I've seen it consistently, not just like once, but Marc Rogala: you. Dr. Samuel Tyriver: many times. People do these. Things, you know, we we're all unique, special individual snowflakes, but our nervous systems are not. I love the nervous system. Anatomy varies, physiology varies, chemistry varies, but our nervous systems don't. They learn the same way. And if we take these steps, we can get better. And one of my favorite parts of my job is when I see people get their life back when Hayley went on her trip, or you know, a lady went back to fixing transmissions, or another person went back to jazz in the park or Summerfest or you name it. It's the best part, best part of my job. But it's not me. Like they Marc Rogala: Thank Dr. Samuel Tyriver: have to. You have to take the step, and that's really hard. Marc Rogala: So Sam, I got a question for you. What would you tell the person who tries that first step, has a flare up, immediately thinks, see, I knew I was broken. Dr. Samuel Tyriver: Person is never broken. I hear it all the time. That's a very common word that I hear in the clinic. I'm just, I'm broken, my system's broken, and you're not, you're struggling with pain. Your brain is not broken. It's actually doing what it's supposed to be doing. It's trying to keep you alive. It's just doing it way too much. It's overprotective. Your brain is trying to help you. Hayley says that in a much more eloquent way than I do. but that's the truth of it. And it you you I use an example of riding a two-wheel bicycle. You know, this is you're learning a skill. What got you here was evolutionary. You didn't have to try. No one tries to get chronic pain. No one tries to be addicted to substances. No one tries to have anxiety. You it just happened to you. But getting out is a skill and it takes practice. So the first time you tried to ride a two-wheel bicycle, congratulations, you sucked at that. You probably fell off. Everyone does. You try to juggle, you fail, but you keep trying and trying and trying. It's not the failing that counts, it's the do. You did the thing. That's gonna force you to learn. And when you fell off the bike the first time, you didn't say, no, I guess I'm just I'm broken. I can't ride the bike. You just tried again and you might still suck at it. But eventually your system learns it. And this process is just like riding a bike Marc Rogala: Thanks. Dr. Samuel Tyriver: and it's just like juggling. You might suck at it at first, most people do, but you will learn it. Your system has to learn it. Kelsey Dunbar: Yeah, so Hayley, I'm gonna give you our last question. So we call this show Rebuild and Fulfill because rebuilding isn't simply getting back to who you were before something happened. Sometimes you come through it understanding yourself completely differently. So what has this journey taught you about what it really means to rebuild? Marc Rogala: Okay. Thank you. Hayley DiMarco: I think it's taught me agency because I've, you know, I'm a child of divorce. I've been through a lot of relationships, a lot of things happened to me that I think at some point my body started to just say, Well, I'm a victim. I I I I what am I gonna do? This is how this is the cards I was dealt and I'm stuck. but this gave me a tremendous sense of agency that that, yeah, your brain is in this predicament, but it doesn't have to stay there Marc Rogala: Okay. Hayley DiMarco: because what it's learned, you can actually teach it to unlearn. And that was Marc Rogala: Okay. Hayley DiMarco: That's life changing. So I really think that us for for anyone struggling with overprotective pain, who you've you've experienced it for years or decades and you've you you've kind of just resigned yourself to this is who I am. I want to tell you it's not who you are. It is who you became, but you can also unbecome that through through understanding what your brain's doing and relearning how to have a a vibrant, healthy life. Kelsey Dunbar: That's an incredible answer and I love your resilience Marc Rogala: Thank you. Kelsey Dunbar: and I I just think what you've done with everything that you've gone through in your life to realize that that was a lot of the pain that you were experiencing physically coming through the mental side and how much you've evolved because of it's incredible. So Sam, Hayley, thank you both so much. What I appreciate about this conversation is that we're not telling people their pain isn't real. We're saying almost the opposite. Dr. Samuel Tyriver: Yes. Kelsey Dunbar: Your brain believes the threat is real enough that it's working overtime trying to protect you. And maybe the path forward isn't fighting your body. Maybe it's slowly giving that protective system enough new evidence to understand we're Marc Rogala: So. Kelsey Dunbar: safe. We can move. We can live again. So for everyone listening, Hayley and Sam have created a free Marc Rogala: Thank you. Kelsey Dunbar: resource called the Overprotective Brain Journal with practice tools, exercises, and strategies for retraining an over-protective brain. You can find that at overprotective brain.com. I also will put that in the show notes as well. And for physical and occupational therapists, Sam created, as he talked about before, the Certified Mind Body Train Therapist or CMBTT program, which you can learn more about at mindbodycert.com. Marc Rogala: up. Kelsey Dunbar: Sam and Hayley are also available for keynotes, guest lectures, corporate wellness workshops, and clinical seminars. We'll put all of that information in the show notes as well. And as always, If something in today's conversation made you think of somebody who's struggling, send them this episode. Sometimes the person who needs a message the most isn't really looking for it. And if you're enjoying Rebuild and Fulfill, follow the show, leave us a rating or a review, and share the episode. It helps these conversations reach the people who need them. Marc Rogala: Okay. Kelsey Dunbar: So for Marc Rogala, I'm Kelsey Dunbar. Keep rebuilding, Marc Rogala: Thank you. Kelsey Dunbar: keep moving forward, keep becoming stronger And remember, you don't have to have it all figured out. You just have to keep going. And we will see you next time on Rebuild and Fulfill. Take care. Marc Rogala: Thank