Why Chronic Pain Isn’t Imaginary: The Mind Body Link

0:00Hi, welcome to my latest YouTube video and podcast. Today, I'm going to interview Dr. Dave Clark. Dave is going to blow your mind. He actually blew my mind. We are going to talk about a subject that a lot of us know about, but no one's ever explained, let alone even said there's a topic. And we're going to talk about the connection of our mind over our physical health, over pain, the mind, body connection. And because of my own personal experience with this and how this manifests so often with my clients and myself, low recovery treatment program, I think we're going to have a wonderful episode. But Dave, can you tell the folks that are listening and watching a little bit about yourself? Yeah, I'm a physician board certified in internal medicine and gastroenterology. And two-thirds of my practice was entirely usual for somebody with that background. But the other third of my patients had pain or illness that was not at all connected

1:03to their bodies. It was not connected to disease or organ problems or structural damage. The symptoms were just as real as the symptoms caused by those issues, but they were being generated by the brain. And I didn't find out about this until I was in my eighth year of formal training. And I encountered a patient very unexpectedly that I didn't know the first thing about diagnosing or treating, which in the year eight of your training, you're not expecting to have that kind of experience. But this patient was cured by a psychiatrist who was also certified in medicine, just with counseling sessions for less than three months from her very severe physical condition. And that's what first introduced me to the idea that your brain couldn't have very powerful effects on your body. Literally from head to toe, migraines, fibromyalgia, irritable bowel, chronic fatigue, pain in the spine, certain kinds of rashes, pelvic pain, bladder spasms,

2:08joint pain, certain all kinds of things, often more than one at a time. But they could be treated successfully by uncovering the underlying psychosocial issues, stress, trauma, emotions, childhood issues, other challenges in life. And people can get better even after they've been ill for years or even decades in some cases. So it became a huge part of my practice. I've been doing it for 40 years, over 7,000 patients, written books, produced documentary films. And I'm president of the association for the treatment of neuroplastic symptoms, which can be found at symptomatic.me. I am so fortunate to have you on the podcast. Wow, what credentials. Hey, Dave, I'd like to start off by me telling the folks out there what happened to me and then inviting you to talk about it, because I think my experience is going to resonate with a lot of other people who have self-love

3:08deficit disorder. And we've already talked about this. I'm going to make this as brief as I can. But I had back surgery when I was 28 years old. I had a very serious spinal fusion. And six months after the surgery, the main symptoms that required the back surgery were resolved. But I had tremendous back pain. And I went back to a doctor and he said, there's nothing on your MRI. And we did a couple more MRIs and he says, nothing. There's nothing wrong that it should be responsible for your pain. And so I just kind of grin and bear it in and said, well, I just had to deal with it. And then six months later, I moved to Chicago and got lucky enough and had good enough insurance to go to the rehabilitation institute of Chicago and got some catnuck services from a physical therapist, occupational therapist, a physician. And they had no explanation for my back pain. It was and they had no explanation for this basming of my lower back muscles. And the therapy

4:12didn't work. And eventually they said, well, we don't really know what to do. And they've referred me to a psychiatrist. Well, by that time, I needed to see a psychiatrist because that's depressed. And long story short, two years after that dealing with this debilitating back pain, someone introduced me to this book by John Sarno called Mind Over Back Pain that introduced the idea that my back pain comes from a mental health issue. It comes from conflict and trauma that I have not been able to sort through. So it's been sent to the back of my head where I don't remember it, but it manifests in the weakest link in my body. And then once I figured that out and went into therapy and started working on that trauma, the back pain disappeared. And that was the miracle, miracles for me. How much of that story or stories like that have you heard? And I'm curious to

5:15hear more about your experience with what patients like that. Yeah, Ross, your story is very much in parallel with those of 60 million other people in the United States alone. This is a condition that affects at least one in four adults. And it doesn't necessarily manifest in back pain. But it can, as I mentioned earlier, it can manifest all over the body. It can manifest in more than one place at a time. There was a study published just two, three years ago now that did a very careful evaluation of people with pain in their spine, either in the neck or the low back to find out how many of them was it structural and how many of them. This is just a series of people just coming in basically off the street with back pain to find out how many of them was it brain to body in its generation. And it turned out to be 88%. And this accounts for why surgery done on the back for pain in the absence of clear evidence of nerve damage so that if you've got your reflexes

6:22are intact, your muscle strength is good. There's no numbness corresponding to a nerve pathway. There's no bowel or bladder problem. So if you're in that category and you just have pain, 88% is brain generated. And that's where you have to go to find the solutions. If you end up operating on the back or doing a nerve ablation or an injection, it's not going to work. Another link to self-love deficit disorder is that the more adversity you went through as a kid, the less likely spine surgery for your pain is going to work. So there's that connection as well. It's interesting because John Sarno, who became quite a sensation back in the day, I think that his book, Mine Over Back Pain, was New York bestseller. And it ended up reading a writing 10 books 40 years past, had really developed this idea that if you, like an SLD somewhat self-love deficit disorder or someone who's had attachment trauma trauma as a child, it puts you at risk

7:29to having similar trauma as an adult, which I talk about in my book. And what I learned is the trauma of feeling trapped. And I get goosebumps as I've been saying this. And not knowing away out, manifested an extreme anxiety that was the focal point of which was in My Lower Back. So My Lower Back was about me being trapped and not having it escaped. And I had no idea. And so it opened up to this concept is that trauma really has so many ways of expressing itself, emotionally, psychologically, and physically. Yeah, and I have to confess, it's kind of embarrassing, but I did not believe this back when I first started. I mean, it just didn't seem possible to me that the brain could cause the level of symptoms that I was starting to see. You know, there are people who have been so debilitated with chronic fatigue, for example, that all they can manage is

8:31to crawl from their bed to their bathroom and back. And people with incapacitating migraines or back pain or bladder spasms or pelvic symptoms. And the severity is just off the charts. One of my patients was a teenage girl. She had unexplained abdominal pain for two years. I was asked to see her on her 70th day in the hospital. She was getting morphine in massive doses around the clock to try to control her pain. She had already seen over the previous two years six other gastrointestinal specialists with no diagnosis. You're never going to convince a patient like that that their symptoms are not real or that they're imagining them or that it's all in their head. These were 100% real highly severe symptoms, but they were all linked to a high level of stress. And when I was able to uncover the stress that was going on in her family, which was, you know, nobody in that family was, you know, abusive. It just was that there was an issue in the family that everybody

9:36was trying to do the right thing, but it ended up with enormous pressure being placed on this adolescent girl. And that ended up manifesting an abdominal pain. But by uncovering the issue that was going on, we could unravel that. We could get the family to manage things in a different way. She started turning down her own morphine dose. She was out of the hospital in a week on opioid tablets. She started weaning herself down from those 30 days after we met no further pain, no need for opioids. But again, manifestation of just how severe this can get and how real. So interesting. So I'm going to give our listeners and viewers a psychological explanation. And of course, I love to hear your thoughts on it. So if you're involved in a trauma in a present moment, your body's sympathetic, parasympathetic, autonomic systems going high alert, you are not a medical doctor. So you will fill in all these details in a second. But all of a sudden,

10:41you are in a fight or flight mode and you are trying to survive. And all of your body's resources are brought to the front of this so that it's just part of our evolution. We either solve this or the body thinks it's going to perish. So if you can accept that, is the basic explanation of the stress that happens during a trauma. Now think of that stress being repressed. Right. It's associated on those memories, disassociated. So you don't remember them that you have been in so much trauma in previous year, especially in your childhood. It's been removed from your consciousness. And then just like regular PTSD, there is a stimulus. There is a situation in the environment that reminds you of what had happened to you back when you were traumatized. And it sends all of the fight or flight symptomology, the biomechanics. It opens it up and your body is right there again.

11:47And the toll of that on your body is it's going to start breaking down. So I'd love for you to tell me whether on it I'm missing it and add more to that understanding. Yeah, there's a lot to unpack there, but you're definitely spot on. When people are in an adverse childhood experience environment, they're not necessarily fully recognizing everything that's going on. If you're in a relationship with parents who are ones in our system, the other one is code dependent or has the self-love deficit disorder. The child in that environment is going to try to fix things. And yes, it's going to crank up their sympathetic nervous system. And they're not going to be consciously aware of it because it's just the environment they're in. It's just like a fish is swimming in the ocean and doesn't realize that they're surrounded by water because it's just the natural aspect of that environment. So that when they're adults and they're having a lot of emotions and their sympathetic nervous

12:50system is switched on, they are not necessarily aware of it. And so I'm reluctant to say that people with this condition have a mental health issue because my patients are mentally healthier than the average person. They're just coping with larger amounts of much larger amounts of stress than the average person. And they're not aware of the burden they're carrying. One of the analogies that I use is describing my patients as if they were Olympic weightlifters who've been asked to carry 50 pounds more than the world record for their weight class. You know, anybody's body is going to break down under that kind of a load. But once they learn how to take that weight and put it down, then they realize how strong they have been all along the magnitude of the burden they've been carrying. And that can be a first step in overcoming a lot of these issues. You know, but before I clarify what I was going to say, I want to compliment you. I always appreciate physicians, psychologists, therapists who do not pathologize everything, who do not make

13:55everything a mental health problem. And it's just and reframe it as just part of being human. So I really appreciate that about you. But what I want to do is clarify because I'm a psychotherapist, your physician, and as much commonality we have, we see the world differently. If you are a child and you had severe trauma growing up that had to be disassociated and repressed and that trauma plays out in your current relationships in ways that you can't understand that is causing medical problems, that is a mental health issue. If you're sad and lonely and you're loneliness and just keeps you from working, well, that's a mental health issue. So I have a much broader use of the word mental health issue obviously than you do. And so a mental health issue is just something that is connects to our mind that is just not

14:55working to our benefit. Yeah, no question. I mean, we're absolutely on the same page. We're both going after helping people with the same issues. So many of my patients grew up learning things about themselves that are not true. I mean, they learned that they are a second rate or worthless human being. They learned that it's their purpose in life to solve everybody else's problems. They learned that it's not something they deserve to take time for their own joy because they need to be so focused on solving the problems and the issues and the needs of those around them. And that builds up the stress level, which then triggers the sympathetic nervous system, which then unloads itself onto the body and symptoms result. Often in multiple locations, we just did a national survey at Symptomatic.me where we found that an average person with this condition has three different symptoms simultaneously and

16:00some have more. Can you give an example of a person with three symptoms, like the different areas, their body or person? Yeah, I mean, it can be any combination, but we found, for example, that migraines and dizziness were associated with each other. Back pain and migraines were associated with each other. So all kinds of connections because the brain and the nervous system is the organ that connects everything else so that it's entirely possible if your brain is unloading on your body to have symptoms pretty much anywhere from head to toe. And one of the ways that, and hopefully I'm remembering it right because it's been like 20 years since I've read the book that what Dr. Sarno explained is that it manifests in your body's weakest link. In other words, if I had back pain to begin with, well, that's where my body is already weak where it already has

17:01pain if you have history of neckaches, a history of gastrointestinal issues. And so as well as it manifests just in other places. So when you meet someone who is struggling with what I call, is it correct to use the word psychosomatic medical issue? It's an older term. People tend not to like words that have the word psychosis. So we call them neuroplastic symptoms because the neuro obviously is for the brain and nervous system. And the plastic is a medical jargon term meaning a capacity for change. So we think it's a very hopeful term that lets people know that they can recover from this. Well, I like that term. Just to be fair to old old timers like me, psychosomatic just means that the connection between the mind and the body and you're not psycho.

18:02You might have a psycho in your life causing you stress. Can you talk to the audience and explain what how it starts and how you proceed with getting someone help with with problems such as this? Yeah. Well, it begins with an assessment of what the sources of stress are. At Symptomatic.me, we've got a 12 question self-assessment quiz that people can take and give them a lot of insight into whether they might have this condition themselves. But essentially, I'm looking for stress that's in your life right now. It could be almost anything. And sometimes it's very simple. One of my patients, he only got his symptoms when he was driving to work. When he was driving home from work, he was fine. So, you know, that kind of let me zero in on the real issue that he was having. Other people, it's a little more complicated. There was a gentleman with over 25 years of daily low back pain that was sent to me. After a while, people started sending me their

19:02mystery cases. It wasn't just gastrointestinal symptoms. And this gentleman had a pretty, even though he was in his 70s, his spine x-ray looked pretty good. And they couldn't figure out why his pain was so severe. But it turned out he didn't have his pain every single day. There were two weeks out of the year when he felt fine. And you could probably guess what he was doing during those two weeks. He was on vacation. But I wanted to, you know, not jump to conclusions. And I'm thinking to myself, well, maybe he's resting his back on a warm beach somewhere and carefully making sure it's not strained or something. But no, he was fly fishing in British Columbia. So he's waiting out into the stream. He's leaning back and forth to cast the rod. He's bending over to net the fish. And then he tells me at the end of the day, he's helping the lodge on a clear brush from behind the lodge. Is he having any twinges? Well, he's doing this. No, he's 100% fine until he gets back to his extremely busy lifestyle running a horticulture business.

20:05So sometimes very simple. But the more complicated ones, I'm looking into childhood adversity, into traumas, into depression and anxiety, those kinds of things. And when we can bring those into conscious awareness, we can deal with them. And even people who've been ill for decades can get better. It was it was interesting. Before I knew any of this, all I knew is when I got a divorce or broke up with someone who was causing me stress, psychological stress and turmoil, my pain went away. And I never put it together. I was just, yeah, this is great. And then it would happen again. And then the pain would go away afterwards. And it was then I turned on to this book by John Sarno. And I realized that for me, it's the idea of being trapped and went back to my childhood. And in my being trapped, manifested in these psychosomatic or neuroplastic disorders. And then I

21:14just with the help of my therapist was very careful and proactive in making sure that I didn't feel trapped in relationships. And the back pain never came back. And for me, that was a simple fix. But I'm thinking it's a lot more complicated for a lot of the people you see there is a range. I mean, one of my patients was hospitalized at a prestigious university 60 times over 15 years. Solid doesn't specialize. She was having a tax of severe dizziness accompanied by nausea and vomiting six to 10 times every year. And half of the attacks were bad enough that she ended up in the hospital. And very prestigious place. She saw a dozen of their specialists. They could not find any reason for these symptoms. They had a psychiatrist come and talk to her. But unfortunately, most mental health professionals are not familiar with the kinds of issues that can manifest physically as opposed to creating mental health problems. He completely missed the diagnosis. She happened to

22:15have one of her attacks when she was in my hospital. And she was so depressed in this garage that she basically tried to kick me out of the room. She said, you know, doctor, don't waste your time. I have already had every possible test. Nobody can find anything. You'd be better off seeing your other patients. Well, you know, I couldn't resist a challenge like that. So I said, look, I'm kind of been making lost causes specialty of mine. Why don't you give me a half an hour and tell me your story once more. And we'll see if we can come up with anything. And her husband is sitting there and he goes, you know, he rolls his eyes and here we go again. Stairs down at his shoes. But less than an hour later, I had learned that all of her attacks were connected to interactions with her abusive mother. Her mother was verbally and emotionally abusive towards her. She's 50 years old. And her mother has been doing this for since she was three or four. Right. And there's so you can imagine enormous emotional tension built up in that relationship. And it turned

23:16out that I could trace all of her attacks back to having interactions with mom. And as soon as I was able to demonstrate this to her, it became the first story in my first book, which is called, they can't find anything wrong. And as soon as she saw the connection for herself, symptoms went away. She was gone from the hospital before I even made rounds the next day. She called me a year later when she was back in town just to say she'd gone the whole year with no episodes. You know, I have explained this. I used to give trainings. And one of the trainings I gave was on trauma. And I explained how the brain works and doesn't work. And one of the things that I came up with, and of course, I don't have any research to back this up, is that we as humans, we evolved to have all these defense mechanisms as I talked about, fight or flight and, you know, and all the reactions that help us deal with trauma. And we also evolved that if trauma is too big for us,

24:21if it is too big for us to process, to remember, to go over, to try to resolve, the brain through this evolutionary purpose, it takes the trauma and it removes it from our consciousness. So we don't have to think about it. So the brain is just doing this mechanical function. And that is where the repository of PTSD is. And that's in the limbic system and then the amygdala. So when you're talking, I'm thinking about, yeah, well, she, this was really a connection to her childhood trauma, her PTSD or attachment trauma. And that part of the brain going on fire, can you talk more about, first of all, do I have it right about, I love to hear your thoughts and comments about how I conceptualized it all? Yeah, absolutely right. She was not consciously aware of this enormous

25:23emotional tension that I was talking about. It was, as you say, all in her sympathetic nervous system, the amygdala, the amygdala, the limbic system manifesting physically. Her mind was basically trying to communicate with her that it was in a state of distress. But it couldn't reach her conscious awareness where she could have used her cognitive skills to work on it. So it manifested physically. And you know, I want to be sure to clarify that I can't cure everybody in a single conversation. Many patients need years of psychotherapy to achieve the same outcome. But the principle is still the same. You're trying to cognitively consciously understand where the stress is coming from, why the sympathetic nervous system is being triggered. And then use your cognitive skills to change those emotions into words. And the more you can put things into words, the less they need to manifest in your body. I have no doubt that you have saved so many lives,

26:29psychological lives, that, of course, it can't be solved in one meeting. But you can open up this thought process, this exploration, this explanation that will lead people forward to a resolution, whether it's with you, a psychiatrist, a psychotherapist. And I can't imagine how many lives you've saved in your career bringing this to light. Yeah, it's been a very rewarding part of my practice. I'm estimating over 7,000 people over the decades. And most of them had been through years of the healthcare system looking in vain for an organ disease or a structural explanation. Because that's what we physicians until recently have been taught is that if you've got pain or illness, it must be from an organ disease or structural damage. I want to also emphasize that a lot of my patients, when they first come to see me, they will tell me that their childhood

27:32really wasn't that bad, that they know other people have been through worse. They don't think it's affecting them anymore. And one of the questions that I have for them, which can be quite telling, is to ask them to imagine their own child or a child that they care about if they don't have one of their own, growing up in exactly the same circumstances that they did. Imagine themselves a butterfly on the wall of their childhood home and they're just watching their own kid try to cope for a week or so. And what's that going to be like for them? And you will see their facial expressions change and that they are frequently horrified by that idea. And it's not to retraumatize them. It's to help them see accurately that you know what, you went through a lot and you should give yourself some credit for the heroic perseverance that you needed to get through all that. And that's an effort to try to flip somebody's self-esteem if you want to call it that into a more

28:36accurate and positive frame. They call that a reframe and that was one heck of a reframe. You know, I created this psychotherapy technique that was 10 years before best of vendor Colk or Peter Levine or any of these brilliant people wrote anything, just kind of like excellent, just kind of happened into it. And it eventually became a part of my treatment protocol in my self-level recovery treatment program is to get to disassociated or repressed memories that we talked about and be able to get the client what you call a patient to remember them and experience them vividly viscerally and then be able to bring those memories forward and integrate them in conscious memory and then be able to solve that in psychotherapy. And although I did not work with this problem, this neuroplasticity or psychosomatic disorder,

29:39I would imagine that if someone does this type of specialty and is in the mental health field, that they would want to find a type of trauma-informed treatment provider that can get to the stuff that someone doesn't even know that exists and help them integrate that in their conscious memory so they can work it out. Because what you do is you make those connections and people have this incredible positive response to it. When I teach my mental health audiences or my graduate students who are going for doctorates in psychology, I emphasize that these physical manifestations, you know, even though they're not going to medical school, they are a form of communication from the mind. And it's trying to communicate concepts and issues and traumas that can't be communicated any other way so that if you as a psychotherapist learn how to interpret

30:44these physical messages from the mind, you're going to be much better at helping your clients. You're going to understand the full dimensions of what they're struggling with much better. And you represent this new wave of medical science that connects to mental health. So I am so glad and impressed that you're helping people make these connections. I like to change direction just slightly. And I want to talk about fibromyalgia. One thing that I've noticed that everyone that I know who's been diagnosed with fibromyalgia has trauma in their background. Probably more than they know. And unfortunately, there are so many good medications that treat fibromyalgia because these are real medical problems that they never really get to the solution. I love to hear what you have to say about fibromyalgia. Yeah, fibromyalgia is just like the other neuroplastic conditions. I didn't mention a few of them

31:45functional neurologic disorders and visual disturbances and tinnitus and dizziness. They all come from very similar places. Complex regional pain syndrome is another one, pots, postural orthostatic tachycardia syndrome is another one. And they all come from very similar places where the brain is expressing its distress via the body. And that if we can uncover what the brain is distressed about, we can help people with that. And as we lower their distress level, the physical symptoms improve as well. And sometimes it takes, as I say, years of psychotherapy, other times it can happen much more quickly. But even people who are needing a lot of time can see that they're on a pathway toward eventual recovery. And the overall treatment of a person's mental health is much better when these issues are understood and addressed.

32:48Yeah, I'm so glad you're saying that because and I might be a little bit out of sync with what's going on now. But what I remember 10 years ago is that the people who have been diagnosed with fibromyalgia by their physician were put on some pretty heavy-duty psychotropic medication, heavy-duty. And I'm sure it had a positive impact, but it didn't solve the problem. So your approach, your explanation, and the people that treat patients for this, you're saving lives. Yeah, the medications, again, their body focused, they're treating the symptoms. Yeah. And in many people treating the symptoms is essential for helping them to cope, but they're not treating the underlying cause. And that's where the long-term best outcomes are found. I wonder how many people got addicted to opiates because of this? Oh, thousands of deaths. I mean, hundreds of thousands of deaths have resulted from

33:53people being treated only with opioids, which again, it just treats the symptoms. And after a period of months, the effect of the opioid is no longer there. And the dose has to be increased if you want the same pain relief level. And that eventually can lead to overdoses. And we've seen, you know, I've forgotten the exact statistics, but I think in the last 20, 30 years, it's over a million people that have died, just absolutely appalling. At our conference, we have a conference every year at Symptomatic.Me and we had 350 people in Boulder, Colorado, last September. And I asked for a show of hands how many people had personally suffered from this and needed more than 10 years to find appropriate care. And there were a hundred hands that were up in response to that. You would never see that with cancer or diabetes or Parkinson's or heart disease that people had to wait 10 years of searching to find the appropriate care that gave them

35:00relief. You know, I would imagine there are so many people that go to their death, deathbed with not ever understanding the origins of the pain that had been compromised and maybe almost ruined the quality of their life. Oh, there's no question. I always remember one of my patients who had 22 visits with the healthcare system in seven months trying to find a solution for her pain. And she was referred to me as another one of these mystery cases. And when we were talking, she told me the story that a week before our appointment, she had gotten out of bed in excruciating pain at 4 in the morning, put on her bathrobe, put a large brick in each pocket of the bathrobe, drove to the Columbia River outside of Portland where I live, walked out to a depth where the water was at her neck. And it's a really cold river. And wearing the bathrobe with the brick

36:02and trying to decide if she was going to keep going. And she stood there. She told me for 10 minutes thinking about what she was going to do next. And obviously, she ultimately decided to turn around, drive home and keep her appointment with me. But just massive depression over this. And nobody had asked her about the origins of any of this. It's a huge failure of the healthcare system. 40% according to a review article published about 10 years ago. 40% of people who come to primary care have neuroplastic symptoms. And they're, for the most part, not getting appropriately diagnosed or treated. Yeah, that is, that is both inspiring and hopeful and very sad that so many people just didn't get the benefit of what is a very logical explanation. And just touching back to what we talked about a few minutes ago, the folks that are prescribed opiates, a lot of these folks became heroin users. And let me explain the connection.

37:07That if you are prescribed pain pills 10 years ago, and you know this more than I do, so it could be more than that, the FDA, the federal government came down really hard on doctors because they were over prescribing pain medication. And they put so much pressure on them. For good reason, doctors now are very, very tentative into, in prescribing pain medicine and only give it for a certain amount of time. So these folks that became addicted to their pain meds didn't have a source and then they found on the street of the best that they could and that would be heroin. And so there are so many deaths, whether it's from this cause or just from the impact of the disorder. Can these psychosomatic, these neuroplastic, divergent, whatever your term is, can it, can it rise

38:11to the point of being deadly and in terminal? It doesn't kill people in and of itself, but it can make people so depressed that they die by suicide or that they are taking pain medication that ends up having fentanyl mixed in with it, which is highly lethal. So by itself, neuroplastic conditions don't kill people, but they can lead to death by other means. If you're going to take somebody's opioids away, you need to replace it with something else that's more effective and that is the treatment of neuroplastic symptoms. I'm really glad to hear that and I know there are so many new meds that aren't addictive. You know, I would think, and of course, I'm way out of my lane here because I'm not a physician, but I would think that if you have this PTSD that we're talking, at least what I'm conceptualizing that we agree on, and it's being triggered and it's coming through manifesting in your body

39:15that the stress could lead to the wearing down of your heart, lead to a stroke or heart disease, right? Is that possible or am I? Yeah, it makes sense. The research isn't quite as strong on that, but definitely adverse childhood experiences have a long-term impact on the body, not only in increasing your chances for getting neuroplastic symptoms, but also for things like cancer, heart disease, diabetes, peptic ulcer, autoimmune disease. The theory is that the childhood adversity activates the body's inflammatory system and that can play out decades later in higher rates of these other conditions, even in the absence of risk factors like tobacco or lack of exercise or overweight, that kind of thing. But what we don't know is whether the treatment for the long-term impact of childhood adversity can change the course of some of these biomedical diseases.

40:19We do know, we do have research now, that shows that the new kinds of psychotherapy that we're doing for neuroplastic symptoms is highly effective. The Boulder Back Pain Study, for example, took three groups of 50 people each who were getting treated for their back pain, one by the new neuroplastic techniques, one by an injection into the spine and one by their usual care. And the people who got the neuroplastic therapy, their pain came down by 75% in four weeks. And these are people who had pain for a decade on average before they got the treatment, just remarkable improvement and the two control groups, very little change, 20% maximum. And this has now been replicated at leading research centers across North America. So we finally can point to gold standard randomized controlled trials that show that this approach works. And

41:20what we're faced with now is just mainly a communication problem to let people know that we've got an effective treatment for a condition that affects 60 million in the US alone. And we are communicating now, guys, spread the word. Where can people find out more about what you're talking about, the research recommended doctors help? Can you give some of folks out there, some information and direction? Yeah, you bet. The association for the treatment of neuroplastic symptoms has been around for 15 years. Many of our board members were actually personally trained by Dr. Sarno. So we have that connection. We've also got researchers and mental health professionals and physicians and patient advocates. We have created courses. We've got recorded conferences. Our next annual conference is in mid-October of 2026 in Dallas, Texas.

42:21We have textbooks that we recommend. There are apps that we have vetted that we recommend. We have monthly Q&A sessions online for people who want to ask questions. That's amazing. All kinds of resources for people that can be highly effective in alleviating their symptoms. Oh my gosh. I wish that was around for me. Well, this has been, as you and I, we predicted this because we were almost having a podcast in our discussion to decide how we're going to do this. But this has been very, very interesting for me. And I hope very valuable to the folks listening and watching. So please continue your incredible trailblazing work. And if people need to get a hold of you or get more information from you, can you give give the listeners and viewers some contact information, please? Yeah. Everybody goes through info at symptomatic.me. That's our mail inbox at the ATNS. And we definitely respond to that.

43:29We've also got a, if people become members and support us in that way to get the word out, we have a forum where people can ask questions and professionals will respond to that. And we have a practitioner directory with people who have taken a special training in this from all over the world. Fantastic. Well, thank you. Thank you so very much for being a part of this discussion. I hope that maybe we can do this again. I think this is incredibly important for people to hear. And I have no doubt that there's another hour of discussion to be had on this. Thanks, Ross. I appreciate you're bringing this to your audience. And there's definitely a lot of parallels in the work that we do. Thank you so much. And keep up to good work. Lastly, for folks who want to know more about what I do and want to learn more about self-love recovery, self-my treatment program, first self-love deficit disorder, how I work with trauma, just shoot me an email at help at self-loverecovery.com, go to the website at self-loverecovery.com.

44:37You be well and do take care of yourself. Goodbye.