Episode 23: The Parts That Hurt - When Protection Becomes Pain

Episode Description

Ever feel like you're at war with yourself when dealing with chronic pain? One part of you wants to push through while another screams "stop!" In this episode, Dr. Zev Nevo explores Internal Family Systems (IFS) and how understanding the different "parts" of yourself can transform your pain experience. Learn why these internal conflicts keep your nervous system in threat mode—and what you can do about it.

00:00 Introduction to Chronic Pain and Internal Conflict

01:21 Understanding Internal Family Systems (IFS)

01:39 Real-Life Examples of Internal Conflict

05:03 The Neuroscience Behind Pain and Internal Conflict

16:31 Practical Steps to Work with Your Parts

31:29 Common Questions and Answers

34:27 Final Thoughts and Encouragement

What You'll Learn

• Why you have conflicting voices about your pain (and why that's completely normal)
• How Internal Family Systems helps you understand your internal "family" of parts
• The neuroscience behind why internal conflict amplifies pain signals
• Four practical techniques to work with your parts starting today
• How accessing "Self" can shift your nervous system from threat to safety
• Real patient stories of transformation through parts work

Key Concepts Covered

Internal Family Systems (IFS)

• Protector parts: The voices trying to keep you safe
• Exiled parts: Emotional pain that needs to be seen and healed
• The Critic: The harsh voice that's actually trying to motivate you
• Self: The calm, compassionate center underneath all the parts

The Neuroscience Connection

• Fear avoidance model of chronic pain
• How threat detection amplifies pain (amygdala & anterior cingulate cortex)
• Polyvagal theory and nervous system states
• Heart rate variability and pain regulation
• The bio-psychosocial model of pain

Four Practices You Can Start Today

1. Parts Mapping - Notice and name which parts show up during pain
2. Get Curious - Interview your parts to understand their positive intentions
3. Thank & Reassure - Acknowledge parts for trying to help, then update them
4. Unblend - Create distance when a part takes over completely

Research Discussed

• Yoni Ashar's 2022 JAMA Psychiatry study on Pain Reprocessing Therapy
• Tracy et al. (2016) on heart rate variability and chronic pain
• Lumley et al. (2017) on Emotional Awareness and Expression Therapy
• Dr. Stephen Porges' polyvagal theory

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This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms.

About Dr. Nevo
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LINKS:

• Body and Mind Pain Center
• Mind Body Rehabilitation
• Substack

Expanding Gratitude Amidst Chronic Pain: Transforming Your Mind-Body Connection

In this Thanksgiving special episode, we explore the complex relationship between gratitude and chronic pain. We examine the neuroscience behind gratitude practices, Polyvagal Theory, the Window of Tolerance, how gratitude affects pain perception and emotional regulation, co-regulation in relationships, and practical ways to cultivate authentic gratitude while living with persistent pain—without falling into toxic positivity. Includes a guided 2-minute gratitude practice.

Episode Length: 41 minutes

KEY CONCEPTS DISCUSSED

• Gratitude as nervous system regulation, not positive thinking
• Emotional complexity: holding pain and gratitude simultaneously
• The neuroscience of gratitude (medial prefrontal cortex, reward circuitry, anterior cingulate cortex, default mode network)
• Polyvagal Theory and the three states of the autonomic nervous system (ventral vagal, sympathetic, dorsal vagal)
• Window of Tolerance and expanding capacity for distress
• Broaden-and-Build Theory of positive emotions
• Pain acceptance vs. resignation
• Co-regulation in relationships and interpersonal neurobiology
• Micro-gratitude practices for chronic pain
• Self-compassionate gratitude
• Managing pain flares and grief
• Seasonal challenges during holidays
• Seven actionable steps for practicing gratitude with chronic pain

KEY RESEARCH REFERENCES

• Gratitude & Outcomes: Davis et al. (2016) - Meta-analysis; Emmons & McCullough (2003) - Well-being; Ng & Wong (2013) - Chronic pain; Sirois & Wood (2017) - Depression; Wood et al. (2009) - Sleep.
• Neurobiology: Fox et al. (2015) - Neural correlates; Kral et al. (2018) - Amygdala reactivity; Huffman et al. (2016) - Inflammation biomarkers; Jackowska et al. (2016) - Vagal tone & sleep; Kok et al. (2013) - Vagal tone; Porges (2011) - Polyvagal Theory; Siegel (1999) - Window of Tolerance.
• Regulation & Resilience: Fredrickson et al. (2008) - Broaden-and-Build Theory; Kashdan & Rottenberg (2010) - Psychological flexibility.
• Relationships & Pain: Algoe et al. (2008, 2016) - Relationships; Cano et al. (2004) - Relationship quality & pain; Gordon et al. (2011) - Couples; Martire et al. (2002) - Caregiver burden.
• Coping Strategies: Kratz et al. (2007) - Pain acceptance; McCracken & Vowles (2014) - ACT for chronic pain; Sturgeon & Zautra (2016) - Coping; Vowles et al. (2007) - Pain flares & self-compassion; Harris et al. (2003) - Grief & pain; Seligman et al. (2005) - Brief practices.

Full citations list located in episode transcript.

Send us a text

This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms.

About Dr. Nevo
Read what patients are saying...

LINKS:

• Body and Mind Pain Center
• Mind Body Rehabilitation
• Substack

Compassion with Boundaries: Sustainable Support in Caregiving

In the final episode of the 'Partners in Pain' series, Dr. Zev Nevo explores the transformative concept of 'compassion with boundaries' as essential for sustainable caregiving. This episode highlights the role of empathy, the necessity of boundaries, and the impact of co-regulation in relationships affected by chronic pain. Dr. Nevo revisits the key points from earlier episodes, emphasizing the importance of self-care, concrete support actions, and maintaining partnership and intimacy despite the challenges of chronic pain. Practical strategies for both caregivers and chronic pain sufferers are outlined to foster connection, communication, and mutual support.

00:00 Introduction: Compassion and Boundaries

00:35 Recap of Previous Episodes

01:36 The Framework for Sustainable Support

02:28 Understanding Compassion and Boundaries

03:10 The Science Behind Boundaries

05:47 Practical Strategies for Caregivers

07:19 Empathy Misses and Effective Communication

18:49 Self-Compassion and Setting Boundaries

25:14 Support for Caregivers

30:46 Guilt and Honest Communication

31:44 Cultural Influences on Emotional Expression

32:10 The Cage of Traditional Masculinity

33:59 Boundaries and Sustainable Caregiving

36:15 Power Dynamics in Relationships

41:00 Talking to Children About Pain

46:02 Concrete Practices for Pain Management

50:18 The Power of Connection and Empathy

52:12 Final Thoughts and Takeaways

Send us a text

This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms.

About Dr. Nevo
Read what patients are saying...

LINKS:

• Body and Mind Pain Center
• Mind Body Rehabilitation
• Substack