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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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.

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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

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

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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
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Mastering Empathy to Support Partners in Chronic Pain

In this episode of Mind Your Body, Dr. Zev Nevo delves into the practice of empathy as a learnable skill, not just an inherent trait, particularly in the context of supporting partners suffering from chronic pain. Dr. Nevo outlines Brene Brown’s four attributes of empathy: perspective taking, staying out of judgment, recognizing emotion, and communicating understanding. He contrasts cognitive empathy, which promotes sustainable compassion and genuine connection, with affective empathy that may lead to burnout and enmeshment. He also discusses practical strategies for caregivers, emphasizing the importance of regulating one's own nervous system to effectively co-regulate their partner's. The episode provides actionable advice on maintaining balanced compassion without drowning in empathy fatigue, setting the stage for the upcoming part three on Compassion Plus Boundaries.

00:00 Introduction: Empathy as a Learnable Skill

00:40 Recap of Part One: The Invisible Burden

01:24 Understanding Empathy: Brene Brown's Framework

03:36 Attribute 1: Perspective Taking

04:32 Attribute 2: Staying Out of Judgment

05:35 Attribute 3: Recognizing Emotion

06:57 Attribute 4: Communicating Understanding

09:40 The Critical Distinction: Cognitive Empathy vs. Enmeshment

12:48 Polyvagal Theory: Co-Regulation and Emotional Intuition

15:31 Practical Strategies for Partners

21:33 Conclusion: Sustaining Empathy Long-Term

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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

In this episode of 'Mind Your Body,' Dr. Zev Nevo explores the profound impact of chronic pain on relationships. He highlights how chronic pain can build an invisible wall between partners, creating a shared struggle where both individuals feel isolated. Dr. Nevo introduces a three-part series called 'Partners in Pain' aimed at addressing these challenges. Through personal anecdotes and insights from Brene Brown's research on empathy, sympathy, and compassion, Dr. Nevo distinguishes between responses that drive disconnection and those that foster connection. He discusses the multiple burdens carried by individuals with chronic pain, including the emotional labor of protecting their partners from discomfort. The episode underscores the importance of empathy over sympathy and sets the stage for learning practical empathy skills in future episodes.

00:00 Introduction: The Hidden Struggles of Chronic Pain

00:48 Welcome to Mind Your Body

01:11 The Invisible Burden on Partners

01:48 Understanding Co-Regulation and Neuroplasticity

02:35 Exploring Empathy vs. Sympathy

04:04 Sarah's Story: The Seven Layers of Suffering

06:13 The Partner's Perspective

09:31 Empathy Misses and Their Impact

13:51 The Power of Empathy

16:26 Conclusion and Next Steps

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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
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Reframing Pain: Understanding Chronic Pain's Messages

In this episode of 'Mind Your Body,' Dr. Zev Nevo, a trauma-informed physician certified in physical and regenerative medicine, explores the complex relationship between pain and mind-body health. Dr. Nevo discusses how chronic pain can become a sensitized signal, not just a warning of physical harm but an attention-grabber that indicates unaddressed needs, boundary challenges, or misalignments with core values. By differentiating between pain as a smoke alarm (danger) and an alarm clock (a call to attention), listeners are guided on recognizing and interpreting pain signals to foster self-awareness and wellbeing. Practical advice is offered on how to pause, engage the prefrontal cortex, and build a more trusting relationship with our body's messages.

00:00 Introduction to Mind Your Body

00:59 Rethinking Pain: A New Perspective

01:35 The Science Behind Pain and Sensitization

05:25 Chronic Pain: Alarm Clock vs. Smoke Alarm

08:59 Understanding Pain's Messages

16:50 Practical Steps to Reframe Pain

18:04 Conclusion and Final Thoughts

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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
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Understanding Acceptance vs. Learned Helplessness in Pain Management

In this episode of 'Mind Your Body,' Dr. Zev Nevo explores the nuanced differences between acceptance and learned helplessness when dealing with pain and trauma. Using philosophical inquiries, a dystopian novel, and nature analogies, Dr. Nevo delves into how individuals process repeated adversity and trauma. He differentiates true acceptance, which fosters resilience and healing, from learned helplessness, which perpetuates a cycle of despair. He emphasizes the importance of community, introspection, and the mind-body connection in overcoming chronic pain and adversity, and offers practical advice for reframing pain and using past experiences to build resilience.

00:00 Introduction to Mind Your Body

01:13 Understanding Trauma and Its Impact

03:11 Exploring Acceptance vs. Learned Helplessness

03:38 The Memory Police: A Metaphor for Pain

12:21 Roots of Resilience: Lessons from Nature

23:18 Call to Introspection and Conclusion

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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
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Decoding and Recalibrating Pain Perception for Mind-Body Wellness

In this episode of Mind Your Body, Dr. Zev Nevo delves into the intricate process of how we recognize, interpret, and respond to pain. He discusses the brain's role in making sense of physical sensations and how survival instincts can sometimes misinterpret these signals, leading to chronic pain. Dr. Nevo explains the importance of recalibrating our internal systems through mindfulness and logic to align our pain responses accurately. By understanding and re-training our neural pathways, we can reduce the impact of chronic pain and improve our overall wellbeing. The episode provides practical insights into the science of pain perception and offers strategies to correct mismatches between sensations and reality.

00:00 Introduction to Mind Your Body

01:06 Understanding Pain Response

01:51 The Brain's Role in Interpreting Sensations

03:25 The Importance of Accurate Data

08:58 Chronic Pain and Sensitization

14:52 Recalibrating Our Neural Circuits

18:32 Conclusion and Final Thoughts

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