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Jessica Maguire: How Nervous System Dysregulation Fuels Pain
120 Plays1 month ago
Today on Pain Coach, we’re joined by Jessica Maguire. Jessica is a trauma-informed physiotherapist, TEDx speaker, and author of The Nervous System Reset. Jessica has helped over 20,000 people understand and regulate their nervous systems. Her mission is to create true freedom from nervous system dysregulation and all its painful side effects.
Resources:
Jessica Maguire's Website
Lachlan's Pain Relief App
Follow Lachlan on LinkedIn and Instagram
Book a Clarity Call with Lachlan
Key Topics & Timestamps:
00:00 – Introduction to neuroplasticity and bioplasticity
01:15 – Jessica’s journey from physio to nervous system educator
03:00 – Vagus nerve stimulation and chronic pain research
06:00 – Burnout, emotional stress, and pain
08:00 – Why the nervous system—not just the brain—matters
12:20 – Personal story of grief, dysregulation, and healing
17:20 – How dysregulation fuels chronic pain and inflammation
23:00 – Signs of dysregulation in the body
27:00 – The gut-brain connection & IBS reclassification
31:00 – Inflammation and nervous system biomarkers
33:45 – What to do if you think you're dysregulated
37:00 – The danger of using the wrong tool (e.g., meditation vs movement)
41:30 – Processing emotions through safe expression
46:00 – Expanding your “window of regulation”
51:30 – The role of media and overconsumption of threat cues
55:00 – Thinking brain vs survival brain
58:30 – The 5 pillars of health and their link to pain relief
01:04:00 – Why connection and community matter
01:06:00 – Final message of hope for those living with chronic pain
Recommended
Transcript
Introduction to Neuroplasticity and Chronic Pain
00:00:00
Speaker
there's good research that supports the way that we can change and we don't have to have pain forever like once it was you know you're going to just have to live with this but that's not what we're seeing anymore is the case so just to really trust in the process of neuroplasticity or as we're hearing now it's bioplasticity where more than just neurons change Today on Pain Coach, we're joined by Jessica Maguire, a physiotherapist, TEDx speaker, and author of The Nervous System Reset.
00:00:36
Speaker
Jessica has helped over 20,000 people understand and regulate their nervous systems. Her mission is to create true freedom from nervous system dysregulation and all its painful side effects.
00:00:49
Speaker
I hope you enjoy this conversation as much as I did. This podcast is for educational purposes only. The views expressed in this podcast do not constitute medical advice and are general in nature.
00:01:03
Speaker
You should obtain specific advice from a qualified health professional before acting on any of the information within this podcast.
Jessica Maguire's Journey and Research Focus
00:01:13
Speaker
Jessica, thank you for coming on the show.
00:01:15
Speaker
I'd love you to just tell listeners a little bit about yourself. Yes, so thanks for having me, Lachlan. As a physio as well. i spent a long time in private practice and then i got super interested in the way that the brain and the body communicated with each other.
00:01:38
Speaker
It always really intrigued me looking at the connection with physical sensations and emotions and how that communicated onto the other systems.
00:01:49
Speaker
So I actually took a little bit of a sabbatical from working as a physio in 2017 and went into more looking at what we talk about as the autonomic nervous system or just the nervous system, looking at things like stimulating the vagus nerve um and how our, how we feel protective or how we might detect threat influences things like pain, our emotions, how we connect with other people as well. so
00:02:20
Speaker
Now I teach all about the autonomic nervous system and the vagus nerve. Yeah, awesome. So when you said you took a sabbatical and you sort of like looked into this, was this in like tertiary education type setting?
00:02:37
Speaker
Like did you go down the research pathway or was it just like you're just intrigued and you were just consuming information throughout it? It's a great question.
Exploring Vagus Nerve Stimulation
00:02:49
Speaker
so There's always been a strong desire to run my own research on the vagus nerve because there's so many gaps in that literature.
00:03:01
Speaker
particular you know We hear a lot about if you've got anxiety, just stimulate your vagus nerve through humming. And it's a lot more complex than that. So... I actually am going back to uni to do my research project at the end of this year. So I'll be looking at, awesome yeah, so stimulating the vagus nerve through transcutaneous vagus nerve stimulation, which is through the ear.
00:03:24
Speaker
um And that link with chronic pain and inflammation is what I'll be looking at. But through that time, I really did a lot of different research that was looking at oh study, which was more looking at trauma.
00:03:39
Speaker
I was looking at what we call interoception, or that's how we feel sensations. And then I actually did the certificate of orthopedic manual therapy. So that was like ongoing physiotherapy training as well.
00:03:54
Speaker
And really looking at that interplay with persistent pain as well. So it was all, it was many different modalities, but they There were definitely common threads. They just explained them in different ways.
00:04:10
Speaker
Yeah, interesting. I'm keen to hear what you what you discover or look at what you discover when you go down that pathway. So you said trans you said like electrical stimulation basically. Yeah, fascinating.
00:04:24
Speaker
It is. it's really fascinating. If you look at how the original work of vagus nerve stimulation was, It was actually through an implanted device for people who had epilepsy, so treatment-resistant epilepsy.
00:04:39
Speaker
And what they found was that through stimulating the vagus nerve in this way, people could so some groups of people's seizures stopped, but then they found there was also benefits with things like their depression improved or their gut improved, other things that they noticed.
00:04:56
Speaker
And so transcutaneous vagus nerve stimulation is where it's applied to the skin um and that can be done through the ear or on the neck.
00:05:07
Speaker
And this there's interesting papers coming out on it, but it's very early. Like we need a lot more to tell us what the protocols are. But in doing that, it is it is but it's coming in with, say, stroke patients and things like that to look at neuroplasticity because it promotes...
00:05:28
Speaker
like neuroplasticity in the brain where we have new connections come in, but we can also see it from improving gut health. We can see it with inflammation as well. So it's very, very early on, but this is where things are going, which is super exciting.
00:05:44
Speaker
Yeah, that's fascinating. that's To be honest, reading your book, I can see where you've gone there, but I wouldn't have picked that particular line of research. I thought it would be more around sort of lifestyle and that, but that's that's awesome. That's so cool.
00:05:57
Speaker
Tell us, where did your fascination around the nervous system come from?
Impact of Trauma and Emotional Stress on the Nervous System
00:06:04
Speaker
It was when I was working in clinic in, I would have been 2016 and I have my own clinic.
00:06:11
Speaker
So if you have a physiotherapy practice, you you wear many, many hats. So you're not only treating patients, you know what it's like, look but you treat the patients, you manage a team and then you have to run the business.
00:06:29
Speaker
And I wasn't quite... informed enough at that stage to understand what I was taking on. So I burned out a couple of times. So I started to get interested in this these states of burnout and how people would swing down into like feeling flat and chronically fatigued and then swing up to anxiety. So I was interested in that. But more so what interested me was seeing that when patients who had chronic symptoms or persistent pain came in,
00:07:02
Speaker
And they would often have had something going on in their life beforehand that may have had an emotional reaction for a long time. You know, they were under stress, there was relationship issues, and and then there would be this flare up of symptoms. And You know, we talk about the biopsychosocial model through physiotherapy, which is, you know, showing that how the brain and the body interact and what happens outside of us has an impact on us.
00:07:32
Speaker
But I really wanted to have like get into the nitty gritty of it. And I kind of always felt like I didn't quite have a clear framework for my own understanding but also to give to patients without making them feel like it's all in your head or your pain's not real.
00:07:49
Speaker
um so it was more my own frustration with that. And so, yeah, in looking at that overlap to how we see the neurobiology or what happens with our brain and our body when we have stress, it helped me to get a really rich understanding of why that was happening and particularly like the the the link that's really exciting between um the nervous system and things like the immune system where we can have inflammation. So i I've always wanted to get into the detail of it. It bugs me when I don't understand things, but I wanted really to give people back this framework so they could understand it themselves. And really what I found was that
00:08:37
Speaker
when people go through stressful things, when it's highly stressful or it's chronically stressful, their system becomes overprotective.
00:08:48
Speaker
So it's a little bit like having ah guard dog that's just barking at every noise and that drives threat. And that is what increases things like pain,
00:08:59
Speaker
but also anxiety. Also, some people can be in that chronic fatigue state and feel hopeless and helpless as well. So it it really is what brett brought it all together for me was understanding that missing piece as well.
00:09:16
Speaker
Yeah, I can relate to what you're saying around... Oh, sorry about that. That's okay. i can really relate to... yeah that sort of struggle of explaining pain because you you see that it's important to sort of have this more, especially with people with persistent pain, this more rounded view of how it works and what's contributing to it.
00:09:41
Speaker
But yeah, you're often, you know, we've all experienced people's thinking and and people that are on the other side of the equation have also felt like they're invalidated or that you're saying I'm fabricating this or making it up or that, you know, it's all in my head. Those are common things. And I've actually moved away from the the word brain a lot in clinic and and shifted to nervous system because I think it's less threatening and it's less because people naturally, when they think of the brain, they think of just like their ability to control and to,
00:10:17
Speaker
you know, have full control over it and therefore they're totally to blame. Whereas the nervous system, there's not full control. There are things we can do, um but I often say to people, you know, often the nervous system sort of is reactive like a small child, like when they chuck a tantrum or those kind of things.
00:10:38
Speaker
And there's environments and things that we can do to to help nurture that child. But it's not like we're to blame for the way that our nervous system's reacting entirely.
00:10:51
Speaker
But, yeah, that shift has been really helpful for me. Tell us, you have in the book you sort of talk about some of your own life experiences. You briefly
Personal Influences on Jessica's Work
00:11:01
Speaker
touched on the burnout.
00:11:02
Speaker
But can you unpack your your brother Sam and his passing and how how that ties into this? I can see that you obviously loved your brother dearly and he had a profound effect on your life.
00:11:14
Speaker
Can you can it tell tell us a little bit of that story? Yeah, of course. I was just going to add to your last point. I think that's a really important distinction because it's almost like we think if how we feel is related to how we think.
00:11:31
Speaker
So it's like, you know, people, whether it's anxiety, think, well, if I just can mindset my way out of this or if I can think better. And so a lot of that piece is saying to people, the way your nervous system is responding is happening in areas outside of conscious awareness.
00:11:48
Speaker
This isn't you choosing this. And I think that is a really key distinction that is helpful with pain is to say, you know, messages are being relayed and communication between the brain and body is the issue. You know, that's a large part. Although I know there's changes in brain, I do think it's much easier for people to understand that overprotectiveness that creates pain or anxiety. You know, is there there's is a lot of similarities. But Yes. So Sam was my older brother, two years older.
00:12:20
Speaker
He was six foot by the time he was 13. So definitely a big, big brother and very athletic, but also coached me a lot in sport and was a big cheerleader of, you know, getting out there and having a go at things, which was great.
00:12:36
Speaker
And right before I closed my physiotherapy clinic, I was due to fly to the US. So he passed away, which was a big shock to me. And it put me into dysregulation. So I spent...
00:12:52
Speaker
a good year where I would experience anxiety, couldn't sleep, gut issues. I'd never had gut issues before. And all of a sudden I was getting like extreme pain. I couldn't eat certain foods.
00:13:07
Speaker
And then I remember it was like the Christmas after he passed away and I'd been invited to a ah party on Boxing Day and I was just lying on the couch And no matter what I did, i couldn't get up off the couch. It was like, I am just floored.
00:13:27
Speaker
And it really showed me how much the nervous system again has this way of protecting us and and either mobilizing us too much, like with the anxiety, where we see gut issues, we can see our body tense,
00:13:45
Speaker
But it also has a way of immobilising us as well if there's threat that's like, no, that's enough. You're not doing like going to this party. But that can also be in the face of really challenging experiences where we freeze or collapse, which our society probably doesn't understand so well.
00:14:06
Speaker
um So it was in that time that I really had to learn to walk the talk, if you like, and embody what I was learning. um But it also gave me a great understanding of what people were experiencing that I wouldn't have today.
00:14:26
Speaker
and as it turned out, I tended to always get chronic pain or persistent pain referrals through to me to look at or people who'd had, you know, they'd been to so many people and then the GP would say, oh, she'll look at that because I don't know why it just ended up being the case. So I had a lot of patience as in I was able to be patient to work with people because I had been there myself.
00:14:55
Speaker
And so I started using, I started looking at the nervous system as the place to work with and look at cultivating safety. I taught people to understand their own states. And it was a big difference in what I saw.
00:15:12
Speaker
And so i started doing workshops around Australia that were on the nervous system and the vagus nerve and then starting off with like a masterclass and then our program.
00:15:25
Speaker
And then now we've had over 20,000 people come to our trainings, which has been amazing and not what I expected at all. And we are training other coaches and clinicians as well in that space. So Sam's, like the effect of his death has had, you know, even though I would give anything to have him back, it has shifted my life in a new direction and will definitely continue to be why I love to explore this work and I think from having the, what I built and recovered from has allowed me to stretch and grow in places I would never have done if I didn't take that step and say, I'm going to really dive into this work.
00:16:12
Speaker
So yeah, was a, it was a really hard time, but also it showed me that our nervous systems are plastic and they can change and we can still I still feel sad over his loss, but I don't get dysregulated anymore. So I think that that's the biggest relief because it creates so much suffering for people.
00:16:36
Speaker
Yeah, I mean, I love, we all have sort of some story, not quite the same. They're all different. They're all unique, but we can all relate to hardship and and grief and struggles throughout our lives. And I just love it when people channel that energy or able to sort of shift that energy into something that's really positive for the world. It's sort of like Sam's legacy lives on in some way through you and and the work that you now do, which is which is so awesome. ah And I'm sure based off what I know about him from your book, which is not much, ah that he'd be super proud of what you're doing and and who you are. Thank you.
00:17:20
Speaker
Well, Nick?
Understanding and Managing Nervous System Dysregulation
00:17:21
Speaker
you You make some pretty bold claims in the book, claims that I happen to agree with. so that That's true. For what it's worth. But you say a dysregulated nervous system can be responsible for a host of health issues that are going on today and including chronic pain, which is obviously um the focus of the podcast.
00:17:46
Speaker
Why is the nervous system so important when it comes to chronic pain?
00:17:54
Speaker
So what we can look at the link here is that if somebody is dysregulated, it basically means their system is creating too much mobilization or too little mobilization. So if they're dysregulated for that sympathetic mobilization, what will tend to say is the anxiety, their hormonal system is releasing excess cortisol and adrenaline, but it's also having an impact on their immune system.
00:18:28
Speaker
So if we look at the way that the nervous system and the immune system talk to each other, it's so close that and we now call it the neuroimmune system.
00:18:40
Speaker
And it's really interesting if you look at the literature of you know, pain and and inflammation, it go hand in hand. But if the immune system keeps getting wound up because we are living in this state, like there's a threat,
00:18:58
Speaker
inflammation is one way that we can we can see pain. Now, this isn't to say that every person that has persistent pain has nervous system dysregulation by any means, but what it is to say is that through the changes that we see in the autonomic nervous system and the way that plays out to the immune system, but also neurotransmitters play a role in that.
00:19:23
Speaker
It's linked to changes in the spinal cord. It's linked to changes in the brain as well. And also like we are going to see an overlap in areas of the brain, like the insula that detects sensations when we also have big emotions too.
00:19:40
Speaker
So it all communicates hand in hand. And it's interesting that we've learned about these things so separately because Yet what we can see is that this nervous system is a bridge, you know, ah literally runs from the brain to the body.
00:19:57
Speaker
So if we are detecting something is a threat, what does our body do? i mean, in mobilization, we brace. And these, like, you know, we have, yes, the areas in our brain for voluntary movement, like we reach for a cup or we kick a ball, but we also have areas for movement or motor functioning that's outside of conscious awareness too down into the brainstem so that's really linked to the nervous system and we'll see that play out so people who may habitually brace from something that's happened to them
00:20:36
Speaker
that can keep driving cycles of pain and protection as well. So that that activation of an overprotective system that causes pain, because you know pain's the alarm that will sound, it's really linked with if we are dysregulated, we're turning up the volume on that protection, you know the guard dogs barking at everything.
00:20:59
Speaker
And so much of what we need to do is to calm that back down. But yeah, there's the way it's often described in neurobiology is allostatic load that builds because technically stress isn't bad for us.
00:21:14
Speaker
You know, we have this inbuilt capacity to mobilize energy to meet a threat. And that's all stress is. We're just mobilizing energy to meet a threat. And then we will come back to our baseline.
00:21:25
Speaker
but with dysregulation, we mobilize threat energy and the vagus nerve is inhibited from helping us recover from that. And so we stay with that ongoing activation in our system.
00:21:41
Speaker
So it's really bringing it back to recover again, that causes, helps people recover from inflammation and things too. Yeah, was going to be cheeky. you've already You've already answered it, but I was going to be cheeky and say, so show so should we just avoid any challenges and any stresses at all? And should we just go up into the Himalayas or something and be a mum? No, we should not.
00:22:07
Speaker
It cracks me up, right? Some patients used to come in and say, my doctor told me to reduce stress. And I was like, well, that's helpful, isn't it? Like, I mean, we're not looking for, this is where I think stress resilience is more important than stress avoidance or reducing stress. It's really about how do we make ourselves get better at being able to regulate under stress and that's that is a challenge it's not an easy thing to do but it is a system we can train so because short-term stress is a healthy for us like you know going in for a run is a stressor but it's healthy if you have adequate time to recover from a body sense that's how we sort of see it the nervous system by the sounds is no different how do we how can we tell
00:23:00
Speaker
whether we're in a dysregulated state? It's a great question. I think the three hallmarks of the nervous system are sleep, number one.
00:23:12
Speaker
If you look at yeah that sympathetic nervous system that mobilizes us, if we've got too much of that in our system, we won't be able to fall asleep or stay asleep.
00:23:24
Speaker
So that's that's a big one. And then we can look at the gut, which will usually always reflect what's going on there. Like look at the vagus nerves and anatomy. It runs straight into into the digestive system.
00:23:40
Speaker
And then we again look at inflammation and those three are clues. So if we if we have persistent pain on its own, that doesn't mean that we're dysregulated.
00:23:51
Speaker
We'd say that Along with that, we feel the, it's almost like the on button is jammed. So it's like anxiety, can't sit still, like hyperactivity, agitation.
00:24:06
Speaker
It shows up in our relationships in a big way. Like, you know, there can be the criticizing, the blaming, the arguing. So imagine that's like the on buttons jammed. And then we can have, it's like the off button is jammed where people, and and this, we don't talk about this as much with the nervous system. Like we don't hear about it as much, but it is common that people can be feeling like they, whatever they try, they just can't get motivated.
00:24:35
Speaker
There's burnout, exhaustion, but it can also show up for some people as like a collapse. Like they actually feel in the face of a challenge, that they just go, oh my God, all my energy's just nosedived.
00:24:48
Speaker
This is hopeless. My situation's helpless. And in relationships, that probably more looks like withdrawing, stonewalling, isolating, not getting back to people's texts.
00:25:01
Speaker
And and and the like in a threat response, people might also freeze. So they they just can't take any action and it's paralysis. So it's really being stuck where we're either on or off.
00:25:15
Speaker
And we can't find that place in the middle where, you know, regulation doesn't mean that we're at this flat line calm, but we're within a bandwidth that matches what's happening in our environment with the right activation.
00:25:31
Speaker
And, you know, there's a fluctuation in that each day up and down as well. Yeah, I think people have like an innate sense that they're not in the right state.
00:25:42
Speaker
um So it's a funny, but it's also ah a good question because I think we sort of get a little bit disconnected to where we are, what's going on, why is this happening to me in in our like nervous system and the way it's reacting.
00:25:58
Speaker
You mentioned a few things. So you mentioned sleep. You mentioned the gut, inflammation, relationships, those kind of things. With the gut and with inflammation, how do we see that? Or are you do you use tests to have a look at that?
00:26:17
Speaker
It's a good question. so the gut, if we're saying... Like people who have long-term dysregulation may already have a diagnosis like IBS or SIBO.
00:26:33
Speaker
And that's challenging, right? Because IBS has actually just been reclassified. So it's we yeah we have thought about IBS as a gut disorder.
00:26:45
Speaker
but it's now been reclassified as a disorder of gut-brain interaction. So it's not necessarily about the gut, albeit it still is helpful for some people to selectively remove foods for a short period of time until their symptoms improve but it is more about the nervous system's role in it so ibs is a nervous system issue primarily rather than it being now just a gut and this is also true with sebo
00:27:16
Speaker
So if we look at what's happening for gut issues like these chronic ones that don't aren't really ah they're not really an explanation, they're just a, well, you've got this, this and this, so therefore it's this.
00:27:31
Speaker
And so what's happened is when the vagus nerve is in is inhibited from doing its role, we don't get peristalsis happening. So if you imagine a tube of toothpaste that was being squeezed along, that's how peristalsis works through the intestines to move our food along.
00:27:51
Speaker
But if the vagus nerve is inhibited, we don't get those regular contractions through there. So we get distension, we get bloating, we get changes in the way that the food moves through, and that causes us pain because of the stretch.
00:28:07
Speaker
Now, if we become fearful of this pain, if we find ourselves going, oh, I can't go out there because I'm going to have to eat this and this is going to be hard, we keep driving that through ah you know our top-down thoughts.
00:28:21
Speaker
But one other thing that really happens is that the the balance of the microbes in our gut will change based on the motility because a lot of the microbes like a healthy movement through the gut to keep the the environment just right.
00:28:38
Speaker
The pH might change, the temperature might change and the secretions. So really what we look at is we can do testing, but no microbiome is the same.
00:28:52
Speaker
So there's not really a point in testing because what is it going to tell us? if this microbiome is like your unique fingerprint. You know, we don't have this perfect microbiome to say, this is what your gut should be like.
00:29:06
Speaker
So really it's about personalised, like the nervous system regulation to get those nice healthy contractions through, balance the microbiome and personalized.
00:29:18
Speaker
You know, people can keep a food journal themselves to say, okay, apples, apples seem to be a huge one for people with IBS. These made me worse. I'm going to take them out for two weeks, or it could be artificial sweeteners, or it could be milk.
00:29:31
Speaker
And thankfully, you know, SIBO, the recommendation used to be antibiotics. But thankfully now that is changing. So it was like, take the antibiotics and you'll get rid of the bad microbes, bad microbes.
00:29:45
Speaker
But now they're saying, no, we won't do that because we're wiping out all of the good microbes as well. So it's it there's this there's this swing in change, but the testing for gut um disorders like that are not necessarily helpful or super validated either.
00:30:07
Speaker
And that it's probably a waste of of money. um It's more looking at, you know, what we find for ourselves. But, you know, there's there's some incredible health practitioners that work in this space as well that can be great to work with for a personalized support too.
00:30:26
Speaker
What about, I mean, I could talk for about gut because it's really fascinating to me, but it's not, obviously, it's not the main focus of this one. so I'll have to move on. I'll have to park all those questions for some other time.
00:30:40
Speaker
But what about inflammation? So do you, like, is there markers that you look at? Or again, is it due to some of these more external symptoms? Like, for instance, what you mentioned with you know, constipation or, yeah, bloating and those kind of things?
00:31:02
Speaker
Yeah, I think the thing to look at is is really the cluster of symptoms that you hear from somebody who's got dysregulation.
00:31:13
Speaker
So they won't just come in with one thing. And this makes sense because of the way these systems communicate together. So, okay, just take the gut, for instance, and it's like you said, constipation.
00:31:27
Speaker
the blood leaves the gut when somebody is in that sympathetic state. So not having the blood flowing through there is going to slow down motility. We're going to you know see that as well.
00:31:39
Speaker
And they probably will tell you they're anxious. They're probably going to say something like they have pain somewhere else. Now, what I used to see, which I think is really interesting, is you'd have a patient who would be like taking something for hypertension taking something like Nexium for their gut, taking something to help them sleep.
00:31:57
Speaker
But there was no connection of the dots. You know, you were treating this in isolation and that was that was frustrating to me. But I think now what you see and what you hear and what you observe, you can start to say, this person is probably mobilized a lot of the time and they'll tell, you know, you'll hear that and see that.
Role of Physiotherapy in Nervous System Regulation
00:32:19
Speaker
So Look, personally, I don't think it's necessary if you have the understanding of the nervous system to have that. It's a little bit like saying if someone's got nonspecific lower back pain, you wouldn't get markers read of their inflammation or an MRI because it's not necessary.
00:32:40
Speaker
But i it from a research point of view, ah definitely can be super, super interesting. The other thing is we can use heart rate variability to look at the improvement of the nervous system over time because it is measuring the vagus nerves connection to the sinoatrial node on the heart, which is great for telling us how it is calming us down or it's releasing.
00:33:09
Speaker
And that's something we can track over time to have an objective measurement of the nervous system, and it's a great biomarker.
00:33:18
Speaker
Yeah, I find that that's cool because a lot of people are wearing wearables. So I'm thinking there'll be someone listening that will go, oh, I could have a look at that. So if if people are thinking, they're listening and they're hearing this and they're thinking, this sounds like me, like I've got i've got persistent pain, have some of these sort of gut issues to some degree or like there's ah there's enough in what you've just explained to say I'm dysregulated.
00:33:46
Speaker
and it's at least part of the puzzle when it comes to, say chronic pain, what do they do? Yeah. So the first place that we always want to start is getting to know our states in a really embodied and experiential way.
00:34:05
Speaker
So rather than cognitively saying, ah I think I might be feeling a little bit mobilize like this it is actually dropping into the body and saying okay i know like a lot of people are holding you know in those bracing patterns like we said when they're anxious and there's not the awareness of that but it's just a habitual thing they might have their belly drawn in and tight and breathing shallow so The first thing is to really get to know the states and know your default when you're stressed.
00:34:40
Speaker
And if there is a lot of stress in your life, it's probably looking at, okay, well, I'm actually spending a lot of time, you know, in that sympathetic state. And The principles around change or neuroplasticity, one of them is specificity, which means although we might see on Instagram, you know, if you want to regulate your nervous system, just hum or just do this, like it's a really simple thing.
00:35:05
Speaker
It's actually more about being specific to the state that you're in. So if we're too mobilized, it's like we need to bring ourselves down. And if we're too immobilized, that means we need to add some movement or add some energy or add some more arousal to the system to come back to regulation.
00:35:29
Speaker
the the The sensory systems are huge with this because they are communicating messages of safety to the brain in a way that says, okay, things are okay down here.
00:35:42
Speaker
You know, it's like, that's what we call bottom up information. So bottom up information can come from things like the senses. So it can be proprioceptive input from our joints.
00:35:55
Speaker
And this is where movement, exercise, things like squeezing our joints. If we tend to dissociate from our body, when we're really stressed, it can be noticing the sensations inside our body and following those along.
00:36:10
Speaker
And as we do that, we often will notice as we tune into sensations for a while, oh, I'm starting to get a settling of this sensation when we allow it. A lot of it is the breath that can send a bottom-up message to the brain as well.
00:36:26
Speaker
So the stretch of the lung receptors, if we if we take a deep breath in our lungs stretch, and also if our belly stretches, that signals to the brain to bring the vagus nerve back in.
00:36:42
Speaker
So those things can be super, super helpful as well. And then if we look at things like the gut, you know, there's a lot we can do in lifestyle as well around what we eat and improving our sleep too. But a lot of what you'll hear now linking to regulation is about a body first approach.
00:37:04
Speaker
And this is where I think physios, I think body workers, anyone in that space are the perfect people to do help with this work. You know, if we're doing teaching people exercises, if we're teaching them movement and we're connecting them to proprioceptive system, the interoceptive system, we are going to be helping people regulate.
00:37:26
Speaker
So that that's really important. You mentioned in your book, sometimes people reach for the wrong tool. And i like I like what you, because I've experienced this myself, actually, I like what you said around you know, mindfulness practices or meditation or or breathing, it it sometimes it's not the ideal thing to do How do you decipher this?
00:37:54
Speaker
Well, you've sort of mentioned a little bit about deciphering the states, but how do you know which tool is best for what state? Without reading your book, of course. Yeah, yeah it's a great it's a great question. So, okay, I'll give you a story, Lachlan, because this will help people. So not long after i lost Sam, I went to a yoga class.
00:38:14
Speaker
Now, I thought this would help me feel better. i was feeling really down, alone, disconnected. I was in that dorsal vagal state of immobilization.
00:38:26
Speaker
So we go into the yin yoga class and it's all let go, let go, let go. The breath was getting slower and slower and slower. The exhalations were getting longer and longer and longer.
00:38:38
Speaker
And I just felt more and more alone. I was in this impending sense of doom. Then I got dizzy But what what's interesting is in that state, we already are experiencing things like bradycardia, you know, so our heart rate slowing down, we're experiencing lower blood pressure.
00:38:59
Speaker
And then you go to a class like that. Now this class it was, it was great for the right people, but it was so much about, you know, dropping down that I came out of it and just felt horrendous.
00:39:13
Speaker
and And I think, this is where we need to be having a broader conversation about things rather than if you have a history of trauma, just do breath work.
00:39:27
Speaker
Because for people who, okay, this is a beautiful example. I went to the, um, the conference on pain that I mentioned to you about spoke to a colleague and she said, oh, I've got PTSD.
00:39:42
Speaker
And I went to other practitioners and they told me to just do breath work. And the reason I have PTSD is because had a near drowning experience.
00:39:54
Speaker
so could you imagine getting somebody who'd had a knee drowning experience to pay attention to their breath i mean it's not trauma informed so this is where we have too many blanket statements too many instagram advice to you know that are just like everybody do this that doesn't work and to know like you know things like meditation where there's no choice to move, there's no choice to get up, there's no choice to open your eyes, there's no choice to pay attention to something else can make people feel worse.
00:40:29
Speaker
So if we're in that dorsal vagal state or we're immobilized, we don't want to be doing long, slow exhalations, which bring in the vagus nerve even more to slow us down.
00:40:42
Speaker
We want to be doing things that activate us. So that could be some playful movement, connecting with somebody, connecting It could be a short, sharp inhalation and then a better, ah small exhalation. So it's really picking, this is why we need to know the states first and have an idea of what marries to that to get a better idea. What if you're, because my experience I think is is the opposite of your yin yoga experience where I felt, where i was probably really mobilised and I was trying to like,
00:41:18
Speaker
you know, do the deep breathing thing and it just like it just did not work. And in your book you sort of mention it that, you know, what I probably should have done is just got up and gone for a run or like something to sort of release that that energy.
00:41:37
Speaker
but yeah, I find it fascinating. But do you have any other examples of when you're in that mobilised state or that sort of flight fight state, what is the best thing What are some techniques you can use in that state?
00:41:50
Speaker
Yeah, it's a great question as well. So i was talking to somebody about this earlier today around anger. And because we often think that anger is a wrong or bad thing, we try and get rid of it or push it away or calm down. And, you know, I keep i keep hearing this message that, you know, to regulate your nervous system, it's just about calming down and it's really not.
00:42:16
Speaker
So I think... For anger, we've got to look at it and say, okay, from a primal level, this is fight energy. And what often needs to happen with that energy? Like it it is it is trying to mobilize you to do something. It's like, go, take action.
00:42:35
Speaker
But if we're trying to say, get rid of it, you know, calm it down, breathe it away, it's almost like it gets like bigger and bigger and then we resist it. So we're just, you know, building it up and up.
00:42:46
Speaker
But often the best thing for fight energy is where we let our muscles contract. Like we've got all this glucose in our system because cortisol has released it And if we actually let those muscles contract, like they want to express and be like even using our voice if we're angry, it's often a way that then the nervous system can discharge that rather than trying to bring it back down and be calm.
00:43:15
Speaker
So there's a sometimes there is a time where we can go, right, I just need to let my body relax here. Okay, I'm settling. But sometimes it's actually about letting that move as well.
00:43:28
Speaker
And like you said, you know you can be going for that fast walk before you sit down. And if you've if you've got a lot of mobilization, that's really helpful. This is the beauty of movement. So think it's like,
00:43:43
Speaker
We can have broad ways of looking at our different states like mobilisation, but within that, <unk> it's quite a vast spectrum. You know, flight energy is completely different from fight, but we put it together.
00:43:58
Speaker
and And flight energy may make us want to do a quick movement, but fight may be like more of that what I was saying. I want to let this anger come through or let this mobilisation come through.
Emotional Processing and Stress Management
00:44:11
Speaker
And then once it gets the opportunity to express, we'll often notice that there is a discharge of activation. We either yawn or we sigh or we twitch.
00:44:25
Speaker
We might notice our tummy gurgling again, that feeling of relief or temperature changes that tell us, okay, that's moved through us now. So you're a big fan of those places where youre where you you go and you smash things.
00:44:41
Speaker
You know those? that they yeah but When you were talking about it, I was like, wow, that's awesome. like Because I've always thought, man, when you ah when you're angry, that would be unreal.
00:44:55
Speaker
yeah Yeah. Maybe there's a place for it Maybe that's in your in your new course you can have that. I think that could work. It's really cool though, because really what we're talking about is allowing emotions to be processed.
00:45:10
Speaker
And I think there's there's like certain parts to it, which is first, we need to let them emerge. And so much of the time, because we say certain emotions are good or bad, they don't get to come to the surface.
00:45:22
Speaker
And then the second part is we need to actually experience them, which means being able to sit with that discomfort And then the third part could be like that expressing, like we just said, where we go, right, let's smash something or let's let our muscles contract.
00:45:40
Speaker
And then the final part is then they expel. But I think people either go, they don't let them emerge in the first place or they rush to this trying to get rid of them and the middle part gets missed.
00:45:53
Speaker
Yeah, as long as you're smashing something that's not harming someone else and it's in a controlled environment, we'll allow it. fact Exactly. but like That's awesome.
00:46:04
Speaker
and You talk a lot about how to increase the window of tolerance and how to, like you were saying, we all deal and cope with stresses and challenges throughout life, but it's how we are resilient through that or one, how we regulate it, but also how how do we build our capacity for these challenges?
00:46:27
Speaker
can you Can you touch on that? Sure, I'd love to. So the window of tolerance comes from the work of Dr. Daniel Siegel, who is incredible and he's US-based, but he created this framework for us to understand our nervous system.
00:46:44
Speaker
So I don't love the word tolerance only because it's like what we said, it's kind of like making people think they just need to put up with what's happening inside of them. So I kind of like the window of regulation better.
00:46:57
Speaker
But if we think of that as a bandwidth, Where if we're within that window, we're flexible, adaptable, our thoughts are coherent, and our energy is relatively stable.
00:47:10
Speaker
But, you know, it could be that we're rushing to work and we do feel a bit nervous. It's not to say we don't ever not feel calm. but it's more that we can still act in the best interest of our values.
00:47:24
Speaker
But above that is that mobilization that we've spoken about, like fight or flight, anxiety, that kind of thing. And below the window is what we would call the shutdown hypoarousal. But the width of our window is dynamic day to day.
00:47:43
Speaker
so you know, I have a two-year-old daughter and I've had many nights where she has slept probably for four hours and I will find the next day my window is a little bit narrower.
00:47:55
Speaker
So there's some things where if I can, I will try and just take off my plate on those days. Not always possible, but, you know, it can be a real challenge.
00:48:07
Speaker
But it also helps me recognise, okay, I probably am going to be a little bit less resilient today. Because sleep changes how we process emotions, how we feel sensations.
00:48:21
Speaker
And then one other thing that happens is that, and this is similar to what we can see with persistent pain, is that through what we experience, our nervous system or our brain and our body change.
00:48:38
Speaker
And so sleep If we have a traumatic experience and, you know, we talk a lot about trauma as though it's a car accident or a tsunami or a war, and those things are still, you know, I'm not taking away from those in any way, but if we classify what is traumatic stress as,
00:48:59
Speaker
It is more a situation where it feels uncontrollable, unpredictable, and it could be completely new or ah could remind it could remind us of a traumatic time in our past.
00:49:13
Speaker
So for instance, we recently had tropical cyclone Alfred headed to the east coast of Australia and that ticked really all those boxes.
00:49:24
Speaker
It kept, you know, the cyclone kept changing. no one knew what was happening, completely out of everybody's control. And if you read the comments earlier, on Facebook, you know, you would you would put yourself into extreme stress. So i was like, off social media, no more looking at it. Basically, you know, we could say that that was, and it went on for days. Like, so if you look at what's happening in the nervous system there, that's a situation where you would be outside your window for quite some time.
00:49:59
Speaker
So through those experiences, the vagus nerve can and be inhibited from calming us down in the moment. So its job is to help us both cope with and recover from stress.
00:50:16
Speaker
It's a little bit like, you know, if we're in a car and we have too much accelerator, the the vagus nerve puts the brake back on. So we slow down to match whatever's happening.
00:50:27
Speaker
and And so if we don't get the opportunity to come back to the right speed, our window we can think of as being narrowed.
00:50:40
Speaker
And so Things that before may not have made us anxious, today we can find that we're feeling really uncomfortable with and definitely saw that post-COVID where people found social gatherings, they got anxious and they never had before.
00:50:59
Speaker
So I think there's this really interesting part where We aren't just passively taking in information.
Influence of Experiences on Stress Responses
00:51:07
Speaker
Our nervous system is really reshaping itself from everything we experience.
00:51:14
Speaker
And it's encoding that into the survival brain, like outside of conscious awareness, which makes up these memories that we say are implicit, meaning it's not like we go and remember a story.
00:51:25
Speaker
It's like we just automatically can do things like drive a car, tie our shoelaces, that kind of thing. Yeah, no, both of those experiences are things that I can relate to being on this this side of Australia.
00:51:39
Speaker
And especially if you're on the news, I would love for you to touch on the news in general. And like, do we consume too much of it? What's your thoughts?
00:51:52
Speaker
Well, it's actually a bit of a strategy. So if we think of our survival brain being that lower part of our brain that doesn't communicate with us through words or narratives, it really communicates with us through like us through sensations and emotions.
00:52:09
Speaker
But our thinking brain, on the other hand, it does communicate with us as it says, but it will evaluate, it will judge, it will try compartmentalise.
00:52:20
Speaker
And so when we're stressed, and this is what people may have also noticed in COVID or times like a cyclone's coming to your coast, is that you want more information as an attempt to feel safe when things are uncertain.
00:52:39
Speaker
Now at first there is an element of, you know, a degree of information, which is great. But then what happens is you start getting news hook headlines, you know, sensationalized media.
00:52:53
Speaker
And if you're taking this in over and over and over again, you are sending messages of threat to your survival brain. So we need to find that place where it's like, okay, that's enough. And, you know, we're not meant to take in all of the world in the news and all of their grief and all of the suffering that goes on, but it's also pretty unfiltered. You know, i'll I'll open up social media and have a look and be like, oh, i need to put that back down now.
00:53:26
Speaker
Yeah. just the the ah level of shock factor that is in that. And I think we've really got to pay attention to how we are taking in news or social media.
00:53:41
Speaker
And a lot of the time, you know, our phones are there when we kind of want to artificially regulate our nervous system. So we might feel stressed and think, well, if I just scroll on my phone for a while,
00:53:57
Speaker
I can distract myself from everything it's or it's like a way we're saying we're winding down, but it's not that true recovery where we really get to feel like settled and down in our body again.
00:54:10
Speaker
Or if we feel disconnected and lonely and alone, we might look to social media as a way of connecting, which in some way it can be amazing.
00:54:21
Speaker
But in other ways, I think it can make us feel more alone because we're watching everybody else have a great time and we think, oh, I'm here alone whilst the whole world is out there having these wonderful connections. So it's really about how we how we use it and how much we use it and when and particularly not looking at comments in Facebook groups when there's a cyclone coming towards your towards your house. I had to get out of there pretty quick.
00:54:52
Speaker
Yeah, for sure, for sure. what you mentioned You mentioned in the book about the thinking brain strategies often fall short. We've sort of touched on that, but you weren't you didn't really connect it with the thinking brain. Can you explain the thinking brain versus the survival brain or the emotional brain or however you term it?
00:55:17
Speaker
Yeah, for sure, for sure. So the survival brain is the lower centers of the brain. So we have like our brainstem, which is down here that the vagus nerve connects to.
00:55:28
Speaker
And then we have the threat detection system within our survival brain, which is the amygdala. And that's like our smoke alarm. And we have other areas down in the survival brain that have to do with regulation as well.
00:55:43
Speaker
Now, the thinking brain's job is around evaluating, judging. It's what enables us to do the amazing things that we can do with you know planning, reasoning, come up with innovative solutions.
00:56:00
Speaker
But when we have stress and people go towards mindset strategies and try and use thought to feel better,
00:56:13
Speaker
It often falls short when we are really activated and we end up with more rumination. So what we want to do is speak the survival brain's language because it's the one that's determining what state we move into.
00:56:31
Speaker
So the language of the survival brain and the nervous system is sensations. And so if we can connect to our body, like we said, if we can work with sensations, but if we can also send messages from the body to the survival brain that things are safe in our body, we will bring the vagus nerve back in and slow back down.
00:56:55
Speaker
But when we try to use our thinking to overpower how we feel, so that's i could kind of like a top-down management.
00:57:06
Speaker
It's not really ah regulation. It's more like a you know management or a grit your teeth and power on. It tends to actually create a little bit more resistance and the survival brain, if it doesn't feel like it's being heard, it's going to get louder and louder.
00:57:24
Speaker
So a lot of what helps us to be resilient is to connect to sensations, acknowledge them, and in a way to attune to what's happening with our sensations rather than just trying to tell ourselves to suck it up get on with it or like you know we hear people say well kate's got it so much worse than me so you know it's not that bad i guess but that doesn't truly create regulation it's just a way that we're trying to manage how we feel
00:57:58
Speaker
You basically just outlined the way i so I, my natural default position was all of those things. So thanks for speaking directly to me. yeah getting Getting out of my head or out of our head can be really, really helpful. And I think that's kind of what you're explaining is just that getting out of your head. Because sometimes we just sort of we try to think our problems away and it's not always possible to do that.
00:58:27
Speaker
Yeah.
00:58:29
Speaker
I'm really quite fascinated on like the pillars of health and how they relate to chronic pain. So when I say the pillars of health, actually, when I say the pillars of health, have a guess.
00:58:42
Speaker
There's five of them. What do you think they are? Because I reckon you'll be very, very close. There'll be some overlap. Okay. I'd say sleep will be what? Tick. I would say connection or relationships or social would have to be another one.
00:59:00
Speaker
I don't know if you'd call it emotional health or if you'd look at it as more psychological health, like around, you know. Tick. Yeah, okay. What else?
00:59:10
Speaker
ah Nutrition's got to be in there somewhere. Wow. There'd have to be movement, wouldn't there? Tick. Wow, maybe we've just come from the same sort of – thought philosophy teaching but I i did not tee Jess up for that but those are the five those are the five that I think of as well and I'm particularly interested I actually think this may not resonate with you but it may resonate with the listeners I don't know i don't know you might but I think of lifestyle as like the Tim Duncan of of pain and
00:59:47
Speaker
Now, Tim Duncan, for those that don't know, is like this underrated basketball player in the NBA that was just underrated, but he was just so good and pivotal for teams.
01:00:00
Speaker
I think of it that way with pain. I think lifestyle is so, so crucial when it comes to persistent pain. Now, you've already talked about, you've labelled the five, but did tell me some thoughts around lifestyle and pain.
01:00:16
Speaker
And how it relates to the, sorry, how it relates to the work that you do.
Importance of Community and Connection in Health
01:00:23
Speaker
I think one that's really underrated and people probably don't proactively prioritise would be connection and community.
01:00:35
Speaker
And so if if we think, if we look at like, say, you know, I've just moved to a newer new suburb and it's been interesting looking at how as adults do we have this sense of community and do we make new friends?
01:00:53
Speaker
And it takes effort, you know, like we really need to make an effort. And so that's been things like when I'm at in the playground and I talk to somebody that I get along with, that I make sure I get their phone number and say, would you like to do this again?
01:01:07
Speaker
You know, it's putting and putting that effort in into to make that connection. It's also been with things like getting involved in in the community and and offering help to people.
01:01:18
Speaker
But it could also be things like volunteering because you get to spend your time with like-minded people working towards a common purpose.
01:01:29
Speaker
And that both of those are really important. So I think as adults, we can tend to get a little bit settled in our maybe our group, our friendships.
01:01:40
Speaker
But I think that sense of belonging to a community gives us something that helps us to realise we belong to something more. And it's probably just the Western world that doesn't have this way of including like spirituality or community as such a big part of their health.
01:02:03
Speaker
you know, if we look at the Maori tradition definitely has family as ah as a big pillar. So, and and that community aspect. And one thing that I think is, does make our nervous systems more protective and make probably us more anxious is not feeling like we have enough people there for us. So for instance, this week,
01:02:28
Speaker
is it was a big week for us and my um husband couldn't take my daughter to daycare because someone was sick and something happened.
01:02:40
Speaker
And then you're like, like we don't have our family in this area. And so there's that feeling of like, wow, we don't have people to ask for help or to rely on.
01:02:51
Speaker
And that in itself does create a feeling of isolation and vulnerability. So I think there's a big part of this and, like, you know, I'll often share posts on connection, belonging, community, and every post, it doesn't matter how long I've shared it for the last five years, someone says, well, that's all good and well, but what if I don't have anybody to connect with or any community? And it's like, well, it doesn't just come to you. You know, you need to make an effort with this. It's like saying, well, why aren't I fit if I don't exercise?
01:03:23
Speaker
Yeah. i think I think for our culture, we are hyper individualised. We look to the person as being responsible for everything.
01:03:35
Speaker
And I think we don't take into account you know, particularly with trauma, the the the societal structures that can contribute to that, like segregation, marginalisation enough. Like I think there's more we can do to help people in that way. But that's been really interesting to observe, you know, with moving and trying to create, like establish new community. it takes a big investment.
01:04:03
Speaker
And also, you know, your friends are worth their weight in gold when you've got good ones. Totally. Yeah, I think that's huge, especially for people with chronic pain, because is that there's a sense of isolation with it because no one else knows really how you're feeling or what you're experiencing. It's it's isolating in in one sense or that sense.
01:04:27
Speaker
And so like developing connections that of people that you can lean on and yeah you trust is crucial so i think you're right i think it's so underrated boom yeah it's it we're very much about you know because there's so many competing priorities in the day-to-day like with work with getting ahead with you know, and and we probably do prioritize success over the the softer parts of connection and belonging and community. But there's amazing things. Like I i just love the concept of park run.
01:05:06
Speaker
Like what a great way to get people together. It's non-competitive. They're exercising, they're belonging to something, they get volunteers in who if they can't, you know, they don't need to run. But it's people cut We have it here. There's people coming together every Saturday morning for Parkrun. I just think it's so fantastic.
01:05:23
Speaker
Yeah, for sure. No, there's lots of things in the you can obviously be a part of and participate in. there's There is very little excuses to be at least trending in that direction.
01:05:37
Speaker
Obviously, you know, people can feel quite lonely and isolated, but there are there are solutions out there. So, yeah, no, it's awesome. Tell me, this is ah this is a traditional question actually and we'll end with this, but if someone um if someone's feeling sort of down in the dumps, they feel helpless because of their, what would your words be or advice be to them?
Conclusion: Reshaping Narratives for Pain Management
01:06:05
Speaker
I think it's really helpful to look at the way that our stories follow the state of our nervous system. So in that state where we feel immobilised and down and flat and hopeless, there's often a story that things will never get better. I'm always going to feel like this. My pain's going to last forever.
01:06:35
Speaker
And then if we're in that sympathetic state where we're mobilized and agitated, we have a story of overprotection or there can be an anger with it. Like no one else has got this, like what we're saying, you know, I'm alone, I'm the only one.
01:06:51
Speaker
So I think it's really helpful to imagine that you're putting on ah different pair of sunglasses and looking at your experience and they've got, you know, different lenses. But when we can come back to regulation,
01:07:05
Speaker
we can learn to see that reality as it is. And that brings a lot more hope for us. And, you know, as we're seeing there's good research that supports the way that we can change and we don't have to have pain forever.
01:07:22
Speaker
Like once it was, you know, you're going to just have to live with this, but that's not what we're seeing anymore is the case. So just to really trust in the process of neuroplasticity or as we're hearing now it's bioplasticity where more than just neurons change but the story will follow the state so if you change the state you can come back to that story that more represents reality and that's going to really change how you feel that's awesome that brings a lot of hope to a lot of people i'm sure listening i want to just have a little quick plug
01:07:58
Speaker
I thought ah got Jessica's book, The Nervous System Reset, about a week and a half ago. It came very quickly by Amazon and and I've nearly finished it.
01:08:12
Speaker
I probably, that's where I'm off to. And it's it's awesome. It's an incredible resource for people that feel like some of what Jess has said fits them. fit It's the the shoe fits, as they say.
01:08:27
Speaker
um so yeah, grab your book. Is there any other places that they can find out about what you do, Jess? head on over to my website, which is just my name, jessicamaguire.com, and you'll find all the upcoming trainings, but there's loads of resources on my website as well.
01:08:46
Speaker
Awesome. Thanks, heaps. I'll link those to the the show notes. Thanks, heaps, Jessica, for coming on. I really appreciate it. Thank you for having me, Lachlan. It's been so much fun to nerd out on all of this with you.
01:09:01
Speaker
Cheers.
01:09:03
Speaker
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