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How to Manage Chronic Pain with Dr. Andrea Furlan - E93
63 Plays1 month ago
Chronic pain can steal your energy, your motivation, and even your sense of control over your own life.
The frustration grows when medication only dulls the edge or when pain resurfaces without a clear physical cause. Searching for answers, many are trapped in a cycle of sleepless nights, stalled routines, and endless appointments that cost time and money but bring little relief.
In this episode, we break down why your pain might not be just in your bod, and how proven daily actions and brain retraining can help you finally reset. You'll learn why real, lasting recovery goes far beyond prescriptions, the role of subconscious and psychological factors in pain, and tips for managing chronic pain.
Andrea Furlan is Professor of Medicine in the Division of Physical Medicine & Rehabilitation, Department of Medicine at the University of Toronto, She is Senior Scientist at UHN"s KITE Institute, and Medical Lead of the Rehabilitation Pain Service at UHN's Toronto Rehabilitation Institute. She is chair of ECHO Ontario chronic pain and opioid stewardship at UHN and she is a social media influencer with a YouTube channel "Let's Talk About Pain". She is the author of two books for people with chronic pain.
“And so if you're in pain, you're having a hard time sleeping. If you're having a hard time sleeping, you're in more pain and it's this terrible cycle that you're in.” - Dr. Andrea Furlan
In this episode you will learn:
- Why chronic pain is not just a signal from an injury, but a complex issue shaped by the brain and body.
- How lifestyle changes, like movement, sleep, and social ties, play a big role in easing pain.
- Why pills may help for short-term pain but often fail for chronic pain, and when to use them.
- The link between stress, worry, and pain, and how your mind can shape what you feel.
- The value of taking control with simple daily actions and building habits that shift pain and boost health.
- How small, regular steps lead to lasting change and relief.
Resources
- Connect with Dr. Furlan on Instagram: https://www.instagram.com/dr.andrea.furlan/
- Watch her YouTube channel: https://www.youtube.com/c/DrAndreaFurlan
- Learn more about her work: https://www.doctorandreafurlan.com/
This podcast was produced by the team at Zapods Podcast Agency:
https://www.zapods.com
Find the products, practices, and routines discussed on the Alively website:
https://alively.com
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Transcript
The Subconscious Mind and Behavior
00:00:00
Speaker
All of our behaviors, 80%, if not more, are controlled by the subconscious mind. And if the subconscious mind doesn't have an outlet to express itself, it's going to talk to your conscious mind, and the only language that it knows is symptoms. Like those vague symptoms that are not explained by a structural problem in the body.
Podcast Introduction and Guest Welcome
00:00:25
Speaker
This is the Home of Healthspan podcast, where we profile health and wellness role models, sharing their stories and the tools, practices and routines they use to live a lively life.
00:00:38
Speaker
Dr. Furlan, welcome to the Home of Healthspan podcast. Thank you so much for inviting me to come here today, Andrew. I initially invited you for our listeners as an expert in all things pain.
Meet Dr. Furlan: Lively Pain Management Specialist
00:00:52
Speaker
And I think as we got closer to the episode, I realized it was going to be a lot for me too, as I started dealing with some new pains. But before we get into all of that and what you do how would you describe yourself?
00:01:03
Speaker
Well, I am a lively physician, professor medicine, professor of medicine, and scientist. I am a professor of medicine at the University of Toronto, and I work as a physician seeing patients in the pain clinic here in downtown Toronto, Canada.
00:01:19
Speaker
Yes, it's a ah beautiful, beautiful city for those who haven't. They're right on the water. A lot of time I spend in Bermuda and for some reason we have a lot of people from Toronto that end up Bermuda.
00:01:31
Speaker
fact, to staying with some friends tomorrow night from Toronto originally, now I live in Bermuda.
Changing Perceptions of Pain
00:01:36
Speaker
But let's talk about your your work as a physician, your work, you're an author, you you educate a lot of people in this area of pain. And I think we're at an interesting point when it comes to pain and chronic pain,
00:01:53
Speaker
And there was a period people thought maybe it's just in your head. People didn't know what's going on. Then you had the Sacklers and where we ended up with opioids and painkillers and just taking pills to, quote, fix it and the reaction to that. And then now to the work that that you were doing before.
00:02:12
Speaker
but is becoming more predominant in how we think about pain and treatment. So can you talk a little bit about what brought you into it and kind of the evolution you've seen and how we think about pain, both as a concept and how in treatment?
Dr. Furlan's Journey into Physiatry
00:02:28
Speaker
Yeah, it's a lot of questions. that yeah ah So yeah, so what brought me to pain? um I graduated from medical school in Brazil 32 years ago.
00:02:40
Speaker
And when I was in medical school, that's when I figured out that I wanted to do something with pain because I had an experience with a patient that had fibromyalgia.
00:02:52
Speaker
The professor of physiatry came to see her and he did acupuncture and she was so much better. Like before she was bedridden, we had admitted her because she was bedridden.
00:03:04
Speaker
And after he put some needles and waited 30 minutes, she could walk and we discharged her from the hospital. At that time, when I asked him, what are you doing with these needles?
00:03:15
Speaker
He explained to me that we had a pharmacy inside of our brain that was able to release medications. Like at at that time, the only ones he mentioned to me was endorphins.
00:03:28
Speaker
And I became fascinated. I said, how come that we have a pharmacy inside of our brain and it can do all of this? um Of course, the patient after those endorphins were reabsorbed, she was back to what she was before. So there was a need for a rehabilitation to maintain that benefit. But that's what brought me to, then I chose physiatry. That's the physical medicine rehab that I chose as a specialty.
00:03:54
Speaker
But I did that with the intention of doing rehabilitation of people who have chronic pain. Personally, i had some experience in my teenage years with terrible primary.
00:04:06
Speaker
and um and i don't know if I had endometriosis, but I had menstrual cramps very bad. So I suffered a lot, like ah having to miss classes and school and things that I wanted to do because I was in pain.
00:04:18
Speaker
Fortunately, when i had my I got pregnant from my son, those miraculously got better. never headed them anymore and But then i I did my residency in physiatry to help people with pain, came to Canada, did my PhD in pain, in chronic low back pain, and then became a scientist and a professor and an educator.
Understanding Chronic Pain
00:04:42
Speaker
So what I would say, pain is a very complex phenomenon, very personalized, very individualized, not easy to treat with a pill. As you mentioned here the opioids, painkillers, they don't kill the pain. They may kill the person, but they don't kill the pain. They just numb the pain for a while.
00:05:02
Speaker
They are very good for acute pain, very good for post-surgical pain. And that's probably this is the best use of opioids. If someone has surgery, an acute injury, like a fracture, and they need a painkiller for a few days, that's the best use of opioids. But for chronic pain,
00:05:21
Speaker
They don't work so well because chronic pain is not the same thing as acute pain. I think people don't know this. a lot of physicians don't know this. They keep treating chronic pain as if it was an acute pain that is just lasting longer, but it's not.
00:05:38
Speaker
Acute pain is that signal that is a good signal alerts that something is wrong and it needs to be fixed. But the moment that the body part that it needed to be fixed heals.
00:05:51
Speaker
And I can tell, I i have people that they say, no, I don't heal. Yeah, everybody heals. Everybody heals. The tissues are amazing. Our body is amazing. What our body does to our own, the ability to self-heal is amazing.
00:06:08
Speaker
So everybody heals. The thing is, if the pain persists, it's a different disease because now it's not a signal that there's something for you to go there, remove, and the pain go away.
00:06:21
Speaker
It's the sensitization that remains. It's that memory in the brain that remains. There are a lot of changes that happen at the level of brain, nerve system, autonomic nerve system, immunological system, even the digestive system responds. Now you have a different disease, which is chronic pain, that doesn't respond so well to opioids. It responds some, but it's not the same way that acute pain responds.
Neuroplasticity in Pain Treatment
00:06:46
Speaker
Is it driven by when you had the the injury, you had the acute, that it's created pathways in the brain that are just kind of mapped now? And so they keep running, even though it's not tied to an acute injury anymore, that those loops are still running? how how does this work? What's the mechanism? Yeah.
00:07:07
Speaker
Most of the time, yes, you have an acute injury to create that cascade of events that will change. We call this plasticity. So we have neuroplasticity, but we also have bone plasticity, muscle plasticity. It's bioplasticity. It's not just the neurological system that undergoes all these changes. It's all the systems of the body.
00:07:31
Speaker
Plasticity is just this ability to change, to regenerate, to modify itself, right? To be plastic, to be malleable. But some people don't need that acute injury, Andrew, to develop chronic pain. Yeah, fibromyalgia just it starts slowly and seriously. You don't need an injury to start fibromyalgia, and it starts slowly ah One pain here, one pain there, one here, one. Migraine, you don't need... Migraine is a classical example of nociplastic pain, this pain from plasticity. You don't need an injury to your head to start having migraine.
00:08:07
Speaker
Tension headaches is another example. There is even people who have no... They don't have the body parts anymore. They are amputated and they have phantom pain.
00:08:20
Speaker
Because that phantom pain is the brain creating a sensation in a body part that doesn't exist anymore. ah So the injury healed. They have the amputation. you look at the stump, it's healed.
00:08:35
Speaker
And how come do they have it? It's a fabrication of the brain. it's We call this cortical reorganization. So then is the treatment, the treatments not of the pain per se, but to the short circuit or the whatever wiring in the brain is that that's what you need to be treating is. The goal is to reorganize, to reprogram those synapses, that plasticity that was a maladaptive.
00:09:01
Speaker
The way we explain to the patient is your your brain was basically trying to protect you. And it identified some dangerous situation. And in this protecting you, overprotected you and created this noise that remains there. So someone needs to go there, lower the volume and turn off the knob.
00:09:20
Speaker
Would a good corollary, maybe for some listeners, you think of um if you live in too sterile of an environment, right? And so your your antibodies aren't attacking outside things, you end up developing autoimmune diseases because your body starts attacking yourself. So it's it's this protective thing, but it ends up attacking the wrong thing. Like it's evolutionarily, there's a reason we have the system, but it can get turned in the wrong thing. Is it is it similar
Lifestyle Changes as Treatment
00:09:44
Speaker
here? Yeah, we have three systems that work together.
00:09:47
Speaker
closely related, and they do the same thing. They overprotect. You have the immune system that when it's deregulated will start overprotecting and attacking your yourself attacking your body.
00:10:00
Speaker
an example is rheumatoid arthritis. You create antibodies that attack your joints, right? You have the pain system that if it is in danger overprotect you and will create that sensation that you interpret as pain. And the third one is the stress system.
00:10:17
Speaker
like a generalized anxiety, fear, phobias. There are also a your brain having an exaggerated fear so something that is not threatful or something that is ah like ah a spider. Yes, you know there's a little threat, but then the spider can become a huge ah threat to your brain if you believe that you have fears of spiders, for example. So fear, the anxiety system, which is the fight or flight response, the immune, the pain, they come together. And in chronic pain, we see sometimes all three together, ah super active. They are like the person has exaggerated anxiety, exaggerated immune response and exaggerated pain.
00:11:05
Speaker
For the the anxiety, I think of ptsd and some other things, and maybe the most exciting stuff in that area, it seems over the past few years is... the psychedelic treatments and ketamine therapies and and things like that, is that useful as well here? Like what what does treatment on the chronic pain side look like and what has been working?
00:11:28
Speaker
Yeah. So I'd say in terms of the pharmacology, like you mentioned things that are substances, right? um We tend to think that substances...
00:11:40
Speaker
ah the psychedelics, a ketamine. and in in pain medicine, we would consider the antidepressants, anticonvulsants, because they kind of ah balance the neurotransmitters in the brain.
00:11:53
Speaker
They help. I would say they help. but We use them, but we're trying to not to use them as the first line and not to use them in isolation and not to forget that lifestyle,
00:12:10
Speaker
Psychotherapy, physical exercise is a still the best treatment for all three things. um Nutrition, sleep, talk therapy, like get your emotions out of your body and physical exercise. There's much more evidence.
00:12:29
Speaker
i would say a thousand times more evidence, scientific, high quality evidence. That sleep regulation, exercise, good nutrition and psychotherapy and movement, they help the body to regulate much healthier than a substance. so we try not to think about them as a first line, but do they help.
00:12:52
Speaker
Sometimes we don't use them. It 100% makes sense. Like what are the things in your control you can do day to day before you start bringing external substances in? i guess my question is around the chicken or egg issue, right? I think there's studies on pain when you're sleep deprived.
00:13:10
Speaker
what normally would have felt like a four to you could feel like a seven, right? You're much more heightened and sensitive. And so if you're in pain, if you're having a hard time sleeping. If you're having a hard time sleeping, you're in more pain. And it's this the terrible cycle that you're in. I assume similar for movement, if it's painful, people are less likely to get the vigorous movement each day that they need.
00:13:33
Speaker
And maybe if you're in pain, you make worse decisions on your nutrition too, because you're just worn down, right? Like we know you make poor nutrition decisions later in the day than earlier in the day. And so people recommend like, if you're going to go out to dinner, look at the menu in the morning. So you pick out, it's not the seven o'clock you picking the meal. It's the 7am you.
00:13:54
Speaker
um And so how, I guess, how do you
Cognitive Functional Therapy for Pain
00:13:58
Speaker
get over that hump? Cause there, there's certainly behavioral lifestyle things you can do, but it may be the pain that, That's preventing you from being able to do those today. Yeah, you you hit the nail on the head. They feed each other. There is a cycle.
00:14:14
Speaker
And somehow the person needs to break that cycle. And sometimes they can't see the way out. They have they need a hand. And I would say the doctor is probably not your best person that will help because doctors will usually prescribe injections, medications, surgery.
00:14:32
Speaker
i am a big proponent of lifestyle coaches, of even lay people or using an interprofessional collaboration with physiotherapists, nurses, doctors.
00:14:46
Speaker
You know, the pharmacist, the social worker, if you people who have access to those professionals. I think because the results of these lifestyle changes are much more pronounced. Like you see big differences and they're long lasting. They're healthy and they only not only benefit the pain, but the whole body is benefited with those things, right?
00:15:12
Speaker
So there are lots of people who, you know, can help um them to get motivated. and it's amazing when they start making one change in their life.
00:15:23
Speaker
they i tell them, you know, find someone that can be your coach or someone that you... it Sometimes it's a psychologist, a social worker, and just seeing them every week or every two weeks and seeing what changes are you making your life. So you they have someone to be accountable to But it could be a partner. It could be your daughter, your son. It could be someone from your family, from your community that keeps you accountable and say, what one change you are going to make this week?
00:15:51
Speaker
And then make that change. So if you're not moving, you need to start moving. Because we know when you make those changes, going back to that acupuncture patient that I saw 32 years ago,
00:16:04
Speaker
You don't need acupuncture to have those changes made to your brain. You can do yourself. Even eating a healthy meal, preparing it, and and eating with pleasure and eating with friends, you are releasing a lot of endorphins.
00:16:19
Speaker
Not only endorphins, but endocannabinoids. People take cannabis, you release your own cannabinoids, endorphins, encephalins,
00:16:30
Speaker
Dynorphins, these are different types of endogenous opioids, dopamine, even oxytocin. And so why would you you know rely on a pill that you have to take?
00:16:42
Speaker
In order to have these benefits, you need to have like probably five or six pills. If going for a walk in nature, come back, prepare a nice, healthy meal, eat with friends, and That you release so many things. um Yeah.
00:17:00
Speaker
I am a big prop proponent of lifestyle changes. You're preaching to the choir here. This is what a lively 100% we do is find for each individual.
00:17:12
Speaker
What is that minimum enjoyable action they will actually take and stick with? Right. If you hate getting dirty, the nature walks, not the way to go, but maybe doing walking meetings outside in the city, right? Like you're finding the thing that actually speaks to you and you enjoy and we'll, we'll have that benefit. And then you just build from there.
00:17:30
Speaker
Going to museums, it's not for everybody, but some people walk in the museum, buy a membership, an annual membership of a local museum and go for walks there and meet people and participate in workshops. People have no idea how this is beneficial to their brain. And if the brain is healthy and happy, the brain will help the person to heal and undo those synapses. And some people will need some help For this therapy that we are doing for pain, for chronic pain, like brain retrain, there are so many names, there are so many different... If you go to Australia, they call one thing. If you go the United States, so different people call different names. But um some physiotherapists, they use a therapy called cognitive rehabilitation therapy.
00:18:17
Speaker
And what means is while they are doing exercises, they're also talking, doing psychotherapy with them, cognitively changing their thoughts. Like CBT meets physiotherapy. yeah Yeah, CBT meets physio. Yeah, they combine. Cognitive cognitive functional therapy, CFT.
00:18:35
Speaker
Yeah, there's evidence. There are many studies done on CFT. There is the talc therapy that's called pain reprocessing therapy, PRT. There is a graded motor imagery coming from Australia. So there are need different names, but these are things that promote movement and promote a different, the way you see your symptoms. Yeah.
00:18:59
Speaker
So most of these therapies, what they do is you have sensations coming from your body and all
Pain Misinterpretation by the Brain
00:19:04
Speaker
the time. Like right now I'm sitting here. So if I stop and pay attention, i will feel, you know, I'm sitting in the chair, the chair is supporting me.
00:19:12
Speaker
i have the air coming through my mouth and my lungs. um I can feel the clothes on my skin. So a lot of sensations are coming to my body. What happens in chronic pain, those sensations, And if I move my joints, I can feel my joints moving. But in chronic pain, those sensations of the the clothes touching your skin, the movements of your joints, a clicking noise that your neck makes, those become painful.
00:19:44
Speaker
I have patients that I cannot even touch their skin. You touch with a paper tissue and they have pain. It's called allogeneia. Why? Because there is this Misinterpretation of sensations has pain and pain is dangerous and the brain doesn't like danger.
00:20:02
Speaker
so then it creates anxiety, insomnia, and a lot of ah other thoughts inside of your mind that drain all your energy.
00:20:14
Speaker
I'd like to personally ask kind of on that front. So day to day right now, I don't have pain. I'm not in pain, but I would say for at least last two weeks, maybe more each night I wake up and my right knee is in terrible pain.
00:20:33
Speaker
And it's only at night only one wakes me in my sleep. It's so painful. Wow. This really hurts. And then by the morning when I wake up, it's no pain there and i can go about my day. i can do everything. And, but for some reason in the night,
00:20:47
Speaker
Is there any explanation that you have for what's going on there?
Case Study: Nighttime Knee Pain
00:20:51
Speaker
I don't know. I don't know what it is. But i i in my 32 years of experience, I heard all kinds of ah symptoms that physiologically they would not make sense.
00:21:05
Speaker
I get very, very curious when I see those things because I say, okay, let me examine your knee. and see if there is some position, any clicking, any pressure that is happening there, any nerve that is being pressured.
00:21:19
Speaker
Probably i will not find anything. But then I get very curious because what other doctors will do, they will say, oh, I can't find anything. They do an MRI. They may find something that is totally unrelated.
00:21:32
Speaker
And they say, I don't know what you have. Go and do some exercise in physiotherapy just because they don't have anything better to do. I get curious because I say, what if that's a synopsis in the brain?
00:21:43
Speaker
We will try to find what is the why the brain is creating that synopsis. Why the brain is waking you up in the middle of the night with a knee pain? What's going on there? what kind of memories you had? What kind of injuries to the knee you had?
00:21:57
Speaker
and What happened in the past? What is your... interpretation this how fearful are you of this pain do you think this is a minor thing do you think how much value you're putting to that pain because the more value you put to that which means the more fear concern and worry you become about that the brain says oh Therefore, this must be important.
00:22:21
Speaker
Next night, I will create that again because I must be doing something important. Or is the brain trying to talk to to ourselves? And the brain doesn't have another language to talk to us.
00:22:33
Speaker
Like i when I say the brain is the subconscious mind, sometimes things are the subconscious and are all of our behaviors, 80%, if not more, are controlled by the subconscious mind.
00:22:46
Speaker
And if the subconscious mind doesn't have ah an outlet to express itself, it's going to talk to your conscious mind. And the only language that it knows is symptoms.
00:22:58
Speaker
It creates symptoms. Dizziness, insomnia, pain, nausea, like those vague symptoms that are not explained by a structural problem in the body.
Mind-Body Techniques Success Stories
00:23:13
Speaker
I'm sure you're familiar with Dr. Sarno's, the mind-body prescription, right? And I i remember initially getting into it because I was having horrible back pain.
00:23:24
Speaker
And my boss had had horrible back pain and his boss who was the CEO and founder of the company and had such bad back pain that they had to get the EMTs to take him off the plane on a stretcher and all this. And his investors said, go check out this book, mind-body prescription.
00:23:39
Speaker
And sure enough, he got healed. And then my boss had this shoulder thing and his the CEO said, hey, you need to go do this. And he said, no, no, no, it's something totally different. And then sure enough, he got healed. And then mine, I was like, no, I did a tough mutter and that's why it's hurt and all this.
00:23:53
Speaker
And sure enough, like I got healed. And so I'm wondering, have some personally stressful thing, custody with my daughter and and all sorts. And I'm wondering...
The Mind-Body Relationship in Pain
00:24:02
Speaker
if it back to the subconscious uh from that book it's like the first ego like trying to take my attention away from these other things to focus there i wonder if there's the psychological component it could be it could be it's good to get checked yeah it's good to get checked just to make sure that there is no uh if if a person doesn't have any other you know ah physiological symptoms like ah the knee is not getting swollen and
00:24:27
Speaker
There's no morning stiffness, like the knee doesn't move. and It's like a very stiff, especially in the morning. And if there was no trauma, it's probably more like a mind-body connection that is trying to say something. Yeah.
00:24:41
Speaker
I mean, there's definitely trauma. I don't have a meniscus in either knee. I've had pocket-handled cares in both, and so both have been cut out. So they're there's a lot of popping and messed up knee stuff, but it's just most of the time it doesn't hurt. It's just recently middle of the night.
00:24:55
Speaker
Yeah, if was like a mechanical problem because of the lack of the lubrication, it would make sense that it hurts when you're walking, when you're putting weight, not when you're resting, but it's good to get checked. Don't diagnose yourself.
00:25:10
Speaker
You've written books in
Dr. Furlan's Resources on Managing Pain
00:25:12
Speaker
this space. So can you share kind of for those that want to learn more what they touch on to to help people steer where they can do a deep dive? Yeah, if you yeah it allow me. So I wrote books because i wanted people to know everything that I know.
00:25:28
Speaker
And I opened the YouTube channel in 2019 because I wanted to share with my my own patients. When I opened the YouTube channel, I did not even tell my parents that I had opened I didn't want to be seen as a YouTuber.
00:25:41
Speaker
I just told my patients, but yeah I guess a lot of people discover my YouTube channel and I have now more than 800,000 subscribers, but that's another thing. So when I twenty i opened the YouTube channel in 2019 2021, we had passed, you know, a little bit of the pandemic.
00:25:57
Speaker
I had so much material from my YouTube channel, a lot of videos, a lot of scripts. And I said, well, I have enough to put in a book. And then, so this is the the first book that I wrote, The Eight Steps to Conquer Chronic Pain, which is basically everything that I know, everything that I told you in this, um like a ah summary of my book is what I just told you in this episode. It's lifestyle. So the eight steps, basically, the first one is know about the, what is the pain? Like ah what I explained to your audience here, pain is not, that chronic pain is not the same thing as acute pain.
00:26:35
Speaker
ah It's the alarm of the house that is, you know, malfunctioning, that noise that is more like a memory. And then talk about emotions, sleep, nutrition, exercises, socialization, goals, and living your life.
00:26:52
Speaker
So basically that's what I try to make. I put a lot of cases, ah like a summaries of my own cases, there are a lot of charts and a lot of ah even QR codes for people to access my my videos. The QR codes will go direct to a YouTube video that you've done on that subject.
00:27:12
Speaker
To that video that I'm talking india Yeah. And then, so this is more like a theory book for people to learn and acquire. If you want to know everything that is in this head that I accumulated in 32 years. So people ask me, how long did it take for you to write this book? 32 years. Because it took me 32 years to accumulate this knowledge and then I put it everything there.
00:27:34
Speaker
And then the second book is more like ah an activity book. It's like a daily journal. I put here 90 prompts. It's a, you are unique and so is your pain because you are unique because no two books will be the same because you will need to write your own journey here.
00:27:51
Speaker
So there are 90 prompts and or exercises, mind and physical exercises. One of them is, um, Let's do a mindful eating. so I tell them, i ask them, get something small that you're going to eat and you're going to do a mindful exercise. Pay attention to the smell, the shape, the colors. And then you're going to describe and that experience for the person to be present in the now and notice sensations that they usually don't notice.
00:28:23
Speaker
another activity is go walk in nature Go find something green outside. Walk a little bit there. Come back and write about your experiences. What you heard, what you saw, what you felt.
00:28:35
Speaker
Because you need to nurture your brain. You do need to nurture your mind. You need to nurture your body with good things. Because in this world, we have bad news all the time.
00:28:46
Speaker
Problems and conflicts. Our brain likes when we are put on a sense of calm and safety. And then you are resilient to fight the pain, to do the things like the little changes that I asked them to do.
00:29:03
Speaker
Change your sleep routine, get more exercise, eat healthier. Now they have the resilience, the strength and the energy to do those things because they are on a less stressful stage.
00:29:18
Speaker
I'd be really curious. Have you done any research on that second book? where it's more of a journal that they're creating on the before and after. And the the reason I ask is there's one thing to consumption and feeling ah one level of locus of control of, hey, these are the things kind of going on.
00:29:41
Speaker
But then there's a separate when it's a journal and you shift that locus of control internally because you're doing creation, you're doing the action, you're writing the plan. And even that, as you shift the the agency and your perception of agency in itself, no doubt changes the perception of the exact same pain. Yeah.
From Dependency to Self-Management
00:30:01
Speaker
I didn't do a formal research. You're giving me some great idea here since I am a researcher. ah But what I get is, ah and ah and again, journal is not for everybody. Not everybody likes to write and and do that introspection.
00:30:14
Speaker
But people who do it, And they say exactly this. Before, I was more reliant on i had to go to the chiropractor. I had to go to the massage therapist. I had to go to the doctor. I had to go to the injection. And they were doing things for them. And they were kind of dependent on these professionals, spending a lot of time, a lot of money, a lot of energy. I had patients that they said I had every day of the week I had an appointment and And they were still, you know, getting better from their pain. Of course, if you do all of those things, your pain will start getting better because you're like, ah who doesn't get better if you go to massage, to a spa?
00:30:52
Speaker
It's expensive too. It's expensive. It's time consuming. It's yeah. Yeah. It's, yeah, it's expensive, but also you become dependent on them. Yeah. And they say, now I find that I can do things for myself. I'm more self-resilient.
00:31:09
Speaker
I can self-manage and I don't need anyone. i know how i know how to identify the triggers in my life. Like if they start getting the muscles hurting, oh they say, okay, my muscles starting to hurt. Instead of panicking, run to the chiropractic, massage therapist, physiotherapist. They stopped.
00:31:27
Speaker
identify what's going on in their mind, what's going on. Okay, identify the stressful situation. Let me do some mindfulness. and Let me do some walking nature. And boom, they save the money, they save the time, and they feel more in control. They can do some things they don't need to depend on others.
00:31:45
Speaker
I think there are RCTs on just that shift in agency and your perception of the exact same thing. And so if if this is shifting that agency, there's one of you're doing the actions that are going to help make it better.
00:32:02
Speaker
And then there's two this totally separate and additive psychological shift that's happening. in those brain pathways. It's really interesting to have those as the two juxtaposition, because I'd be curious the movement before and after when you read the Eight Steps of Conquering, and then the before and after if you're doing the work. It just gave me an idea for a research project. Okay. We'll have to have you back on once you you run the study and see what it looks like.
Conclusion and Contact Information
00:32:28
Speaker
Well, Dr. Ferland, this has been fantastic. I think most of our listeners would be familiar with you from your YouTube channel and and hopefully now can go check out your books. But for those who are not, where can they find you if they want to hear more ah from this 32 years of knowledge that you've built up in this area?
00:32:47
Speaker
Yeah, so I think the best ah way is um my YouTube channel, which is just my name, Dr. andrea forland and i also have a website that ah I have more than 50 something handouts related to my YouTube channel and all about me. They can know more about me and the books. My YouTube, my my website is www.doctorandreafurland.com.
00:33:12
Speaker
d o c t r andreafoland dot com Fantastic. And we'll make sure all of this makes it into the show notes to to make it easy for all our listeners. And thank you so much, not just for your 32 years of work. I did not know in Brazil that you could go to med school at eight, but it's amazing to know when you're such a child prodigy. I'm little bit older. But yeah, thank you. Thank you for all the work and no no doubt the the number of lives you've already touched and will continue to help.
00:33:41
Speaker
Thank you so much, Andrew. andrew Thank you for joining us on today's episode of the Home of Healthspan podcast. And remember, you can always find the products, practices, and routines mentioned by today's guests, as well as many other healthspan role models on Alively.com.
00:33:55
Speaker
Enjoy a lively day.