Chronic pain and dizziness recovery and the effects of trauma - interview with David Goguen, LMHC

In this interview, David Goguen, MEd, LMHC, CCTS-I shares his own story of recovery from chronic pain (including back pain, headaches, sciatic pain and fibromyalgia), and discusses the role that trauma plays in the development of and recovery from chronic pain and dizziness. TIMESTAMPS 00:00 Introduction to chronic pain & dizziness recovery and the effects of trauma 02:12 David starts telling his story of chronic pain (back pain, sciatic pain, fibromyalgia) 04:34 Definition of mindbody pain 07:19 Seeing many specialists and having many treatments with no effective resolution of pain (including epidurals and spinal cord stimulator) 12:25 On having no more treatment options 13:16 Blaming symptoms on structural issues (biological) 15:35 When symptoms become chronic, this is likely not structural 17:17 David had many different medical diagnoses, and none led to effective treatment 23:30 Placebo and positive expectancy vs. nocebo 24:47 David's daily life at the peak of his symptoms 30:35 Spending thousands of dollars on treatments, elimination diets, equipment, none of which worked 31:52 The first big turning point toward recovery 37:20 Openness to the idea of mindbody syndrome/psychophysiologic disorders being a big part of recovery 41:12 Resolution of headaches, back pain, sciatic pain and fibromyalgia pain in the months after reading Dr. John Sarno's books 42:15 At his worst, David was in a wheelchair 47:52 The major role that loved ones play in recovery, the importance of social connection 51:06 The second turning point in David's recovery 53:02 Why cognitive behavioral therapy (CBT) is NOT the best choice for treatment of trauma and psychophysiologic disorders 55:05 Training on trauma and adverse childhood experiences (ACEs) 57:00 David’s symptoms today 1:02:35 How responding differently to your symptoms can change everything 1:04:55 The pain/dizziness-fear cycle 1:07:21 Education and the pain/dizziness-fear cycle 1:09:36 Why do so many people with chronic pain and chronic dizziness have a history of trauma? 1:11:00 What is trauma? 1:12:25 Multiple types of trauma 1:14:09 What all trauma has in common 1:16:15 Why childhood trauma can be potentially more problematic 1:18:00 How trauma sets the nervous system to be hypervigilant 1:20:15 Factors that affect how trauma might program the nervous system in childhood 1:22:35 The threat response and the stress response are the same thing 1:25:31 The ACE study and likelihood of developing many illnesses 1:28:00 Dose-dependent relationship between ACEs and illness 1:30:34 High ACE score (4 and higher) is even more likely to have major impact on nervous system 1:31:46 Sympathetic nervous system activation is supposed to be temporary 1:35:00 Learn more about ACEs 1:37:00 The key to reversing the effects of trauma on the nervous system 1:39:00 How to get out of the threat response/danger mode 1:42:00 The role of the pelvic floor 1:45:00 What happens when trauma is triggered 1:46:43 Some character traits like perfectionism, people pleasing can be self defense behaviors 1:48:46 Emotions as a trigger 1:50:20 How a Forward-Facing approach treats trauma differently from conventional exposure methods 1:53:00 Confronting trauma-related triggers 1:56:00 The difference between dizziness triggers and trauma triggers (they are not the same thing) 1:57:06 The value of self regulating when exposing yourself to dizziness triggers 2:00:00 David’s opinion on when avoidance behaviors are ok 2:02:16 What to look for in a mental health professional for help with trauma and chronic dizziness or pain 02:03:50 Why David is partial to the Forward-Facing approach 2:05:46 Why how you feel with a therapist is more important than a specific credential 2:08:55 David’s advice to you if you are trying to heal Boulder Back Pain Study (one of many studies clinically validating Pain Reprocessing Therapy and similar approaches): https://jamanetwork.com/journals/jama... ACE Questionnaire: https://www.acesaware.org/wp-content/... Book we mentioned (available for purchase at your favorite bookstore): Healing Back Pain by Dr. John Sarno The Mindbody Prescription by Dr. John Sarno Forward Facing Freedom by Dr. Eric Gentry Videos we mentioned: How to tell if you have neural circuit dizziness:    • How to tell if your chronic dizziness is P...   Dr. Nadine Burke-Harris (about ACEs), author of The Deepest Well.    • How childhood trauma affects health across...   Dr. Eric Gentry:    • Tools for Hope (Part I):  Perceived Threat...      • Tools for Hope (Part II):  Self-Regulation   Dr. Howard Schubiner's short videos on chronic pain:    • Animated videos with Spanish subtitles   Links: David's website: https://www.davidgoguencounseling.com/ Psychophysiologic Disorders Association quiz on identifying neural circuit issues: https://ppdassociation.org/symptoms PPDA directory: https://ppdassociation.org/directory