What the medical system gets wrong about chronic dizziness: interview with Dr. John Stracks, MD

foreign [Music] my name is Dr yonit Arthur and you are on the steady coach today it is my great privilege to bring you this interview with Dr John Strax Dr stracks is a board-certified integrative physician and family physician and he also happens to be one of the world's leading Physicians who works with people with medically unexplained chronic symptoms such as chronic pain and yes of course chronic dizziness in this interview we talk about Dr Strack's background we talk about his experiences with people suffering from dizziness specifically and their road to recovery we talk about what recovery even means or what it looks like and we talk about some of the advocacy you can do for yourself as a patient who may or may not still be working with physicians in the conventional field and of course where some of those relationships can affect recovery I hope you enjoy this interview as much as I enjoyed speaking to Dr Strax and of course if you enjoy this interview please like it please share please subscribe to my channel and I'm looking forward to your questions and comments below please enjoy all right Dr Strax thank you so much for joining me today I greatly appreciate you agreeing to come visit on the study coach uh happy to be here thanks for inviting me well let's just let's get get started by giving everyone a primer on who you are if that's okay with you so would you mind sharing a little bit about you your work how you got involved in this work to begin with yeah so I'm Dr John Strax I am here in Chicago and also I have the ability at this point to see patients by Telehealth no matter where they are um I have been practicing medicine now for for 13 years I finished my residency training in 2009. I also had my own health issues that got better with mind-body medicine even before I went to medical school so this was probably almost 25 years ago and we can talk a little bit about that and I've recorded podcasts talking about that also but but I got two medical school with the idea that what was going on in our lives would show up in our bodies and and when I got there I thought oh this is great like I'll tell people about it and people's pain will be healed and everybody will be happy and it took like a nanoseconds to realize that wasn't going to be how it worked and so um I had had a separate career I was a social worker for a while before I decided to go back to medicine and and so always thought in more psychological ways and once I got to medical school I was in 2001 I did everything that I could to sort of push my career into more integrative fields and so I did research with a psychologist who was studying the physiology of loneliness and took every course on health and healing that I could could find in medical school and I started calling Dr John Sarno in New York City who did a lot of work on the psychology of back pain to see if I could come work with him and eventually did a little bit of work with him as a resident I chose residency programs that would I only applied to places that would let me do some integrative work also and so spent four years at the University of Michigan in Ann Arbor working in their Integrative Health Clinic there that's where I met Dr Howard schupener who had just opened up a Mind Body medicine program in Detroit so I spent a lot of time with him during those four years that I was in residency and then moved back to Chicago in 2009 to open not to open to work in the integrative Center at Northwestern University in downtown Chicago and I spent eight years there seeing a lot of patients for a lot of chronic issues that weren't getting better in any way and so my job was to sit with them and explore options that they hadn't thought of already including including paying attention to the psychology and the stress talking about diet talking about the use of of supplements or alternate practitioners and my passion has always been the Mind Body medicine side and it was a small piece of what I was doing at Northwestern and so in 2016 I made the decision to open my own practice to try to do more of that work so left the hospital in late 2017 I've been running my own Center since then we've added in the past two years a physician's assistant and for psychotherapists and a physical therapist and we continue to see a lot of people who aren't getting better using conventional medical means and are looking for diff different Alternatives including this idea that what's going on in their lives is showing up in their bodies so you it sounds like you started this path of being a physician already knowing that you were going to be going down this more integrative Road already knowing in my own body and so in 1998 this is a long time ago now I I fell down a flight of stairs and seemed to be okay but then a couple months later I started having strange symptoms that nobody could get a handle on and I went to see conventional Physicians I want to see alternative Physicians and tests done and um and nobody nobody could get a sense of what was going on I had a lot of hand and foot symptoms a lot of numbness and and tingling and pain and I was having trouble typing and imbalance issues too I saw and balance issues yeah and and nobody could nobody could sort it out like I didn't know what what it was it became my whole world trying to figure out what was going on and and how I could get better and then you know after about nine months of dissension into like being only a patient I was talking to a friend who had seen Dr Sarno for his back pain a number of years ago and I'd always been interested in alternative healing I had read Dr sarna's book I knew who he was but I went back and I reread it I was like oh too much going on in my life I was trying to figure out how to get into medical school I was dating the woman who is now my wife and um and as that relationship was getting more serious that was um overwhelming to me and just on top of that as having a spiritual crisis at the same time and so too much for me to manage at that point in my life so it started seeping into my body once I recognized that I actually was able to do some things and get better quite quickly which was great and I think a lot of people who end up doing this work professionally have similar experiences right A lot of people learn these strategies and then it takes a while still for people to feel better but some of us had very dramatic very quick turnarounds and I think that Spurs us on to figure out how to do this work for a living and so so yes I got to medical school I'd had this experience I had done a lot of reading I talked to some leaders in the in the field and I brought that with me to the practice of medicine from the very beginning and knew that that was the type of medicine I wanted to to concentrate in then you're going to be the perfect person to comment on how conventional medical approaches to patients with these types of chronic medically unexplained conditions can set up the trajectory of someone's recovery or lack thereof do we have a few days I know I I think that you could go on for six hours and people would still be listening so so um you know so it's interesting I think you know I and probably you and a number of people in this field the way we conceptualize chronic symptoms is that you know the medical system would say if you're not feeling well then something's wrong in your body right it's completely biomedical approach and so if you're not feeling well and you go see somebody in the conventional medical system they're going to say like oh I can see you don't feel well and then they're either going to say I think this is what's wrong and this is what we're going to do about it so um physical therapy or injections or medications or or procedures or they're going to say I can't tell what's wrong let me try to send you to somebody else who who maybe has a better handle on it or worst case I can't see what's wrong you must be pretending you must be or so anxious it's just anxiety yeah for it yes yes and and so those are sort of the options there but but I believe from my research that that chronic symptoms frequently are not about damage nothing wrong in the body but about the sense of danger and danger comes from a lot of different places and you can I can talk more about that over over the course of this conversation but I say to my patients all the time there is nothing more dangerous than the medical system hmm the kinds of things that practitioners have said to my patients over the years in terms of you know it's going to be like this for the rest of your life it's going to be Progressive you're going to be in a wheelchair you might be paralyzed it's never going to get better it's going to you know it's only going to get better if you spend hundreds of thousands of dollars on therapies get used to it higher I've had people told higher you may as well hire an aid now it's never going to get better just get used to it yep and and so so there's really very little out there that creates more more of a sense of fear and danger than the medical system it does and so so often it just pushes people into the symptoms getting worse rather than better yes so if it's okay with you since on my channel as you know we we talk primarily about chronic dizziness and people who are familiar with your work or some of the work of your colleagues hear the word pain a lot and wonder if it applies to them first of all can we clarify here that when you say chronic medically unexplained conditions you are indeed including dizziness conditions including dizziness and I have treated many many patients with dizziness okay so have some of them had some of the common diagnoses persistent postural perceptual disorder malda to barkmont syndrome vestibular migraine right maybe even post-concussion syndrome patient yesterday cervicogenic dizziness dizziness yes I I often forget to name that one but yep so that one too you've seen those and they can recover using these mind-body methods people experience correct yeah yeah that are using these strategies for sure yes okay so now that we've established that I'm wondering in your experience have you seen not to say that not to say that this occurs only or exclusively for people with vestibular issues I think people can get danger or fear messages from any physician in our medical system but it seems to me and again I recognize my bias that in the vestibular world there's a particular Mystique or a particular I don't know you have to go to 10 Specialists before you get diagnosed with anything do you see this in your patients who show up with dizziness disorders that they've had a particularly hard time yes and I'm thinking you know I'm here in Chicago Dr Hayne I don't know if you know yes very familiar yes I like Dr Hayne yeah calls himself The Dizzy doctor and so yes most people in Chicago if they've had the symptoms long enough have gone to Dr Hayden Dr circle's office yes so they've been evaluated there and I feel like they actually take a pretty nice approach they're pretty integrative yeah and and so you know the language that I'll use with patients is that the the conventional medical system is very good at some things and so if you have strep throat you can come into my office I can look at your throat I can do a swab I can get a test it shows up positive I can give you a treatment the treatment always works you're better in three days like it's a perfect system the only issue is that it works for very little besides strep throat and maybe bladder infections and and so so when we're looking to to try to treat dizziness and vestibular disorders what I will frequently say is that it the the whole process does not map well into the conventional system if you walk into my office with dizziness it rarely means you've got this disease or that disease that's easy to to name and so I think that's what happens to patients is that they go and see practitioners and the practitioners can see that they are suffering but they don't have a good framework there is no great framework in the medical system to say this is what it is and this is what you should do and so we give it various names and it's interesting to me so say someone gets diagnosed with vestibular migraine all of a sudden they're in migraine land and so now they're using trip dance and and and new medications and and medications to try to prevent migraines and so it provides a Playbook but the Playbook doesn't usually I think have a whole lot to do with what's going on that's causing the patient's symptoms and so I think because dizziness and and those types of issues don't have easy explanations then people keep getting passed around from practitioner to practitioner practitioner trying to sort out what's going on and frequently not having much luck no matter who they see yeah so I like you're saying not to say that people with certain types of chronic pain conditions don't run through exactly the same rigmarole people with fibromyalgia for example there's often no finding at all but with vestibular issues in particular there's almost never a finding and there's no there's no herniated disc to blame things on right and not to say that that doesn't carry its own type of distress but the especially for for people growing up in our system they're expecting the physician to find something and when there isn't a finding and they just have to go to doctor after doctor it's it just adds to the fear and stress and there may be there may be Regional components to it here in Chicago people frequently get diagnosed with crystals oh yes and um I'm not I'm not sold on the whole concept but it you know like you said it's it's the physician and practitioners attempt to say like okay here's the issue right this is what we're going to do about it but again it doesn't oftentimes lead to relief right right when it does then the proof is in the pudding right if someone has a physical issue microcrystal's bppv a repositioning maneuver will fix the issue but when someone's on their 10th repositioning maneuver and right they don't actually have symptoms that are consistent with the crystal then why are we still persisting in this approach that's right or what I see frequently is that people will will get the treatment initially and the the Maneuvers will work but then the symptoms come right back and then it does right right right because as I've I try to explain here on my channel and to people I speak to your brain once it it has a template for something like like dizziness like vertigo from bppv your nervous system can keep those symptoms going with no physical damage necessary absolutely yeah okay so so in that case I I have a feeling I know exactly what you're going to have to say about this one but we just talked about diagnosis and we talked about how that process can be so Laden with fear for people so people are now given this symptom-based diagnosis and they're depending on which diagnosis it is like you're saying they're they're in migraine land or they're in incurable neurologic disease land which is super fun or they're in you have this unexplained vestibular disorder maybe maybe this will help you so where where are we going wrong with our our recommendation to just put someone on a medicine or send them to CBT or vestibular or physical therapy where are we going wrong there why is that not helping I think it's not helping because it's not getting at the underlying source of the problem and so you know so I trained in integrative medicine and and the message that I always got and internalized was that we have medications which should be used as a last resort for people and in the medical system being what it is medications frequently are are the only Resort and I've had physician colleagues say to me they say I don't I don't understand like if I didn't give somebody a prescription what would I do like there's no recognition anymore in the medical system that we as Physicians are supposed to do anything other than write prescriptions um or now make referrals and so if if somebody's dizzy and has that symptom and goes in and say okay here you know take this antivert that will make you better it that's not what's causing the problem and so you know not totally this is a dramatic example but if somebody had cancer and was feeling nauseous and we said here take this medication that will make the nausea go away We're not gonna do very well by that patient and so um we did a a webinar last year with the psychophysiological disorders Association and I interviewed one long-term patient who's quite active in this world and his mother had died when he was quite young 10 11 years old somewhere in there and and he developed symptoms of repetitive strain injury and so a lot of hand numbness and tingling and and had those symptoms from the time he was 18 I think until he was about 35 and and I said to him in the course of the interview how often in those 17 years that you were looking for answers did anybody ask you about what it was like to have your mother die when you were so young he said never right right and and another dramatic example of this Dr David Clark who does a lot of this work is a gastroenterologist who you probably know he made his career in Portland Oregon seeing patients with GI issues who nobody could help make better and he's got this story that says somebody sent him a referral for a woman who's having abdominal pain and it turned out she was in an abusive relationship and so they got Social Work involved and they got her into safety and the symptoms got much better and so he he wrote the report and sent it back to the referring physician who then responded by saying oh it's comforting to know I didn't miss anything oh I I like you I've I've been shocked that when I see my clients for the first time I am the first person to ask what was going on in your life when the symptoms started as though our bodies are completely removed from our lives correct correct and and what I will say frequently is that it is rare for me to see somebody who's feeling off balance in their body who's not also feeling off balance in their lives when the symptoms start and so I I have recognized that over the years that that it's fairly rare not impossible fairly rare that somebody comes in with dizziness who's who's not going through some sort of stressful event right right and and as you say there are some exceptions although on my YouTube channels frequently I'll have comments I'm not stressed I've never been stressed everything's fine I I don't know why I got this dizziness thing and I'm like I'm amazed like tell me how you managed to have a stress-free life it does seem to be a fact of of life for many of us so do you have any thoughts on why some people then go on to develop physical symptoms as a response to stress I think everybody develops physical symptoms in response to stress and so you know I I say this regularly and to my patients who who are Savvy about the mind-body medicine world and they'll ask me periodically like gosh why are we so much more prone to pain than than other people are and and so my responses are generally like let's take a step back there's you know 150 million people in America who are suffering with chronic pain right it's not just the handful of people who are coming to see me most of those people don't know anything about this and so they are using medications having procedures done and all the the rest of it and as you know you know too many people using high-dose opioids and having complications from from that and so it's it's not that people who recognize what's going on are more prone to pain they just have a lot better and more effective ways to deal with that and so during the the height of the pandemic my patients who understood these Concepts would get in touch periodically and say like oh my gosh this is so stressful can I can I set up an appointment and talk to you about it whereas my patients who who didn't understand this well would call me and say like yes my arm really hurts do you have a surgeon who can cut it off so so knowing about these Concepts it just gives people a chance to to get at the symptoms at the root of it that's the advantage I don't think that that people are are any more or less prone to symptoms like everybody responds to what's going on in their lives that's such a great observation there and this kind of goes back to what we were talking about earlier this this Mystique surrounding dizziness and vestibular symptoms if the first line physician if a family physician said oh you're feeling a little dizzy I just want you to know how normal this is that this is happening I know it's scary that has there been any stress in your life recently we see that sometimes bring these on what percentage of people would just stop right there and be done right but that's not happening it's immediately pathologized oh you have a symptom okay well now we've got to figure out which which diagnosis May apply we got to start sending you to Specialists and it's a safety-ism really I mean again it's well-meaning Physicians who are doing this absolutely but it's it's the way that medicine has taught these days that if somebody has a symptom then something must be wrong and so the same as what I said about Physicians not recognizing that they can do anything other than write a prescription there's no there's no teaching in medical schools at this point that people can be very very sick and very very symptomatic even though there's no physical damage and it's so shocking to me that that's even possible when the biopsychosocial model of medicine has been people publicly laud it I mean they always say oh we know it's all but they'll put that at kind of the beginning of a a research paper yeah we know it's biopsychosocial but let's just ignore the psychosocial stuff because that stuff's messy we have to sit down and talk to people let's let's look at this these biomarkers of disease yeah and I think that there's you know there's a lot of pressure in the medical system for Physicians not to do these things you just hit on one which is time right if you've got four minutes to see a patient it doesn't make sense to ask them what's going on and leading to a conversation that could take 10 minutes and there's um you know I think because it's not taught particularly well a lot of Physicians don't know what to do with that information even if they got it um I you know have written publicly I get heart palpitations sometimes and uh and they were pretty bad for a while when I first started practicing medicine for obvious reasons and so I called a colleague and said like hey I've been noticing this I should probably get checked out so I went to her office she's a delightful friend of mine I bet I said half a dozen times in the 20 minutes I was with her I thought it was stress related and she picked up on that zero of the times did not engage in the conversation at all and so you know and another one of my friends says that she's she's older she's in her 70s and says that every time she gets sent a intake form for a medical appointment and you know she's in her 70s so she goes fairly often and she she always says that she's feeling suicidal she's not feeling suicidal but she always says she's feeling suicidal in the report and nobody has ever asked her about that and and so it's it's not it's not great training and how to have these conversations and then the system isn't set up to have these conversations and so Physicians just don't don't do it right and then folks like you and like me like Dr schubener like many of our colleagues we just end up going outside the system right and we have to make our own our own practice outside the system entirely in order to be able to treat people effectively yeah and like I said the the medical system in the United States is very good at some things and so you know if I if you and I finish the interview and I I go to have lunch and trip and and break my arm I don't want to call you and have you say like hey I think you should just meditate I want to get somewhere where somebody can evaluate it and treat it but but what we find I think is that those situations are are much rarer than we've all been led to believe and much more often meditating for half an hour or having a conversation with you or or talking about what's going on in my life is going to be much more effective than getting to a major medical center to evaluate it well so that of course raises a really interesting question so people who view my channel there are coming here from all over the world mostly Western countries where the medical systems are similar to ours but all over the world and how what can they what can they do for themselves to advocate for themselves in a system like this when they are dealing with a a chronic condition like this and they don't have access to to me or to you in in their country what can they do so I mean I think that there's a two-part answer right it's things that they can do within the system things that they can do without the system and so outside of the system right there's a lot of resources you have a lot of resources that you've put out I have resources that I've put out talking about these Concepts helping people try to understand where the symptoms are coming from helping people to try to understand that the issue is a sense of danger not the possibility of damage and so there's a lot that people can do on their own when I first had these symptoms I was 28 years old and and the landscape was much different then right there's doctors in New York and Dr David Schechter our colleague in Los Angeles who had just opened his practice and so so I read Dr sarno's book and I contacted Dr Schechter and he sent me for you know twenty dollars a a workbook that asked me to journal write every day about things that were going on in um in my life and and that combination helped me a ton over the next couple of months so not not super complicated not super in-depth but enough to keep my focus on what was going on in my life and not going on in my body and you know that has um you know all that has exploded exponentially over the past 10 to 15 years I don't know what I can say and what I can't say about various resources that are oh I'm and out it's it's open whatever whatever you think would be helpful I mean there's tons right that Dr shubiner and and his unlearn your pain and he's going to be doing a little bit of work in our office and his his book that's out there and his program and the psychophysiological disorders Association has a lot of resources on their website and you know the curable app that I've worked with for a long time they have a ton of information and they have groups that people can join and the Avo app which is based here in Chicago they've got a study going on currently that people can get in into with with no fee at all and and your resources in my website and my blog and you know and that goes on and on and on at this point and so there is a wealth of information about how this happens how we can feel so terribly physically even though nothing is physically wrong in our bodies that people can learn those Concepts and then start to move forward to towards using these strategies and resources to feel better and so I'd say there's a lot that people can do I'm part of a an email list I don't I don't know if you're on or not of a lot of practitioners around the um okay we'll talk offline um but you know somebody just messaged this morning through that email list and said hey where can I get a copy of Dr sarno's book in Korean and and then somebody messaged back and said here's where it is and so even when people are learned in English-speaking countries there's still ways that people can tap into into these resources yes absolutely and so and then in terms of being in the medical system I think that's a little bit harder right I mean we've been talking about how Physicians are trained in certain ways and I don't think it matters so much whether the United States or or other countries and and so they've got their ideas about what they need to do which is right prescriptions and and run tasks and so when my patients are trying to figure out like how to get some of this information to Physicians I say a couple of things one like Physicians are really busy and they just don't have time and so figure that you're going to get four to five minutes of their time and again I don't know that it matters which country you're in and so in that four to five minutes how can you get 30 to 60 seconds across about this saying like hey I just want to tell you the story I just want to tell you what I'm working on I just want you to listen for one minute and so if if we go in and think that we're going to try to to explain this over a 10 to 15 minute time period you're going to see the physician's eyes glaze over after 30 to 60 seconds it's just the nature of how it works with electronic communication I think that can be helpful sometimes and so I think sending a message ahead of the appointment and saying like hey I've been researching this and I'm really interested in it can we spend two minutes while I'm there just talking about it and talking about what this means and so sometimes um getting Physicians uh uh information ahead of time is helpful and then I'm chuckling because Physicians are very susceptible to flattery like you may not know this but my dad's a doctor so okay and you know so I mean Studies have shown over time right if I'm a pharmaceutical company I can influence Me by like giving me a pen with a pharmaceutical company we're not we're not difficult to manipulate like that and so I patients can use that to their advantage and saying like you know gosh I've been looking at this working at this so hard and you're the one physician who really listens to me and and helps me out even if that's not necessarily true Physicians respond to that and that's a great tip the flattery goes a long way in trying to get the attention of um of people you're working with but one of the take-home messages I think from what you were just saying though is to for people to recognize what the physician is there for and what the physician is may not be capable of doing it so Physicians are a wonderful resource for ruling out a major physical abnormality that is causing symptoms and if you go into your medical Journey viewing it that way I am here to rule out a medical problem that could need medical or surgical treatment and then at the end I advise people to to say to the physician okay so now that you've we've run all these tests and all these things do you feel in your medical opinion do my test findings explain why I have these chronic symptoms and and frequently I think at least from my experience Physicians are relieved to get that question because that gives them license to say you know actually I don't know that these this really explains what you're going through not to say that the opposite won't occur sometimes too in the vestibular world yeah because you know so many symptoms can arise from a vestibular problem but I I find Physicians I think are are often they need permission to to tell the client that there may be some kind of mind body or anxiety as they may call it anxiety or stress related component I think Physicians do pick up on that they just don't always feel licensed to say it but this is my thought yeah no I think you're accurate on that and I think that some Physicians are more eloquent than that at that than others and so some traditions are able to say like yes sometimes we see symptoms and we don't have good explanations for them and it turns out that oftentimes things that are going on in people's lives can be just as important as what's going on in your body when it comes out less um you know less caring than that it sounds like what you said like wow dismissive yeah get out of my office you're faking or wasting my time and I think that ties into the idea that a lot of Physicians sort of learn that their job is to fix things and so they when when they can fix things when they can give antibiotics for strep throat it's very easy it's very happy it's one of the reasons I think dermatologists are so happy and and so popular like you know I'm gonna pop out this mole and send you on your way and fixed and all is good and and so when they can't fix when Physicians can't they start to get uncomfortable and and if we as patients are in there saying like look I need you to fix it I need you to fix it then you set up this Dynamic where like they don't know how to fix it they don't really know what to say about that and so then it gets uncomfortable but as you said if you give them the space to know that they don't have to fix it and then there's a specific role that they can play to help you recognize that it's not an infection it's not a tumor it's not a fracture it's not a it's not a broken neck then then that does free them up a lot I think too to turn that relationship from an adversarial one into a Cooperative one is what we're all looking for sure then it's and it's it's certainly worth trying but you know to be fair as well that we're giving people the benefit of the doubt and and in the system that we're in and with the training people have frequently it will not it still won't turn into a a Cooperative relationship that way and in that case my general advice to people is don't listen to people who say that you're broken conversation with people especially you know especially pain but also the the dizziness and the other vestibular symptoms it you know when people say that you're broken and you can't get better it's a fundamental misunderstanding of human physiology like we are so neuroplastic and we have so much ability to to change and to heal in so many different ways that to say like this is the way it is and you better get used to it it's just it's a fundamental misunderstanding of of who human beings are I I want everyone listening to this interview to rewind and listen to that sentence a few times so which which is a wonderful segue into another topic I think that you're going to have a lot to say about because I'd like to know more about what this process looks like so not just the treatment but what does recovery even mean so as people start to recover you know you see all these success stories online and I I like to have success stories for people to listen to but what does this even look like long term for people with chronic dizziness disorders what does recovery mean what does it look like so it was interesting I was talking to a patient yesterday with um who had been diagnosed with cervicogenic dizziness who's very interested in these ideas and it you know I think that he's been working hard on this and and and doing a lot and has been improving a lot in a variety of ways but still has some of the symptoms and so you've been working on it I first met him maybe six weeks ago and I think that he was feeling badly because he wasn't better better with everything what does that mean right and so so we talked about it for a while and I normalized that physical symptoms even when we know where they're coming from and are working hard on it they they gradually improve over time and so a lot of the success stories out there are people who say like yes I realized this and I read this book I talked to this person and then I went out and ran a marathon the next and and I think that's not what it tends to look like for people that that healing tends to to go up and down and there tends to be a process to it and you know I recorded two podcasts with the the curable app in 2017 and 2019 and especially that 2019 podcast like I talk about my own experience of having a flare-up when I opened this practice and just very gradual and and slow Improvement but you know within a certain amount of time to the point where I can play you know 36 holes of golf if I want and I can go on a 50 mile bike ride and we can do an hour of Power Yoga every morning and I don't have limitations in my life does that mean I never get pain or symptoms no and so I'm a human being just like everybody else says and sometimes things are going to happen in our lives that are too much much for us to process just with our brain and so that our body helps us to do it as well and so as people move forward I don't expect that people are never going to have symptoms or never going to need to to call me or another physician ever again what I'm hoping for is that people have a nice framework for what to do when symptoms develop and then they can recognize that they can be evaluated or not but that having symptoms doesn't mean that there's damage going up and once we recognize that then my hope is that people can have a variety of tools and a variety of strategies so they can get those symptoms to calm down quite quickly so that they can get on with the important part of living their life and well and this is where yeah people the way that this is explained to people matters so much because people with Malta de Bergman syndrome they'll talk about remission which already implies a lifelong neurological problem that sometimes you get breaks from right and with triple PD they'll talk about relapses oh I had it and now I have it again but what you're describing is how we talked about this earlier as well it's normal to have unpleasant Sensations I I I've never felt a hundred percent every day of the week it just doesn't happen but the framework in my mind is oh yeah today I'm being affected by whatever's bothering me whether it's stress related or what have you and I don't have that word in my head I don't have the word relapse I don't have the word remission in my head and so the danger signal it comes up it's not pleasant to have pain my personal Mind Body symptoms are migraines digestive issues and back pain so that's how mines show up but I I just say oh yeah I'm a human being who's being affected by something and here's my body telling me about it and that's it there's no there's no meaning to it so it just doesn't stay but what you're describing here is the way that that you're framing this is that it's completely natural to have those ups and downs and have this take a while and be a slow process of growth and that that is that is that is normal that is that is what recovery looks like yeah and I think you know a couple of thoughts about that that my patients who who learn not to be afraid of symptoms are the ones who do the best and so even if the symptoms are significant if they can be confident that they're they're fundamentally okay and a lot of them have seen a lot of Physicians and had a lot of tests and so they they tend to know that then they can work with those symptoms and work their way out of it fairly um fairly quickly and and so you know even in in my own life like I said you know it's it and like you said it's not that that we feel 100 every day there are times where where things are going on we can feel them in our bodies and I think that's natural um over Christmas break I come from a long line of of golfers and have now passed that down to my 15 year old son and so we went down south and uh and played golf for a few days and uh and I sort of like tweaked something in my back on the way uh in a couple of days leading up to that and it was interesting like I do this for a living on Dr strikes like I know these things and then this thoughts keep coming in like oh my goodness like this I'm gonna play golf again and and what probably is more likely is that my 15 year old is now starting to be better than me I'm gonna try to stay ahead of him but um but but even me right those thoughts start to creep back in like oh no something's really wrong this time and you know we we went down there we got caught in the Southwest Airlines mess and so we ended up driving instead of uh of flying but you know we play golf we had a good time like we drove back up here I'm very sorry about the Southwest Airlines thing I caught that oh my gosh oh goodness yeah so so this is just normal life this is you this is this is human life and I again I I very much understand and I'm sure you do the the distress and the despair people feel when they're being told oh it's a lifelong condition but it is a lifelong condition to be human and have physical symptoms show up in our bodies but that doesn't mean you have a A syndrome it doesn't mean you have a disorder it's just part of The Human Experience yeah and I think that you know practitioners and Physicians have known that since the beginning of time right you look back at the writings of of Aristotle and and and and and early European Physicians and they wrote about this they knew that what was going on in people's lives was was part of uh part of what was showing up in their bodies it's just in the past say 50 to 75 years that the medical system seems to have forgotten that and that's partly the training partly the influence I think of the pharmaceutical industry and then medicine as a business and really pushing out the ability to sit and talk with people and so the the goal becomes to try to make the correct diagnosis and prescribe the right treatment um one of my my colleagues has a story that he uh he actually wrote the book on it like literally wrote the book on integrative medicine but before he was interested in Integrative Medicine he was a small town uh physician in rural Idaho and he said a woman came into his uh office several times with terrible buttock pain like she just couldn't couldn't make it better and uh and he tried everything and ran it for tests you know all the things that we do as Physicians and so and again this is sort of before he really was interested in Integrative Medicine he made the decision the next time she came in he was just going to talk with her and so he said that he came into the room he took off his stethoscope he put his phone to the side and said just tell me what's going on in your life and she said gosh Dr Dave I just got to tell you that that my husband retired six months ago and he's around all the time he's just the biggest painter I'm not [Laughter] yep right and so so if we give people space like as Physicians and practitioners like they will give us the answer um I was in a staff meeting at the hospital one time we were talking about these Concepts and I said how I had made a pledge to myself when I first got to medical school right it's 25 20 20 years ago that if somebody had back pain I would always ask them what was going on in their in their lives and and my colleague said well like what if something comes with a sinus infection do you ever ask them what's going on in their lives if they have a sinus infection and it's like no I usually just write antibiotics but but I'll do that and so I we had to take like like five or six shifts in the Urgent Care centers on weekends when I was at the hospital so I was doing an urgent care center shift and um and somebody came in with sinus infection and so I wrote the prescription for antibiotics and said like hey anything stressful going on and and they started telling me like as a couple and he had just lost his job and they were worried about it and what was going to happen next and and I swear we had a two-minute conversation about it two minutes 120 seconds and and so it got up to go and and they just started talking about like how wonderful it was to talk to a physician and somebody who cared so much and I walked him down the hallway and they kept talking about how wonderful it was I told people at the front desk oh my goodness I can't believe that he said like two minutes two minutes and and it just like that's what it takes but I say this all the time in lots of different contexts the difference between two minutes two minutes and zero minutes is huge and so if we don't take that time out to just say hello how are you I'm sorry you're not feeling well tell me about it then we get in a situation where people just get shuffled from practitioner practitioner practitioner or in the the underlying issues never get discussed well it's a system that also unfortunately rewards that and this pains me so because people send me research articles hey Yoni did you see this latest one on Triple PD these biomarkers there are brain changes this is the cause you just described the problem it's like me saying my hand hurts and I had hurting hand syndrome and that's my diagnosis so I I again it's unfortunately not to say that this it's all bad news everyone obviously there are Inc incredible research projects going on Dr shuburner is involved in one of them the eaet study for fibromyalgia there are many studies like this going on now but it's it's like pulling teeth to get funding for those kinds of studies whereas oh I have this brand new lab test that's going to show you definitively if someone has one of these conditions that's that's what gets the funding that's what gets the momentum that can get people in and out the door a lot more quickly so unfortunately you and I both work with people who are the you know again no one's trying to victimize anyone but these these folks are are victims of that mentality of that system absolutely and it like I said there's a lot of different pressures in a lot of different directions to treat biomedically to get to do procedures and and hopefully you know that in in your field and you know the I say this fairly regularly like none of us I don't think would have if we were starting from scratch set up the health system the way that it is like I don't know that anybody would no one would have yeah it's a great idea two minute visits like that right and yet sort of that's the way it's been pushed over time for a whole variety of reasons and that's the system we have to work with and so as you say it's you know you and I and Dr stupener and others we've managed to put ourselves in places where we have time to to talk with people and hear their stories and get to know them and and find out what's going on and if we can if we do that if we can elicit some of the story and and not be judgmental and and be empathic that that goes for a lot well I'm curious to know what your thoughts are on why that is so again many of the people that I help I'm not working with as individuals either just watching my YouTube videos and you know they'll leave a comment and I'll say yeah that makes sense with neural circuit dizziness but there's still again in many in many cases able to recover however some people need that now why do you think that is why does why do some people need a practitioner to to help I mean everybody's different right and I you know that's one of the things I love about practicing medicine is that everybody's different everybody's got their own story and so some of it I think is people's background and you mentioned Dr shivner's eaet study and and so I worked with him when I was a resident on the very first fibromyalgia pilot study and we um you know and then and then we from there branched out we were going to do a different study and so we worked with a rheumatologist who had a fibromyalgia clinic and I was in charge of doing the intake with the fibromyalgia patients and it included a structured interview on history of trauma and so I went and I started asking these questions and these patients in the fibromyalgia Clinic went on and on and on and on and on about their experience of trauma over the course of their life so much so that I got overwhelmed and didn't know what to do with the data we never published that particular study but it always stays in my mind and so whether it's fibromyalgia other chronic diseases there's always the possibility of significant trauma in somebody's life and I think the more of that the more likely people are to need a lot of patience and a lot of kindness and a lot of guidance in the process of getting better some people are um some people just by their nature I think are more prone to want a expert to say like hey I think you need to do this or I think you need to do that and so some people and you know my experience when I was was young and I had been a a college athlete and so I had a lot of confidence in my body and so once I recognized what was going on I felt like I could move forward with without a professional opinion on it although for a long time when I told the story publicly I'd say like I read Dr sarno's book and I went out and I got on my bike and I did much you know I went on this bike ride and I got better but but in truth like it took several months after that and I still have the journal that I kept it's probably in in the bookshelf behind me but um but for months I would say I would write like how is this really right nobody's really examined me should I get a practitioner and so I just think by nature some people are more comfortable in hearing this and being able to enact that to help themselves move forward and some people I think are more comfortable having a professional say like a I think you're okay to do this that's one of the things I'm always trying to do when I'm evaluating somebody and then B um here are the things here's where I would focus my attention if I would try yeah okay so you you frame that in a very um you know a cognitively oriented way which I think is really the way I explain a lot of things on my channel because everyone can hear it and understand but something else you're saying here reminds me of something you said just a few minutes ago so you mentioned people with trauma and you've also mentioned a few minutes ago that symptoms show up in our bodies and I'm wondering if you can explain a little bit more about why people who have had histories of difficult life experiences perhaps not things that people would classify as trauma but difficult life experiences are more likely to have physical symptoms later on I think that it goes back to what we were talking about at the beginning and so the conventional medical system when I was in medical school I was taught that if somebody had a symptom something was wrong in the body there was damage and that's an intuitive way of understanding physical symptoms there must be something wrong in our bodies but but the research doesn't really show that the research says that people can have a a lot of symptoms without any damage and interestingly a lot of damage without symptoms as well absolutely yes and so it's so it's not that that's not why we get symptoms more likely we get symptoms because our brain is registering potential danger not just in our body but in our lives and pain and symptoms are a potential brain response to danger and so so one of the ways I talk to people about this is that when we get in danger so um you know say you you walk into a unsafe situation and there's a gang there and and you're being threatened right there's lots of different things that we can do to try to work our way out of that we can try to bargain with that we can get on our phone and call 9-1-1 we can get a lot of blood flow to our big muscles and we can run away we can try to fight back and it's a lot of different levers our brain can pull but in certain situations it makes the most sense to pull the peen lever and create pain or symptoms or dizziness or or nausea or any of those symptoms there's a whole variety of reasons that that those symptoms will develop in response to this sense of danger that our brain notices and so people who grow up in difficult circumstances stressful circumstances abusive circumstances their brains have experienced a lot of danger over the years and if the situation is stressful enough it's appropriate to assume that the situation is going to be dangerous because often enough that it is and it's better to assume that it's danger and find out that it's not than to assume that it's safe and then find out it's dangerous and kids are smart and Savvy about these things and so they don't need to have bad experiences very often for them to recognize that it's best to see the danger if there's any chance that it's present and so we grow up in those environments once they're adults their brains are very attuned to the possibility of danger and if lots of different situations look dangerous there's more opportunity for our brains to say like okay pain and symptoms are a good way of dealing with with this particular situation at this particular time and so I think that's why people who have high a scores at first childhood event scores or or have grown up with a lot of stress can be more prone to Chronic symptoms as as they get older which which raises another important question can that be I guess I don't want to say undone because we we can't change the facts of our lives but can that hyper vigilance be reversed yeah I think that Studies have shown that absolutely and you know those of you know people who are watching who've read vessel vandercook's book the body keeps the score about all the resiliency that can happen in people who've experienced trauma there's a book I like called upside which is the new science of post-traumatic growth and so you you interview people who've experienced trauma and over half of them feel like it's LED them to a better place than when they started and the the what they've been able to research about how people experience this post-traumatic growth it looks very much like what we talk about for healing chronic symptoms having connection connection with Community Connection with professional practitioners connection with a higher power doing the the journal writing telling the story speaking truths all of those accepting your emotions accepting and expressing emotions give yourself permission to have them absolutely that those are both ways that people move through chronic symptoms and that people move through this history of trauma and so there are are you know so many examples out there people who've grown up in difficult circumstances and have found their way through these um you know through the hypervigilance and through the the difficulty and Trauma to to lead great wonderful productive fantastic lives and so absolutely I believe in the power of the human body to heal and the human spirit yeah well it makes you when you when you describe it that way it it makes you wonder if essentially we're doing both things by addressing Mind Body disorders and I've always found well the more I do this work really the more I find this dichotomy between the mind and the body to be less and less relevant that you can't really treat one without treating the other you can't they're one system they're connected a hundred percent of the time so whether someone's had traumatic experiences or doesn't specify traumatic experiences or recall stressful experiences that were involved this this post symptom growth or post traumatic or they're the same process essentially right and and I you know I've heard that from people over and over and over the years that that they don't they don't they don't want the symptoms but they also wouldn't trade the experience because the symptoms have pushed them into a place that they wouldn't have been able to go to otherwise and so sometimes I'll say to people that I I think our body at some point says like the status quo is no longer an option and so so we get sick or we get symptoms and it's pushing us to go to a different place and different places can be professionally and relationally and how we interact with ourselves and how perfectionistic we are and self-critical and all the rest but that if we still have symptoms it's because we haven't gotten to where we need to go and our body is giving us feedback about how um how we're doing and what we need to work on if the symptoms are still present there's still work to be done get to this place what a what a hopeful message though and and this is one reason I I take the approach you do I I I hear this too much in a good way from people who have recovered I wouldn't trade this experience in as awful as it was I would never want to do it again I wouldn't wish it on my worst enemy I'm a I've I'm a different person I've grown so much from it and I I feel that there are so many methods out there neuroplasticity programs for example that can help you overcome your fear of the symptoms and ultimately in many cases knock them out and all power to people who want to do that again I'm I'm not judging anyone who chooses whatever method's working to to help with symptoms but when we when we view the symptoms with this laser focused I'm going to program this out of my brain we lose this opportunity for growth there's there's a reason we have symptoms there's a reason the brain was in that state it was susceptible to it there's a reason so let's let's learn what we can and make sure we're not susceptible in that way in the future yeah I mean I say to people all the time right the symptoms are not the enemy and and I was talking to a patient the other day and said that she was a college student I said say you you got a bad grade and the mail person came and delivered your grades and and you were disappointed with one of them would it be smart to get mad at the mail person that's not where the action is and so the symptoms are giving us messages and the symptoms are trying to convey something to them and once we can recognize that once we can recognize that everybody's on the same page everybody's working together our body's not trying to sabotage us or make our lives miserable then we can interact with these symptoms in a much different way and we can learn from them and we can grow from them and we can can get to the amazing places that we all need to go wonderful so I know our time here is coming to an end but before you go I'm wondering if you have any practical tips to share with people who are dealing with chronic dizziness right now many of the people who watch my channel understand they've seen a lot of my content and they understand where it's coming from but some of them are still struggling with that frustration and those ups and downs and they're wondering is am I going to be the exception am I going to be the one who never gets better so I'm wondering if you have any advice for them I think it's you know if we say that like you know 95 of people get better you know I don't know what the numbers are but um but everybody thinks that they're in the five percent right right it doesn't matter what the statistics say everybody worries about that that you know I think it's a two-part process one is understanding what's going on so as long as we're locked into this idea that something is wrong in our bodies then we're kind of locked into to physically based treatments and so understanding that we can feel very very sick even though our bodies are healthy is the first step and then using the symptoms to try to point to what needs taken care of do we need to be kinder to ourselves do we need to be less perfectionistic is there a relational issue that we need to work out as their workplace issue that we need to work out understanding that the symptoms are not there on accident and the symptoms are not there randomly but we're human beings so we're responding to what's going on in our lives and trying to to use that to understand what we need to work on and what we need to do in order to move forward and there's a lot of resources and you know in your world and and my world and and other places on the web and so even if people can't get to practitioners who understand this or even if people are in different countries and don't have access to us there's still a lot that can be done that helps people to move forward and you know it can take a while I have worked with people I did a recording during pandemic of a patient of mine who who had terrible foot pain and she got better like two percent a month for about five years and that's how she got better and she coined a new term called two percenters of people who just slowly and steadily move towards being healthy and so even if people are working hard on it and feeling like you're not getting where you need to go it it can take a while and there can be ups and downs to it and and it never goes away all at once it's it's much more like learning a new skill than it is um just having something happen right away and so sticking with it and uh and understanding that yes it can be frustrating but that healing is possible for all of you for all of us in including people with dizziness disorders it's not just pain it's it's not just pain and and we see it you and I both see it in our practices just how debilitating it is and if we could Rush that process for people we would I tell people if I find the secret I will release one final video and then I'll go do something else it'll be fine I'll tell you about it first but there there isn't a shortcut to growth there just isn't there isn't and you know I was talking to one of our psychotherapists about this yesterday she's been working with somebody who'd had sort of chronic chronic head symptoms and derealization symptoms for for a while and they worked on it for about 15 18 months and we were talking about like is there anything that that he or she or I could have done to speed up that process but we feel like it you know it happened at the rate that it needed to happen for him and that as you said like we can't rush growth and and that's just the nature of being a human being in the 21st century yeah well thank you so much that those are I think are very wise words to people who are struggling um and I'd love for you to share how people can get in touch with you to work with you if if they're interested I know you said you work via Telehealth as well so not just with people in your area yeah we're via Telehealth we're licensed in Florida and and several other states around the country Dr Schumer is joining us uh you can go to our website cormandyhealth.com and I'll link to it in the description and uh and people can read information on my blog johnstractsmd.com as well and okay either of those you can send a message to our staff and they'll reach out and get you all set okay thank you so much I uh just on behalf of everyone who watches my channel and who needs to hear this from as many people as possible thank you so so much for sharing your experiences and the hope that people are gonna feel after hearing this interview so thank you so much you're welcome delightful to be here and talk with you and I am always up for for sharing information about what I know can be so helpful awesome well thank you so much Dr Strax have a good one thanks [Music]

Channel: The Steady Coach

Views: 4,147

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Id: 7VljACOmMJA

Length: 68min 13sec (4093 seconds)

Published: Sun Jan 22 2023