Host: Hi. Welcome to Behind the Miracle, the Sierra Tucson podcast where we talk about the science and stories behind the miracles that we try to provide for patients here at Sierra Tucson. Today on the program, we've got Dr. Maureen Schwehr, the Director of Integrative Services at Sierra Tucson.

Dr. Schwehr, I could read your bio, but maybe we could actually talk through a little bit of your background because you've got a really interesting background. You've got an NMD and you've done a ton of work in different areas, such as stress hormones, you talk a lot about the gut-brain connection now, you talk about different kinds of nutritional supplements. And so, I think this integrative side maybe makes you a little bit more open to new ideas in medicine.

Dr. Maureen Schwehr: Yeah. I'm a naturopathic doctor. And in Arizona, I get to call myself a naturopathic medical doctor. Sort of the title depends on the state. But naturopathic doctors are actually completely different kind of medical providers. There's only six schools in the U.S. that have four-year medical degrees in naturopathic medicine, and then there's actually two more in Canada. So, my training was sort of best of both worlds. It's a four-year medical degree. I had the same anatomy, biochemistry. I learned about medications and pharmacology. A lot of my basic training is consistent with how MDs and DOs are trained.

And then when it comes to treatments, we have sort of a broader perspective. My goal is always to try to find the cause of what's going on. And I have a lot of training in nutrition. I have a lot more sort of in depth training in hormones and how stress impacts different hormone levels. So when I'm meeting with someone, I'm always kind of trying to find the whole picture. And I think that lets me do a better job of trying to get to the cause of things instead of kind of coming up with, "Here's your symptom, here's something that will relieve your symptom."

Host: Yeah, I think that's actually really cool. I think of your training as being doctor plus other things, right? Which is kind of nice because I think in the broader culture, there's a lot of fast-moving research and fast-moving discussion about, "Oh, hey, did you know that stress can do this or inflammation can do that?" And maybe that's not part of the sort of standard decision-making algorithm that a doctor who doesn't have that background would use. And I'm sure all the patients here, they always give you rave reviews. So, I appreciate that.

Dr. Maureen Schwehr: Thanks. Yeah. Whenever I meet with someone, I mean, I spend an hour and I'm always asking them about, "In your childhood, were you sick a lot? Were you not? Did you have allergies?" I think about digestion. I think about their thyroid function. I just try to put it all together. And I think I'm a little unique because, for me, it's always been obvious that stress and trauma make a big impact on people's health. I think I was just that person that everybody felt really comfortable telling me their biggest secrets. And so, it made me more aware of that. I mean, I've been around other colleagues and they're like, "Oh, I don't think about those things," but I think not everybody feels comfortable telling every medical professional kind of personal trauma stuff. So that, I think, informs me and a part of my brain's always paying attention to like how is their nervous system regulated, because they don't feel safe in the world or because they're under chronic stress.

Host: Yeah. I think that willingness maybe to hold space that the kind of people see in you. I remember a psychology professor when I was an undergraduate saying, "That's the best predictor of whether or not you're going to do well in mental health," right? If you have this kind of natural ability to hold space for people and listen well.

What led you to want to go into naturopathic medicine? I guess, this is kind of like just leading more into, you know, you're saying, "Oh, I was already that person who listened to people. I was already that person who people could confide in. But was there any like moment when you're like, "I don't just want to do the normal medical track, I want to do this extra piece."

Dr. Maureen Schwehr: Yeah. You know, what's funny about that is it was my golden retriever. I had a golden retriever, Amber, she was a great dog. And when I moved off to college, I left her with my mom for a while. And when I got her back from my mom, my mom had fed her the cheapest dog food she could find and she never exercised her and she kept her in a kennel a lot. And the poor dog, she just looked completely different and she had this like horrible skin condition. And I brought her to the normal vet and they would do steroids and then her skin would be better, but she would be super hyper and then it would wear off and then her skin would come back. And I actually found a holistic vet and he said, "All right, your dog is stressed. Your dog has all this dietary deficiencies." So, he gave her a new diet. He made us exercise. She spent, I think, three days laying next to her bowl, because I wasn't feeding her as much as she normally did. But in the end, she made this remarkable recovery. She was such a healthy dog and she lived such a long time. And then, I was like, "I want that. I want that. I want to find someone who can do that for me." And I called around. And I mean, this was a number of years ago. That was probably 30 years ago. And I couldn't find anyone like that.

And then, 10 years later, I was sort of burnt out. I was working in the environmental field and I was sort of burnt out. We took a trip and I found an announcement for a naturopathic college that is actually in the Tempe area. And I read about this and I'm like, "Oh my goodness, this is what I was looking for." And the more I read about it, the more I was like, "I think I want to do this." So, I actually went back to school, completely retrained as a doctor in my 30s. And that's how I sort of found it. And I'm super grateful because I think it's a great way to approach medicine. And it's been a great career.

Host: Yeah. That's actually really inspiring, I think, to say, "Hey, this is a passion. I bet I could actually go back and become a doctor, you know, get that degree." That's a tough decision to make in your 30s and a real inspiration.

So today, we're talking a little bit about a kind of new program that's starting at Sierra Tucson. And this is a program for treating chronic pain with pain reprocessing therapy. And this is something you've been learning about a lot in the last few weeks and that we're sort of preparing to offer to patients. Can you give kind of like a brief overview of what it is?

Dr. Maureen Schwehr: Yeah. I was happy to do this and talk about it, because I'm very excited about this. So, pain reprocessing therapy, I'm going to start by using kind of their official definition and then we're going to kind of break that down, right? So, it is an evidence-based approach to retrain the brain to interpret and respond to signals in the body properly, and that breaks the cycle of pain.

So to break that down more, the thing that I think has made this therapy sort of blowing up in the world right now, like a lot of interest in it was, they did a study out of Boulder. And it was a randomized controlled study at the University of Colorado Boulder, and they took a hundred chronic back pain sufferers. And if I remember correctly, people, I think, had to have had chronic pain for 10 years or more. And they chose people, they did not do an exclusionary criteria based on severity of damage, right? So, there was someone with a scoliotic curve that was really intense. There was someone who had been injured in the military with some really violent kinds of injuries. They just took everyone. And they included in people in the study, people who they thought, "You know what? This pain actually might be coming from the body from actual tissue damage," I'll say it that way.

So, in this study with this 100 people, half of them ended up using a technique that Alan Gordon had developed pain reprocessing therapy and he had had some amazing results. And so, half of the people in the study were given pain reprocessing therapy and the other half were just using regular therapy that they had been using. And the pain reprocessing therapy group, they met with a pain reprocessing therapist twice a week. And at the end of the study, at the end of four weeks, 98% of the people improved. So, almost all of them had a lowering of the pain numbers, but 66% of them were pain-free or almost pain-free. So ,they were at a zero or a one, which is unbelievable, right? They followed it out six weeks, these results stayed. And then, they followed it out. I think when I was doing the training, they said a year later, and it's still there.

So, pain processing therapy, what it recognizes is that the brain has a natural tendency to associate pain with tissue damage. So when someone's experiencing pain, all pain is real, but the brain will interpret pain as tissue damage. And then, the problem is that if there is also fear or anxiety or stress associated with that, that the brain can actually misinterpret normal sensations as pain. And I think that's really the piece.

So for me, I have recognized this all along, that this is something that's going on, but what they have done, I think, is really add that psychoeducational piece to the beginning. And they also now have a number of studies that are starting to really back this up. It isn't some guy's theory that this is happening. They have a number of studies to actually explain how this happens. And with the functional MRIs now, we can more carefully actually study that and see that this is true.

Host: Yeah. And so, I'm part of the way through Alan Gordon's book, The Way Out, and I remember him sort of emphasizing it was a really neat opportunity in this Boulder randomized clinical trial to have the neuroscience piece to it, right? So it's not just about, "Hey, you subjectively feel better," but you can actually see in the brain where your brain is changing.

And I know for the two of us, it's like, "Oh yeah, that makes sense," right? We think, oh, the body and your subjective experiences are connected. You know, of course, if you're feeling differently, your brain's going to look differently. But I think for a lot of people, maybe that adds a little layer of credibility or it adds a layer of understanding. It helps them maybe understand it a little bit more concretely.

Dr. Maureen Schwehr: No, absolutely. Do you mind if I give you an example?

Host: Yeah, please.

Dr. Maureen Schwehr: How I think this is going to be better. So, this concept that we can experience increased pain and also lots of other health issues associated with stress and anxiety and fear, that I really, really believe. I do a therapy called craniosacral therapy. It's an osteopathic technique. It works on like fascia in the body and alignment. But Dr. Upledger, when way back in the '50s and the '60s and the '70s when they were working on this, Dr. Upledger recognized that people will hold stress in their body, but we didn't have the science to explain what happened back then, right? And so, he would use words like energy cysts. So, he would be working with someone and he'd notice that as he was like maybe unwinding tissue in their arm, that they would sort of go into this trance-like state. And then, they would do the movements associated with how that injury had happened along with this kind of emotional release, right? And he's like, "We hold that in the brain." Well, now, we know what is happening.

For instance, I worked on a woman, she had a chronic wrist problem, but it started when she was riding a horse and the horse took off on her and she ended up falling off. And as I was unwinding it, because I actually ride horses, first, it pulled straight out because the horse took off, and then I could feel it twisting as she fell off the saddle trying to hold on. And we were talking about it. So, instead of it being an energy cyst, as he was saying, what was happening is that when that happened, her brain, our brains are designed primarily to keep us safe. There's a huge component in the human brain that is really there to keep us safe. And so, our brain remembers everything that happens that didn't feel safe, whether it was safe or not. Because if we associate something with danger and we avoid that, then we're more likely to survive. So when her horse took off, she was scared. And when she was scared, the sensations from that are associated in her brain now and linked with specific movements and stressors in her wrist. And so, later, if her wrist got tired or if she something pulled on it, that sensation would remind her of the sensation she had when her horse took off. And then, her brain fear centers are activated. And then, that fear center says, "I'm not really sure, but this could be a very dangerous thing that's happening. I better create pain." And so, we can create these pains almost from memories of pain, because our brain is trying to keep us safe.

Host: Yeah. I think that's a great message. So, one bigger piece here is, you know, if you're listening to this and you have chronic pain, is thinking the pain actually is partially in your body. You literally had maybe something physically happened to you, but then it kind of goes into your brain. And as you kind of get in that state where you're like, "Oh, I could be injured. You're a little bit more at risk," you're kind of potentially just re refiring the neurons in the brain without the same tissue damage.

Dr. Maureen Schwehr: Right. And they did a study with functional MRIs or MRIs where they will put someone in and, instead of just getting a snapshot like they might if they're looking for a tumor or something like that, it runs throughout. And what they do is they can put you in a functional MRI and say, "Tell me about the day you got a puppy," and we can see what part of the brain lights up with like puppy happiness. Or we could say, "Tell me about the day that you, you know, had that auto accident," and we can see what parts of the brain light up. So with this, we've been able to really map out the parts of the brain and understand so much better what parts of the brain are associated with what sorts of pain, emotions, things like that.

So, what they found is if someone has acute injury, you know, like if I go out and I drop a rock on my foot and they do a functional MRI, the parts of my brain that will light up will be associated with the area that's hurt, the foot, and the pain centers. Exactly what we would expect and how we've understood pain, right?

Chronic pain suffers when they go in, what happens is the parts of the brain that are active are associated more with the fear centers, near the amygdala, like in the emotional centers, and the part of the brain associated with storytelling, which is really interesting. And so, it's almost like this piece, like the brain isn't really sure, "But to be safe, I better put out this pain signal to keep you safe." so my foot, it keeps hurting, so my brain's like, "I don't know. I'm pretty scared, maybe I should keep limping because maybe there is still tissue damage, but I don't really know for sure." And so, the science is starting to really show. And in the Boulder study, what they found is that the original functional MRIs showed the chronic pain pattern. But after treatment, when the pain went down, actually their brain scans change. And so, we can actually see that we're changing not just their perception of the pain, but what's actually going on in the brain.

Host: Yeah, I think that's really cool. And I think that it's really nice to be able to say, "Hey, this is about fear. This is about the story that you're telling," because certainly to somebody who's like really interested in the brain, it's like, "Oh, cool. What areas are there that are lighting up?" But I think maybe from a more patient or sort of like layman's terms, if I say, "Hey, this is about your fear. This is about the story that you're telling around your pain. Then it sort of makes sense, "Oh, what could I do to change it?" Right?

Dr. Maureen Schwehr: Yes. Yeah. So, the first part of this therapy is just providing them that information to say, "We believe your pain is real, but it is possible that what's happening is that it is coming from your brain. Your brain is interpreting normal signals as painful." And then, they start by having people gather what they call evidence.

So, one of the things they do, for instance, and I've done this for years with someone, I'll say, "Okay, just take a couple deep breaths, calm your mind. Do you feel safe here yet?" You know, "Yes." "All right. So just notice what's happening with the pain," right? And so, you just calmly notice. They'll say like, "As if you were watching fish in a fish tank," you use some analogy of something really safe. And so often when you do that, people's pain sensations will shift. They'll shift. And then, they talk about, "Okay. Well, that's evidence." If you were experiencing the severe back pain because the nerve in your back was being crushed by your spine, it wouldn't change because we were just gently looking at it. I remember I had someone I was working with who had chronic fatigue and fibromyalgia. We did this work. She really got to a better place. She would get better, but then she kept kind of relapsing. And then, she noticed, like, "Oh, I'll be sitting at home. I'm feeling completely fine. The phone rings, which is usually my mother, and suddenly I'm in terrible pain again."

Host: Okay. And her relationship with her mother was maybe a little bit fraught?

Dr. Maureen Schwehr: Yeah, it was really difficult. It was really difficult. There's a really difficult dynamic there. And so for people to be able to understand that, for people to be able to understand like, "Oh, my shoulder pain..." "Do you notice if you're stressed, is it worse?" "Yes." "Okay. Well, that's evidence." and so, they just go through and then they use a number of just kind of techniques to help them listen to their body, to be able to do that, to help them gain evidence.

And what they found in the study is that people, really their logical brain could recognize that there might be a link, and that if they calmed their brains and saw their pain through a lens of safety, that pain would be less, that was highly associated with a decrease in pain. And it sounds so simple, but they really have developed this nice technique. And I think an important piece is that they're giving them the studies, they're showing them the background information about that first so the logical brain doesn't think like, "Oh, I'm just making this up" and then backing that evidence up with their own experiences. And then as you go through the therapy, what you do is start looking more closely at kind of your own patterns of thinking and dealing with stress to determine whether or not they're benefiting you.

So, one of the things that people will often do is when they're trying to like tap in with their pain they do it with this intensity as if they were like watching something super, super dangerous. You know, so it's super normal, right? Like, I'd like you to listen to your pain. And then, they're like listening as if they're like, "All right, I'm watching you, pain." And of course, then the body feels nervous in the same way that anyone would, right?

And so, what I love about this is working through the levels using the techniques to help them recognize, "You know what? I spend most of my day worrying," or "Every time something is stressful, I just work harder and I don't take a break," or "I notice that when I take time after work to swim and reduce my stress, I'm in less pain." And so, it links sort of our negative and positive patterns of thought, our negative and positive patterns of taking care of ourselves to the pain levels to let us, it's a sneaky way of making us take care of ourselves. And that's what I really love because humans are horrible at taking care of themselves on average. So, that's part of what I love about this because even if it wasn't sort of the technique that was going to cure the pain, in the end, the result would be a more regulated nervous system, a better case of care to take care of yourself. But I have to say my experience as a doctor is very much that if we have pain and stress, at the very least, it magnifies pain signals.

So, the pain may not completely go away, but it could be like, "Oh, you know, my back's got a little twitch, but then the fear around it and the stories inside our head and all of that caused this level of suffering and intensifying." And my experience very much is if we can get people to come into that calm state and calm down, almost always the pain goes down.

Host: Yeah. It's really interesting to connect it with all these other things that you've been doing, that you've already been observing as a practitioner.

Dr. Maureen Schwehr: Yeah, very much so. And I mean, I was thinking, I've been trying to help people make those links for a long time because of my training, I'm trained in the advanced form of craniosacral called SomatoEmotional Release or SomatoEmotional dialogue. It's helping people kind of connect to sensations and giving them permission to let go of stress and pain in their body. I have EMDR training, I understand like somatic tracking.

 I think the piece that's been missing is this psychoeducation, the logical piece. And I think the second thing that I love about this kind of this therapy is that early on you tell people this is not going to cure your pain. Like, it is highly likely that your brain is going to not be sure if it should be afraid and create pain signals again. And in the training, they talk about extinction bursts. So when Skinner was doing his work on training rats, they'd push the lever and then they'd get a pellet. So, they push the lever, they get a piece of food. They push the lever, they get a piece of food. So in one of the cages, the lever broke and then they decided to leave it and see what happened as part of the study. So, the rat pushed the lever, no thing. And then every once in a while, it kind of pushed the lever. And then, it kind of stopped pushing the lever. So in our brains, that would be you've disconnected the relationship between fear and pain, right? You get to the spot where you've realized, "My pain is associated with fear. I'm going to quit being afraid." But what happened is before the rat really stopped pushing the lever forever, they do these things called extinction bursts. And so, what would happen is one day the rat wakes up and it just goes to that lever and it pushes it, pushes it, pushes it. Like, "Are you sure? I really still want this." And then, after that, usually it kind of goes away, it's like, "All right. I tried it," right? And so, what they're talking about is our brains will do the same thing. You do the work, you realize like, "Wow, stress is really related to this. I'm taking better care of myself. My pain is way lower. You go." And then, what will happen is maybe something will come up. You wouldn't even know what it was. Our brains link all sorts of things to stress, and suddenly the pain is back.

In the past, when I was working with patients, they would be like, "I thought that this all worked, but it doesn't. This is all hooey. My pain's back. It's a failure. This is nothing," which really makes no sense, right? Because it was much lower, but people are very quick to go to that. They're very quick to go to this dark place of like, "See, this is all a hoax," whatever. So early on, they tell them, "You know what? This is going to happen. And it's no big deal." It's no big deal. Your brain's going to one day wake up and say, "Are you sure? Maybe this is all..." and it'll just create a whole bunch of pain. And when that happens, you keep doing what we did, right? You take care of yourself. You look at it through a sense of safety. Maybe you up your self-care. You maybe go back and have a therapist help you reprocess that. But their experience then is that although most people have some sort of relapse, that they move through it. And then knowing that means that in the future something else triggers this old response that you just go back to, "Oh, I know what to do." And I can't tell you how valuable that is because I think in the past I hadn't thought about that. And too often, I think, people would go back into that and then just give up on it, even though what we'd been doing was really helpful.

Host: Yeah. I think it's really interesting thinking about the kind of animal metaphor because it does feel like, we have our logical brain and we'd like to think that that's really what's in charge. That's always what's going to be making the decisions. So once you explain it to me, I'll get it. But then, there's this kind of like associative feeling piece that is going to take longer and that it's not really about believing or not believing. I mean that has an influence, but it needs to have that kind of safety, that kind of corrective experience over and over again until you're like, "Okay, I believe it."

Dr. Maureen Schwehr: Yeah. And what they found is people don't need to completely believe that this is true. They just have to be open to, "You know what? I'll give it a try" and start to recognize it. And so, that's the place where you can have someone come in to have them recognize it. And I've seen that over and over. As part of the integrated program here, I have a staff of 20 some massage therapists, acupuncturists, craniosacral therapists, yoga instructors. And I can't tell you how many times I've had someone come in and they'll have a lot of pain or anxiety. And they'll say, "Oh, after that massage, I was completely pain-free for like five hours. But then, it came back." And then they were like, "So, massage doesn't work." And to be able to reframe it in this thing of like, "Oh, no, no, this shows it did work. When your nervous system was calm, when you experienced therapeutic touch, when you were like in a caring, safe way, allowed yourself to have a pleasant experience, your brain felt safe, your nervous system calmed down, and you weren't getting the pain signals."

Host: Right. It's undoing. There's that fear. If it's all about this fear and the stress that activates it, then how do you undo that? Right.

Dr. Maureen Schwehr: Yes. And what's been going on, I think the pandemic made it all worse, but people's levels of fear and stress are super high. And, you know, it was really interesting. I was doing extra research on this and so you know how you do the scrolling. So, I found this little video where one of the researchers in that Boulder study was being interviewed on like the Good Morning America show. So, you know, they start out with this guy and the guy says, "I had all these terrible injuries. I had terrible pain. I couldn't do anything. I did the pain reprocessing therapy. I couldn't believe it, within like four weeks, my pain was gone." They show him riding a bike, lifting weights, like all this, right?

They explained the piece, the researcher talks a little bit about, "Okay. Well, the brain is creating these pain signals, even though there's no damage, we have a lot of issue." So, it was interesting after all of that, they're doing their little chitty chat back and forth, right? All the hosts are there and they're talking about like, "Wow, that's amazing. Wow, I should think about that and this." But then super quickly, they go back to this narrative in our medical field of, "Well, yeah, but my pain is caused by disc damage" or "But my pain is caused by something else. This won't work because there's a physical one."

And I remember Dr. Lerner was our pain doctor here for a while. And he would always say, "The nature of pain is to provide a safety signal when there's damage. And the nature of pain is to either resolve when the damage is healed or to fade into the background." There's no biological reason to keep getting pain signals when there's no actual tissue damage, right?

So, what the new studies are showing and what this therapy is showing is that that's really true. Like for instance, bulging discs, everyone talks about that. The studies show that within a year, almost all of them actually reabsorbed. And the studies have shown that if you just randomly, you know, do imaging of someone's low back and then randomly ask people about their pain level, there is no association with the damage shown on the scans with the pain levels. People who you look at, you're like, "Holy moly, that's a lot of damage going on here," may say they have no pain, people with very minor. So because we've been trained in the medical world to think a pain is coming from damage, and if you have pain, people go and they want a doctor to tell them what's wrong. And then they scan a thing and they're like, "Well, I don't know, there's this little bulge here, maybe that's it." And then, people get super hyperfocused on that and start to internalize the belief that I can't be pain-free because I have this damage.

Host: As long as I have this buldge. Right. Yeah, this bulge.

Dr. Maureen Schwehr: Yeah. And as part of this, Dr. Schubiner was part of the study and I noticed he's training physicians to have them look at this differently. He talks about arthritis and changes as like gray hair. He's like if you look at a 60, 70-year-old, they're going to have arthritic changes. That does not mean you have to hurt.

And I think so very quickly these guys went to that and it was so funny because it was like a microcosm of the problem with this. The problem is that we, our medical field, has really taught people that pain is always from a problem or damage. And then, there's lots of things. So then, you get surgery or you get shots. But the studies are showing that, when they really test it, these things aren't any more effective. And they're actually less than not doing anything. And actually in relieving pain, they're way less effective than the pain reprocessing therapy study showed. So, I'm so excited to be able to have all of this come together and us to be able to work with people and help them.

I think I've already played a little bit with this. We don't have our pain program totally up. We're working on it. But I've already stopped in the middle of visits and said, "All right. Let's talk to him a little bit about this," told him to get the book. And I've already had people say, "Oh, once I started recognizing that, my pain is way worse." I've had great results with very little effort on my part. So, I'm excited because our plan is to actually put the whole program in place.

Host: Yeah. That's great. Yeah, I think I was going to ask you a sort of last question, which is what are your thoughts about this as kind of a larger picture? I mean, in some ways I think we've already hit it in the course of this conversation, but do you feel like this type of thinking and this type of research has the potential to have a really big impact, not just at Sierra Tucson, but in the broader culture, in the broader medical treatment space?

Dr. Maureen Schwehr: I really do. I'm very hopeful. I did the training. It was well done. It was easy. It was clear. This group is sharing a lot of their information on their website in a really like openhearted manner. It's not, "Oh, you have to pay $1,000 to get this information. It's all there." Yeah, I am hopeful that this will start changing the belief. Right now, the belief is someone has pain, there must be something wrong. We have to do all sorts of invasive and sometimes expensive ways to figure out what's wrong with that. And then, the treatment of choice has been things like pain medications or surgery. And I think the whole opioid crisis made all of this.

Host: Sure. Yeah, we didn't even touch that, but I'm sure people use that to self-medicate for pain.

Dr. Maureen Schwehr: Yeah. I mean, I remember I had a cousin who had a heart attack and he's like, "It was super painful." And he's like, "When the ambulance got there, they gave me opioids." And he's like, "It didn't take away the pain, but I didn't care anymore." And so, that's the problem. Studies have shown opioids don't actually treat pain. What they do is they calm those anxiety and the fear receptors in a super dangerous, addictive way, right? And then, the trouble with that is also if our brains link, "Oh, if I hurt, I'm going to get this like wash of this drug that will stop my anxiety." Our brain will also increase pain signals to get that wash. It's like a little lever, right? When I hurt, I get opioids. And we really have been able to show there's a link. And so, that was a very dangerous path. I think much less we're doing it. But I think the benefit of this is even if we manage through pain management like medications or injections or whatever to lower the person's pain, but in their mind they still don't feel like the world is a safe place, they still worry about stuff all the time. They're still highly anxious. They're still not taking care of themselves, it lowers their quality of life. I've always thought that pain can be a gift. I know in myself, the thing I say is my low back will take me down if I overwork, like it'll literally take me down, like I get out of bed.

Host: Okay. But the gift is you realize, you know, "Hey, maybe I'm overworking myself."

Dr. Maureen Schwehr: Well, I've recognized, and Dr. Sarno who wrote a series of books, I think it was around like 2017. You know, he was sort of a pioneer in saying the brain would rather create pain signals than deal with emotional things. That was his way of explaining it. The brain, if you have something emotional going on, it's going to be safer. And so, having read his book, I sort of like, "Okay, my back hurts." And I'm like, "All right, what's this about?" And it was just like he said, right? I'm sitting there, and then my back pain went away. But then, I got a headache, which I never do. But I was dogging and I'm like, "No, no, no, body. What am I angry about?" Like, what is it? And then, it was all this anger came up and it was all about like overworking and all of that. And I really noticed often my back would go out after I would work all week. And then, I did seminars over all weekends. So when I would do that, it was very consistent. I would work too much and my back would go out.

And so, I mean, I just think everyone should be a little suspicious for themselves if there's a relief. And, you know, the basic thing people can just do is, when pain is there, take some deep breaths, think of something beautiful, kind of gently notice the area of pain with compassion like, "Hey, little shoulder, maybe we could calm down and not hurt so much right now. What if I just take some breaths and give it permission to hurt less? And notice. So often, there'll be a significant change, even with us just checking in with ourselves. And that's a great way to kind of check it in with yourself and notice to tell if something like this might be helpful.

Host: I think that's a great way to maybe wrap things up is you're not just somebody who's practicing this on others, but you're somebody who has found this as a solution for yourself. And I think both of us are really excited about what we can do here at Sierra Tucson to help people with chronic pain. Well, thanks very much, Dr. Maureen Schwehr, for being on Behind the Miracle. It's been great talking with you.

Dr. Maureen Schwehr: Yeah, it's always great talking with you. Thanks.

Host: All right. Thank you. And if anybody wants to learn more about Sierra Tucson, you can go on www.sierratucson.com and find out more about our programs and our upcoming pain program.