Solving For Joy

Becca Kennedy, MD (00:00)
It is not your fault.

We are not blaming you. I developed symptoms after I learned about this work. This is about our subconscious brain that we do not have control over and the automatic functions with our

body.

Chrissie Ott (00:18)
potency of having those shifts of seeking those shifts especially with support can never be underestimated.

Becca Kennedy, MD (00:30)
a lot of it is also really looking at someone's childhood and what their brain learned because they went through in their childhood. And now why their survival brain is perceiving danger even though there's not danger.

Chrissie Ott (00:56)
Hello friends and welcome to today's episode of the Solving for Joy podcast. I'm so glad you're here. Today's guest is someone who's challenging the status quo of how we treat chronic symptoms and offering a path to healing that's grounded in science, compassion, and personal transformation. Dr. Becca Kennedy is a family medicine physician and the founder of Resilience Healthcare.

After more than 20 years practicing conventional medicine, she noticed that traditional treatments often fell short, especially for patients with chronic or poorly understood conditions. Her deep curiosity led her to the pioneering work of Dr. Howard Schuebner, Dr. David Clark, and others who are helping us understand the connection between the mind, the body, and lasting health.

What she discovered didn't just change her approach to medicine, it changed lives, including her own. And now helping people heal through this new lens is the sole focus of her work. It's such an honor to welcome Dr. Becca Kennedy to the podcast. Thank you for being here.

Becca Kennedy, MD (02:05)
Thank you. It's my pleasure.

Chrissie Ott (02:08)
We connected through social media channels not that long ago and we had such a riveting conversation that I was left with the feeling like I almost wish we had recorded it because I was learning so much about this work and the work of addressing what you called and what taught me is called neuroplastic symptoms. So ⁓ I'd love to connect your

you know, your backstory with where you are today as a first step, but I'm just really eager to get into hearing, how, like, how does a physician or lay person wrap their head around what you treat? And we get to just like dive deep into neuroplastic symptoms and stories of healing.

Becca Kennedy, MD (03:00)
Yeah.

Well, as a family medicine physician, I, we see as you, ⁓ as you well know as well, the whole person over time, and we work with all of the body systems and the family medicine physician at a PCP is really the end of the road. So people can go out and try all of these different things and different approaches and

medicines, procedures, treatments, and when things don't work, they come back to us. ⁓ And so over years and decades into my career, I just didn't understand why there was so much we couldn't help. And many studies have shown that 40%, even more of the patients coming into primary care every day is because of some sort of medically unexplained symptom, which is a huge number.

and to think about nearly 50 % of the patients that we see in primary care every single day, we actually don't have a great solution for. And it's incredibly frustrating for a patient struggling in their life and also frustrating for the doctor on the other side that wants to help them. So as many of us know, in medicine is really seeing this pattern. There's lots and lots of different diagnoses, many of which

don't actually have an abnormal test. those diagnoses often are in the similar people or the same person have many of these diagnoses. And then sometimes and often there are also mental health diagnoses like anxiety, depression, but those aren't necessarily the cause of the symptoms. And they're also not necessarily. ⁓

the result of the symptoms, they're more kind of coexist. And then often people have more stressors or history of trauma, although not always, but seeing this pattern over and over, but sending people to mental health or the chronic pain specialists or all these different places just really falls short a lot of the time. So I felt like there was this some piece that we were missing.

And it just is what developed this really intense curiosity in me. And I just looked for years and years and years to look for whatever other approaches could help. And I tried lots and lots of different things. And I was open to helping my patients with anything, alternative medicine, lots and lots of different approaches. And there was, again, nothing quite really hit the nail on the head to really help people. So I just would always keep looking and looking and looking.

until I found this mind-body approach that I use now.

looking at what was happening with my patients is what brought me to where I am now. And the reason I found this is because I was talking to my best friend from medical school about this, and she said, I send my patients with chronic pain to Dr. Schubiner, and he fixes them. And I said, wait, what? And she said, yeah, they come back to me, and their pain is gone.

And this is, you know, this is a cognitive dissonance, which is where there are two beliefs that you hold to be true, but they're opposite. And the one belief was chronic pain is not treatable. That's not possible. You can only manage it. And, but the other was my best friend telling me that this was her experience with her actual patients. And we can't hold both of these truths to be true. And because it was my best friend and I believe her, I chose to let go of

the belief that we can't cure or completely resolve chronic pain. And so then I stepped into this field and learned everything I could and took all of the trainings and read every book I could. And then it was when I was working at Kaiser in the integrative clinic, as well as in primary care, and really started applying these principles and kind of seeing what worked, what didn't, and really seeing a lot of great results.

Chrissie Ott (07:06)
I am so impressed that you learned about this and dove straight into it. It's like running into a house fire as opposed to away from it because I'll let our listeners in on a little secret. Maybe it's a dirty little secret, but when in primary care, our many interventions have not worked, it's actually very, ⁓ it's hard on the providers. I am not discounting of course that it is harder on

Becca Kennedy, MD (07:14)
Yeah.

you

Chrissie Ott (07:35)
you know, the beloved patients who are suffering the actual ills. But when we do things that don't help, ⁓ it makes us feel sometimes ineffective and that can be exhausting, especially at the pace that medicine is practiced and all of the things that are stressful about working in health care these days. So many people who see ⁓ a few patients in their day with chronic fatigue, chronic pain, what we

politely call functional GI disorders or ⁓ non-epileptic seizures or idiopathic neuropathies. I mean, I could go on and on about all of the different, you know, symptom heavy, but not well understood diagnoses that you frequently help correct, Becca. So most people want to distance themselves from those patients. You know, you see a fibromyalgia patient on your

Becca Kennedy, MD (08:26)
Mm-hmm. Yep. Yep.

Chrissie Ott (08:35)
day and part of your energy sinks a little bit. This is not everyone's experience, but I do believe and I know, you know, from living in medicine, it's such a common experience. So thank you for running into the house fire and gathering all the tools that you could possibly gather together and say, I will answer this call.

Becca Kennedy, MD (08:51)
Yeah.

Yeah, right. And gosh, Chrissy, that's exactly right. And I think that nearly, maybe not all, really nearly most doctors go into medicine and they truly want to connect and help people. And when we started careers, we're so excited and we're going into our clinics and we're seeing all these patients and ⁓ a lot of these patients with medically unexplained symptoms is one of the terms for it.

Chrissie Ott (08:57)
Yes. ⁓

Becca Kennedy, MD (09:25)
is that we can't help is that we try and then they come back and we try something else and then come back and they try something else and then years and years and years and years go by and we have exhausted every single thing we could possibly do and the patient's still coming in and it does it feels terrible and I completely get that for the patient and their own life it can be overwhelming and devastating and really really

Chrissie Ott (09:45)
you

Becca Kennedy, MD (09:53)
I mean, people's lives are ruined through

symptoms that we can't help.

Chrissie Ott (09:57)
They live for years

without any symptom relief or they, know, sometimes they live with the medication treatments that we offer them that have unfortunate side effects, right? Their entire identities get built around their suffering. ⁓ I mean, it is devastating the quality of life years that can be taken. And they're living many times if

Becca Kennedy, MD (10:08)
Yeah, right. ⁓

Yeah.

Chrissie Ott (10:22)
they're conservative or like, you know, conventional persons, they may think under the fallacy that, you know, doctors know everything or doctors are supposed to be able to fix everything. And then they are left feeling like the failure.

Becca Kennedy, MD (10:36)
Mm-hmm. Yeah. I mean, it's just a terrible situation all around. And actually, it was when I was at Kaiser and I was 10 years into my primary care career and I actually left primary care because I was so burned out and it was so difficult. And I stayed at Kaiser. I was in urgent care and emergency department in different places. But I thought it was back when fibromyalgia was a little bit more of a common diagnosis than it is now. And I thought

Chrissie Ott (10:37)
It's tragic.

Becca Kennedy, MD (11:02)
Well, if at the least in our system, we could have a clinic just for fibromyalgia patients, even though we don't know how to help them very well, if we could have a place to at least support people and have them, let them be heard and help them in the best way we could outside of the primary care office where we only have 20 minutes when we're trying to deal with all of these other things, then it could be better for the patients and the primary care doctors. So the primary care doctors could spend their time.

focusing on the other issues that they could help with diabetes and hypertension and whatnot. So that's kind of how it started. And also that as a physician, it's really our job to find the solution. It's not the patient's job. And unfortunately, because mainstream medicine doesn't know the answers, really the burden gets on the patient. And so many patients...

end up spending hours and hours, you know, research and researching because I mean, what else are they going to do if they're not offered any other solutions from their other clinicians?

Chrissie Ott (12:09)
Indeed. So you ran into the house fire, you gathered up all of these tools. What happened next?

Becca Kennedy, MD (12:15)
then.

Well, I was really fortunate actually to be in the situation I was in at Kaiser, as I had actually just gotten a little bit of time, half a day a week in their integrative clinic. And also I was no longer a paneling primary care provider. I was just same day ⁓ in primary care. So I had a little bit less work to do and I mean, still overwhelmed, but it just allowed me some space.

to be able to talk to patients in a different way through this new lens. And what I found was, so what I did is I said, well, if Howard Schubiner can help patients resolve their pain completely, what is he doing? So that is unbelievable, right? I mean, it was unbelievable for me. Like, no, that's not possible. But if I'm going to hold space for this belief that my friend is telling the truth,

Well, now there's pieces of information that are missing in order to make this true. And so what are those pieces of information? So I sought out Howard Schubiner, who fortunately is a very nice man, whose son, he's involved in lots of research. He teaches courses, he has books. mean, so this information is out there and I just dove in. And really what the pieces of information are.

In some ways, it still sort of boggles my mind, like years into this, sometimes I wake up and even think, wait, am I really saying this to people? ⁓ But in other ways, I feel like it's actually the only thing that could make sense. And really with symptoms like chronic pain or chronic fatigue or many, many, other chronic symptoms, dizziness, GI dysfunction, know, lots and lots of different symptoms around the body.

where the tests are normal or the tests don't fully explain it or people don't get better with the treatments or the symptoms shift or move around or lots of different presentations. Really what the, would say the three pieces of missing information are. And those two of them are renewed to me and one of them are. But so the first piece is that all pain, and I'm gonna use the example of pain, but then I'm gonna...

spread it to the other symptoms. But the new science of pain, I didn't know this, many people may know this, I did not know this, ⁓ is that 100 % of pain is made by the neural circuits in our brain and it's a warning and a danger signal, not necessarily a tissue damage signal. So I thought as a doctor, I've been a doctor for 25 years, I actually thought that pain was actually generated out in our

body by our nerves. Like if I cut my hand, that it's the nerves out here that are making the pain signal, which is not the case. The nerves take the information that the tissue is damaged, and then they send the information to the brain. And then the unconscious brain, it interprets that signal and it makes meaning out of it. And it makes meaning of, does this mean danger or is this safe?

So all of our nerves throughout our body are constantly checking in with our unconscious brain and our brain is deciding if this means danger or if it's safe. And when it decides that this signal coming in means danger, it then creates the pain signal or other signals in order to communicate with our conscious brain that something needs our attention because our conscious brain is what decides our behavior.

So if I break my hand, my conscious brain needs to know don't move your hand so it can heal. So the two bone edges don't move around all the time and that the cells can actually repair themselves. So my conscious brain needs to know that there's danger in my body so I can respond. And that danger signal, the pain signal is made by a neural circuit in the brain. So sometimes that happens when there's structural damage in our body.

We cut ourselves, we have a broken hand, an infection, a tumor, know, something is going on structurally out in our body. Our brain is then responding to that to communicate. Absolutely. And that is necessary. We need to have that. But what happens is that our, our, the neural circuits in our brain can make these warning and dangerous signals in the absence of tissue damage in our body.

So if we have stage fright and we go on stage because of fear, our brain says, whoa, danger. And we could have a headache or a stomach ache or dizziness or tingling or diarrhea, or we could faint. So these biochemical changes are happening in our body. But this is happening because of our unconscious brain just perceiving we're in danger, psychologically even.

There's nothing wrong with our body. We're perfectly healthy when we're on stage and we have stage fright. So our brain can make these danger signals for many different reasons. Because our brain has a bias for danger. So our brain errs on the safe side of danger. ⁓ And that's what's kept us alive on this planet. So sometimes what can happen is we do have, we have some sort of damage in our body. We broke our hand, the pain signal is made.

And the normal process is for the pain signal then to get turned off once the tissue heals. But for lots of different reasons, sometimes that warning signal gets stuck in place and that neural circuit of making the danger signal of pain keeps on loop and it keeps making that signal even after our body healed. And there's lots of different reasons that that can happen. So,

Now that we understand that the symptoms in our experiences are made by neural circuits in our brain, and there can be different reasons for it, damage in our body or our brain just interpreting psychological stress, danger, that the experience is happening in our brain. So now the second piece of information of new science is the idea of what's called predictive processing and that our brain creates our experiences for us.

in our brain through neural circuits. So our sensory stimuli like vision and hearing and touch, sight, smell is happening through neural circuits in our brain being put together in order to create the experience for us. So we don't see with our eyeballs, our eyeballs bring in the light, but it's our brain circuits that put together the image for us inside of our brain. And actually a lot of this is actually happening through our brain predicting

what's happening based on what it's learned. Again, this is a super mind boggling idea. But so our brain categorizes information and puts it into sections and categories so that we can respond to the world as fast as possible. Because if our brain is just bringing in all the sensory information and de novo creating the experience for us, it's just too much information and too overwhelming.

So our brain categorizes it, which is why we can glance out the window and just see something tall and skinny. And our brain says, that's a tree. But when we look closer, it actually was a person because our brain predicted wrong in that circumstance. So our brains are prediction machines. our brain is where experiences are made. And so even this information coming up from our body, the experience of what we're

Chrissie Ott (20:00)
Okay.

Becca Kennedy, MD (20:29)
feeling and hearing and seeing is happening in the brain circuits through prediction. so then, so now you have the sensations being made in our brain. Our brain uses prediction and expectation as a lot of what actually generates our experience for us. And now you add in the idea that everyone knows of conditioned learned response.

is the experience that Pavlov did with his dogs, is that our unconscious brain is always making meaning of the world. And all of these sensory stimuli that come in, our brain is associating that with different information. So it will learn to associate the information from the world and make meaning of it. So for the Pavlov's dogs, they made meaning of the sound of the bell and eating.

So this just the sound of the bell by itself would cause an unconscious response, the salivation. So our brain is doing this all the time. So when I look at a computer screen, my brain learns to associate the light from the computer. So if I'm at work and it's very stressful and I'm in front of a computer all day, my brain learns to associate that light with stress. So a headache can be then the pain made as a danger signal.

in the brain, then a headache can be formed. My brain trying to protect me from this stressful environment, or maybe my boss is yelling at me, my brain is saying, hey, this isn't okay, you need to get out of here. So now my brain can create a warning signal of a headache. But now because of learned association and the condition learned response, now my brain goes out into the world and is always scanning for danger. And now my brain says, oh, the sun, well, that's a really bright light.

There's this other bright light that I've associated with danger. So now the bright light of a sun through prediction, the brain can then create a headache, create a migraine. Or maybe I'm watching TV and I'm perfectly relaxed watching a funny movie, but because my brain has learned to associate the light from the TV and now a headache gets made, even though I'm not stressed in that moment.

But because of, again, our brain having a bias for danger or using prediction, the experience that we're having is made inside of our brain away from our conscious awareness. Now you roll all of that together with our incredibly stressful lives. And our brain then can make all of these warning signals throughout our body that can get caught and stuck in place. And then they can even get stuck in a fear symptom loop.

So if we don't understand that our brain is generating this symptom that we're experiencing in our body, but it's made in our brain as a warning signal. And we believe that it is because of some sort of damage in our body, which is absolutely understandable and normal, because that's what we all generally speaking just spend our whole lives learning.

But so now we're focused on our body and we keep looking deeper and deeper for some sort of damage in the body as the generator of the sensation. And then we're kind of fearing the sensation even more. And we, you know, we just get caught in the salute.

Chrissie Ott (24:02)
Wow, that's a lot to digest. So all pain and parentheses, other symptoms are created in the brain as a response to are we safe or we in danger? Our brain uses predictive and expectation to create our experience. And we have strong associations which then drive

Becca Kennedy, MD (24:03)
So it's a lot of information.

Yes.

Chrissie Ott (24:30)
further manifestations of these experiences independent of there being tissue damage or ⁓ observable dysfunction in the distal system that we're talking about. When is it right? I'm asking this, know, as a curious observer and also as a practicing clinician, when is it right?

from your perspective to ⁓ jump tracks, to go from, are looking for ⁓ sources in the inner ear to treat ⁓ biokinetically versus it's time to now observe where the symptoms have been regenerating unbidden in the brain. What is that jump over like when?

Becca Kennedy, MD (25:15)
Yeah.

Yeah. Yeah.

Yeah. So like you were saying is that so there's lots and lots of diagnoses that people can have that generally is what this is, is a neuroplastic symptom. So things like fibromyalgia, tension headaches, migraines, irritable bowel syndrome, you know, the majority actually of chronic back and neck pain.

many pelvic pain, you know, there's lots and lots and lots of things. But so everybody needs a medical evaluation, right? And so we, so as doctors, we listen to the symptoms, we listen to the history. And I think many people don't recognize that actually in mainstream doctor world medicine is that

Chrissie Ott (26:00)
Yeah.

Becca Kennedy, MD (26:17)
80 % or so of our diagnoses are made on history alone. Like, I don't know if that was your experience, but in medical school, that was like driven into us, right? Even like 85%. It's based on history alone. And I think a lot of people don't understand that. But we look at the pattern of the symptoms, and then we get our differential diagnosis of what makes sense based on that pattern. We use the physical exam to look at, again,

Chrissie Ott (26:24)
totally.

Becca Kennedy, MD (26:45)
narrow it down what makes sense physiologically, and then we do tests to rule in or rule out ⁓ a structural problem. So every patient needs to start with that process. Every person needs to have a full medical workup. They need to have the appropriate tests. And if someone comes in with dizziness,

Well, yeah, sometimes dizziness is neuroplastic, but sometimes it's because they're anemic or they have a thyroid problem or a brain tumor. We have to know that, right? And so doing a whole full, thorough medical exam is absolutely critical. Once you do that, then it's looking at, well, now what else makes sense? So...

So if you've done a full medical workup and you haven't found any other reason, structural reason that really truly makes sense physiologically for the symptoms, well, you're not done. It's not where you're there. You're not there making the diagnosis yet. I think it's so hard for people because there isn't a test. There's no test I can do that is abnormal to show this, right? But now what you do is you look at the whole story. And so you look at...

physiologically what's happening with the symptoms. Like what was happening in someone when the symptoms started. So if it's pain, was there an injury or did it just come out of the blue? So if it just came out of the blue and there wasn't an actual injury, which happens all the time, it's more likely that this is the brain, just the brain creating the signal in the absence of ⁓ damage in the body. It's also looking at what was happening in someone's life.

And I think if there's one thing for a medical industry to change, I think it's really starting to ask more about what is going on in someone's life rather than just what's happening in their body. So if it came out of the blue and there was a stressor going on, and the thing is sometimes stressors are obvious, right? Clear, but sometimes they're not so obvious too. And so that's, you know, the other part of kind of going into.

Chrissie Ott (28:45)
the context.

Becca Kennedy, MD (29:00)
But the big piece of it is something that Dr. Schubiner calls the FIT criteria, and that stands for functional inconsistent and triggered. And essentially what that is, is really looking at the pattern of the symptoms. And so are they things like, does the pain or does the symptom move around? Like I've seen people where they come in, like actually quite a lot in my career, where they say, it's just my whole right side of my body.

is pain, has pain. Well, there's nothing physiologic that would happen on just someone's half of their body. It's just not how we work. or it's, you know, maybe it started in on one, one area, but then it shifted and then moved to the other side of the body, or maybe it moved up, you know, up the limb or moved around. And I use the example of a sprained ankle because I think everybody understands that really well.

If you step off of a curb and you damage your ankle, you're not going to have pain in your knee. You're going to have pain in the ankle and it's going to be consistent over time. It's going to get a little bit better, little by little over time. But so again, if the pain, maybe it's there one day and not another day, or maybe it's worse in the morning and better in the evening, but then worse again. Again, if it's kind of shifting, moving around, it's inconsistent.

Are there external triggers that actually don't have to do with damage in our body that are causing the symptom, like looking at a computer screen? I there's nothing about just looking at a computer screen that actually would change anything structurally in our body. And this was actually a big one for me that was sort of a big aha moment because I think it's just something that we just take for granted. It is so normalized. yeah, of course computer screens cause headaches.

But when we really come down to thinking about what would actually be the mechanism physiologically, it just doesn't really make sense. It's really a conditioned response is the thing that would make sense to us. Yeah, right, exactly.

Chrissie Ott (31:06)
And why don't they cause headaches for everyone? It would be another question or of a majority

of people even. ⁓ So, so interesting. I love thinking about the context of illness. That feels so important ⁓ to me. And ⁓ yes, it makes absolute sense that yes, everybody gets a full medical workup. And then you look for particular patterns like these, these fit criteria.

Becca Kennedy, MD (31:14)
Yeah, exactly. Right.

Yeah,

right.

Chrissie Ott (31:37)
⁓

I just feel so excited for all of the people out there who might get some hope from hearing this. ⁓ I'm remembering my own journey with chronic low back pain. had about a five year period of an unstable lumbar disc. And while the entire five years was not marked by excruciating pain, the whole five years was marked by subdued physical trust in my body.

Becca Kennedy, MD (31:46)
Mm-hmm.

Chrissie Ott (32:07)
subdued physical freedom of movement, the feeling that anything could happen at any time. And it happened to me with a sneeze and it was like the second day of medical school.

Becca Kennedy, MD (32:14)
Mm-hmm.

Mmm.

Mmm.

Chrissie Ott (32:24)
So that was the first time that it blew out. And the last time that it really had a flare was during my last week of residency. So like, I don't know that I've ever put those two facts quite so succinctly next to each other before.

Becca Kennedy, MD (32:33)
Mmm.

Yeah. Mm-hmm. Yeah.

Chrissie Ott (32:42)
but I feel that there

is important insight in those bookends.

Becca Kennedy, MD (32:45)
Mm-hmm.

Yeah, right. And I think that we often we're really trained to to really connect up what's happening in our life and the stressors in our life with ⁓ really also like a specific symptom in our body. I think that we often assume that if there's stress, we just will feel generalized anxiety. And that will be how we feel it. But and I think actually, this is the other important part is that when our brain makes

a warning signal, it can be very, very specific. It can be not feeling anxious at all. And then just like I developed chronic pain and fatigue actually after I learned about this work and with lots of stressors going on for me in my life at the time. And in the manifestation for me was pain in my right knee. And it was very specific, just right there in my knee.

When I stood on it or walked on it or pressed it, I had pain, but that's where my brain chose to send the warning signal.

Chrissie Ott (34:00)
And you did this work.

Becca Kennedy, MD (34:03)
Yeah, right. So I did. So I kind of applied all of this and I had quite a lot of stressors going on at the time. Part of it was actually going diving, running into the house fire with this work. was challenging to do in a big system and learning how to do it. you know, a lot of people are understandably not necessarily open and some people got

really quite angry at me, but I actually was sort of feeling trapped that I now saw so many people that were helped with this that I couldn't stop doing it, but I didn't have the time and I didn't have the support. ⁓ then, you know, some of the patients getting mad at me, although it wasn't very many ⁓ and sort of feeling trapped going forward. But ⁓ it took me quite a while to

resolve my own issues, but it really helped me to having gone through it myself. It made me such a better doctor and able to give patients the tools that they needed to get better.

Chrissie Ott (35:15)
I definitely find that ⁓ is such a truth. Whatever I have gone through with my own body always makes me a better clinician, empathic and informed from having suffered. ⁓ I would love to hear, ⁓ especially for the sake of our listeners, what are the actual operational parts of this work? What does it look like to quote unquote do this work with you?

Becca Kennedy, MD (35:23)
Mm-hmm.

Yeah, right.

Yeah.

Yeah, yeah. So that when I learned about this, I was like, okay, all right, it's the brain, know, all this stuff. was like, okay, well then what do you do? Like, what did Dr. Schubiner do to get people better? Yes, right. And so I know exactly. So.

Chrissie Ott (35:58)
Yes, what is the doing? Tell us the doing stuff.

Becca Kennedy, MD (36:06)
I would say that nearly all of it is counterintuitive of what you actually do to get better. Because what's intuitive is an acute injury. What's intuitive is structural damage in the body. So again, if you have a sprained ankle, what you do is you listen to the pain and you stop moving it. You get off of it.

Chrissie Ott (36:12)
Okay, so get ready.

Becca Kennedy, MD (36:36)
You don't move it.

But now what you're doing is actually you're turning and facing the fear because what you need to do because it's what this is is a faulty danger signal that you don't actually need. so, mean, I guess yes and no. So.

Chrissie Ott (36:52)
Hmm. Ooh, I

like a light on your dashboard, which doesn't actually mean the engine is hot. It just means the light is malfunctioning.

Becca Kennedy, MD (37:04)
Right, exactly, yes. Right. So if the reason that that symptom is there, say you broke your hand, the pain signal is made, your hand healed, now your hand is perfectly fine, but your brain is still hypervigilant about your hand. Your brain is like, whoa, whoa, whoa. And this happens a lot. And I think a lot of physical therapists and even orthopedists even know this part. After someone has had surgery,

Chrissie Ott (37:06)
You

Becca Kennedy, MD (37:30)
They're actually healing okay, but their brain is super hypervigilant. So they need to sort of desensitize their brain around that area. So this is sort of the idea of that pain doesn't mean damage. So you actually move your body even though it's hurting. And so, but the way that you move is by bringing it, bringing in safe signals. So it's sort of like graded exposure. Like if your brain were afraid of heights,

you would go to a little bit of a height, little by little each day, bringing in safe signal. And as you do that little by little, then your brain kind of slowly learns, okay, I'm all right. So for me, for instance, I had pain in my knee and I knew that my knee was okay. So I would move it just the tiniest little bit. would like just even flexing my muscle would cause pain.

And I did like, there's no damage that I could be doing just with that movement. So I would actually turn that on. I would make that movement all through the day, just little by little kind of breathing easy, smiling, just saying to myself, Hey, that's my brain. It's okay. and then when I move my body, instead of moving in a way that's like guarded and be like, you know, like all of that is sending messages to the unconscious brain.

And so instead, it's just kind of moving light and easy. Like I work with a physical therapist ⁓ who does this work with me. And she talks about just move your body light and easy. So if you have shoulder pain is where you have the neuroplastic symptom, is you move it just light and easy. like if you're trying to do a big range

like you're just reinforcing that circuit. But if you're just like light and easy, like in a smaller range, you know, over and over, then your brain is learning, it's getting these signals and your brain is learning that that's okay. Like, and especially like moving something kind of like, kind of, kind of fast and loose. Like we don't move our body this way when it's injured. We move our body really guarded and slow.

So now this is sending different signals to my brain. again, it's counterintuitive, doesn't seem believable, but you have to start with the science first. Like someone has to understand the science, then you really have to go through the pieces of information of why it makes sense that they're having this symptom that's very specific in this part of their body, even though that

their body is not actually damaged, that this is the neural circuit in the brain. then it's, and again, if your body is damaged, then you would not move it. You would hold it and not move it so it can heal. But the difference is this, now you're moving it despite the symptom, but little by little. So that general concept is kind of one of the pieces.

Chrissie Ott (40:33)
If it were dizziness, what would that be like if it were not a musculoskeletal symptom? Would you just slowly do the things that induce dizziness?

Becca Kennedy, MD (40:34)
Okay.

So the other thing is, yeah, right.

So all of this is about turning and facing your fears, but doing it in a gentle, slow way with love. And it's all about compassion, self-love, like really is at the root of all of it. And so it would be so if it's pots, for instance, a pots is

positional orthostatic tachycardia syndrome. So the brain is hypervigilant.

Chrissie Ott (41:08)
Right, so when you stand up or sit up, your heart

goes really fast and your blood pressure drops and you probably pass out.

Becca Kennedy, MD (41:14)
Yeah. And people get dizzy. Sometimes weak.

Yeah. So it would be standing up and when the symptoms are there, sending yourself safe signals. So again, you're not going to start bungee jumping if you're afraid of heights. So, you're not going to stand up on the edge of something and just go up and down and up and down, know, 50 times. And so sometimes it's even starting with visualizing, doing the action.

And we know through functional MRIs that the same parts of our brain light up from visualizing doing a physical activity as actually doing the physical activity. And it's funny, because when you say it in this context, some people are like, and it seems woo woo, but this is what athletes do. And there's lots of research to show that visualizing what you do physically helps. And I always use the example, I'm like, LeBron James, number one, he's not gonna show up to a game.

Chrissie Ott (42:07)
Absolutely.

Becca Kennedy, MD (42:11)
and be sending himself these messages and say, you know, I can't really hit that basket. I'm not really good at shooting a basket. Now he's going to say positive messages. I know I can do this. I got this. He's going to visualize himself making the basket over and over. He's also going to warm up. He's going to get those neural circuits, that muscle memory that's just straight from his unconscious brain, straight to his body. He's going to warm that up before he gets on the court.

So it's the same sort of thing. And so I teach people visualization exercises where they visualize themselves standing up, feeling good, being strong and healthy. And sometimes that's where we start is they just visualize that because even just the visualization brings in fear. So we start wherever the patient is and little by little and then slowly kind of open that up.

Chrissie Ott (43:06)
Awesome. Will you please tell us some of the stories of people healing in surprising ways that you have personally observed?

Becca Kennedy, MD (43:19)
Yeah, absolutely. so before I do that, I'm going to give like a little bit of an overview of the other things too, because sometimes breaking that fear symptom loop is part of it and important and necessary. But the other part is also looking at what was going on in someone's life of why the symptoms started in the first place. And that's a really huge piece as well. And so

Chrissie Ott (43:28)
Sure.

Yeah.

Becca Kennedy, MD (43:46)
when people are going through a stressor and especially conflict is a big one. And so if someone is angry at someone that they love, can be where they feel trapped. So feeling trapped in someone's life is often an area that then it comes out through our body. And so sometimes repressed emotions is actually what's causing that warning signal. So again, being angry at someone that we also love.

And that anger gets created automatically in the unconscious brain. But if we don't express it, then it comes through our body. And so teaching people how to feel and express their emotions in a healthy, safe way, just by themselves, ⁓ is one of the other things, kind of tools that I use. ⁓ Also teaching people healthy communication of standing up for themselves, of boundary setting. Many times people have personality traits that

that lead to symptoms like this, of which I have all of them. But more often people have personality traits that are things like being high achieving, hard on ourselves, being a people pleaser, needing control, being a perfectionist. And those personality traits came about generally because of what our brain learns, what we went through, and they can be helpful for our lives in lots of different ways, but our brain takes them to the extreme. So learning to recognize that. so sometimes people need to start saying no to things in their life.

really put themselves on the front burner instead of themselves on the back burner. And that can be a very, very uncomfortable thing for someone's unconscious survival brain. So a lot of it is also really looking at someone's childhood and what their brain learned because of what they went through in their childhood. And now why their survival brain is perceiving danger even though there's not danger.

So a lot of this is really kind of more psychological ⁓ and really connecting those dots can be a really big part of this. And sometimes it's clear and this isn't people's unconscious brain and sometimes their unconscious brain actually doesn't want them to go there specifically. And so sometimes it can really ⁓ need some uncovering.

Chrissie Ott (46:07)
tracks. Do a lot of your patients also work with a therapist if that comes up and there's a lot of subconscious resistance to going there?

Becca Kennedy, MD (46:20)
Yeah, so actually a lot of the people that do this work are therapists. ⁓ The typical therapy though is doesn't like sort of the typical cognitive behavioral therapy or talk therapy generally doesn't address this stuff much, which is again why I started doing it myself because as a family medicine doctor, I see someone with, you know, chest pain or something, get them all worked up. I mean,

you know, their workup was completely normal. They're, you know, young, healthy 30 year old woman, for instance, and it would send them to mental health, and then they wouldn't get better and then come back to me. But you know, when there's the therapist and the therapist doesn't know sort of this work, and they tell the therapist, so I'm having crushing chest pain, then they, you know, send them back to the doctor. And then it's just like the sort of this chasm. So there, there are some really wonderful ⁓

therapists that do this mind-body work, but it does sort of require more training of the therapist to really connect up these pieces in a different way. But yes, many people do work with therapists.

Chrissie Ott (47:36)
Thanks for explaining that so thoroughly. ⁓ Now would you mind sharing with us some of the stories that you found particularly inspiring and exciting?

Becca Kennedy, MD (47:42)
Yeah.

Yeah!

Yeah, yeah, yeah, for sure. So

One of the focuses of my practice in this world is through long COVID. I was the lead of the long COVID clinic at Kaiser. So I assessed hundreds of patients with long COVID. And what I found, and also there's hundreds of people around the world that use this approach and have been doing so for a couple of decades. ⁓ And people around the world using this approach also help people with long COVID.

And ⁓ so looking at lung COVID is that it's really more about like the brain perceiving threat and then the sort of a dysregulated nervous system kind of stuck in the on mode, then sort of showering down all of these faulty messages. And there can be lots of different reasons why any one particular person kind of has their nervous system stuck in this dysregulated state that then is creating

all of these symptoms. ⁓

one that I worked with was kind of early on the sort of long COVID coming to light quite a few years ago. And a patient of mine was having buzzing and zapping kind of sensation. And for anyone that's worked with long COVID patients, that's a symptom that

lot of long COVID patients would have, and felt I think particularly scary because it was such an unusual sort of a symptom, like dizziness or the GI system not functioning or pain or something like that is something I think that we experience more, but feeling sort of little tremors inside in specific places or buzzes or zaps.

around the body felt very, very scary. And then coming into doctors and doctors sort of looking at her with wide eyes and not being able to understand it or, you know, would say, I don't know, I, you know, I've never seen this before. And whenever a doctor says that to a patient, really a patient's brain goes to, well, I must have something that's so dangerous and rare. My doctor doesn't even know about it and I'm going to die. I mean, that's kind of the go-to of, you know, where your brain goes.

But so working with her and talking with her about the science of it, and many of my patients would say, especially the long COVID patients would say to me, again, not everyone said this to me, but said, wow, that's the first thing a doctor said to me that actually makes sense. And she was one of the patients that responded in that way. And she was having a lot of ⁓ that conflict with her husband.

and felt angry at her husband who she also loved. And so one of the tools that we do again is teaching people how to express their emotions in a healthy, safe way and expressing anger to your partner and really getting mad at them doesn't necessarily work well, right? And so expressing that emotion actually just needs to be done by ourselves. It's really just for the benefit of our own unconscious brain.

So I teach people a technique of expressing the emotion just by themselves. And this can be done kind of spoken out, or there's a tool of expressive writing where you just write stream of consciousness and then get rid of it. It's different than journaling. And it's a way to just really get up and out what your brain is really fearing and wants to keep bottled up. so I taught her this technique and it's

And it's also, it's not just about like just getting angry and letting out the anger, although that's part of it. You deserve to be heard. But then it's connecting into compassion and understanding for yourself and really building and growing again that self-love. ⁓ And so doing a visualization of bringing in that compassion for yourself. And then it's getting to the understanding and compassion for the other person.

in order to then let go of the anger. And again, letting go of the anger is not about saying that's okay, anything like that, but really understanding humanity, frankly. But in processing the emotions in this way, and she was one of the first patients of mine that just started getting better really quickly. And the buzzing and zapping just started fading and got less and less until it resolved.

⁓ And the beautiful part of all this is it's not even just about the symptoms resolving and sort of getting your body back, but it's really about getting your life back and really looking at the patterns in our life that are not serving us and are not helpful for us. And again, that sort of healthy communication, being kind to ourself. And so it's really more of a transformation about kind of learning a whole new way

being that is again one about self-love and taking care of ourselves.

Chrissie Ott (53:09)
That's so remarkable. It's so holistic. ⁓ It's very deeply inspiring. And I know that so many people today are suffering with this conflagration of symptoms that we call long COVID. ⁓ And to have hope, just to have hope of getting back to normal is, ⁓ it's everything.

Becca Kennedy, MD (53:32)
Yeah.

Chrissie Ott (53:37)
everything if you are a loved one are in that camp. And I'm listening to the words with the with the ears of a physician coach, right? We started this conversation off with you explaining how you had two contradicting beliefs and you had to with awareness shift a belief which opened up this entire world of medicine exploration and service for you. And it points out to me

Becca Kennedy, MD (53:37)
Mm-hmm. Mm-hmm. Mm-hmm.

Yeah.

Yeah.

Chrissie Ott (54:06)
the potency of having those shifts of seeking those shifts especially with support can never be underestimated. Their importance, their potential cannot be overstated ⁓ because you wouldn't have helped this particular woman much less the scores of others had you not shifted that one belief. You just as well could have blown your friend off

Becca Kennedy, MD (54:17)
Mm-hmm. Mm-hmm. Mm-hmm.

Mm-hmm.

Chrissie Ott (54:33)
and said, well, guess Sally's gone off the deep end finally. You know, she's reporting to me that chronic pain is solvable with this guy named Howard Schubiner and whatever. And the cynicism could have just flushed that away. But instead something in you identified there's a spark here for me. Something here that just lit something up in my brain that I need to respond to creatively and with all of my life force right now.

Becca Kennedy, MD (54:37)
Yeah, right, right,

Yeah, right.

Yeah.

Yeah. Yeah.

Mm-hmm. Yeah, right. Yeah, that's exactly right.

Chrissie Ott (55:05)
How good, how good. And I wanna ground our conversation also a little bit in solving for joy. We haven't been in an explicit conversation about joy today, but I wanna make a dotted line because I have no doubt that doing this work and seeing its efficacy change lives, bring hope, must solve for joy for you. That must bring you meaning, alignment and delight. And for the people who are getting better from things that have been dismissed or

judged or in the worst case is actually ridiculed by allopathic medicine. ⁓ What, how much joy blockage has been removed for them? Am I right? Tell me about how that shows up for you.

Becca Kennedy, MD (55:39)
Yeah.

Yeah. my gosh, absolutely.

you know, and that's such a great reminder is that actually, so what I start with when I teach, like I teach a class around this, eight week class, and the first thing I start with is self-compassion and joy. And those are the tools because people want, you know, they're, high achievers, they're hard on themselves, you know, they're perfectionists and

Chrissie Ott (56:08)
Hmm.

Becca Kennedy, MD (56:16)
So they, and they want to fix themselves understandably. they're like, okay, well tell me what to do. What are the tools? What are the tools? And I, and I start with learn to really love yourself for who you are and bring joy into yourself every day. And that is where I start. And the joy piece is so important because the thing is, that when you are overwhelmed with these debilitating symptoms and

I mean, I work with people who literally can't get out of bed, you know, for years and can't tolerate any stimulation. Often the idea for me to say bring in joy just is so foreign. And they can even get angry at me about that and say, how can I possibly experience joy? And actually this is a beautiful story. This wasn't my patient, but my colleague, this wonderful, wonderful woman, Lili Agrawi, ⁓

who's a physician from Mexico. She had a patient that was bed bound for a very long time. And so the only thing she could do was move her fingers. So she started finger dancing. So she just danced with her fingers. And that's what she did for joy. And then she just slowly then danced with her hands. And then she just little by little by little.

started moving more of her body and it took her a very, very long time. I think it took her a couple of years, which is a ⁓ quite long time, but she got there and her symptoms resolved ultimately. But yeah, and I have another patient that actually is a patient of mine from Kaiser who when I first told her this, again, she just had so much pressure on herself, just carried around this huge burden and ⁓ her story is on my website even and she said,

Chrissie Ott (57:52)
Wow. Wow.

Becca Kennedy, MD (58:11)
She said, wow, you know, when Dr. Kennedy told me about this, I thought to myself, I've had a lot of trauma in my life and this is the thing that took me down. You know, it was really like surprising to her even. And it's really the accumulation over time that just makes our danger systems, you know, more and more more vigilant. And then it can just be the straw that broke the camel's back of actually having the viral infection.

Chrissie Ott (58:23)
You

course.

Exactly.

Becca Kennedy, MD (58:39)
And she, but she really talked about, said, yeah, bringing in joy, however you can do it, was really key to her recovery.

Chrissie Ott (58:49)
so powerful. And you know, if you're a listener who's hearing this and feeling absolute shut down in the face of it, I am here to normalize that too. Your response that this is unbelievable is completely believable. And that doesn't actually negate the fact that it's happening and real and you can take, you know, a baby tiny little step towards

Maybe it's possible, know, maybe it's not impossible. Maybe my negating brain is not all knowing. ⁓ And maybe I could crack this door just a hair to let in the possibility that there is ⁓ a shift in a change possible.

Becca Kennedy, MD (59:27)
⁓ huh.

Mm-hmm.

Mm-hmm.

Mm-hmm. Yeah.

Chrissie Ott (59:43)
share about your ⁓ eight week class. ⁓ And I really want to make sure that we leave a good trail for people who want to find you or send loved ones to you, because I don't think I know anybody who doesn't know somebody who's dealing with medically unexplained symptoms of some kind.

Becca Kennedy, MD (59:43)
No good.

Mm.

Yeah, exactly. Right.

Yeah, yeah, absolutely. So while I just finished my eight week class, it's a virtual class. I'm actually currently working on creating a self study online course right now. So hopefully, so I'm not doing another class live class for a little while. Hopefully that series will be done by the fall. And

I do, I hired this great team recently that is ⁓ a physical therapist that I talked about, a coach who recovered from debilitating chronic pain, back pain herself is really wonderful. And then a naturopath in Portland who's shifted over to doing this work completely. Who are all lovely, lovely people. On my website are lots and lots of resources. And the thing that's beautiful about this work is that

It's all self-management tools. And actually what I was gonna say is I think the hard part of this is really holding the validation for your symptoms. It is not your fault.

We are not blaming you. I developed symptoms after I learned about this work. This is about our subconscious brain that we do not have control over and the automatic functions with our body. It's like saying, make your fingernails stop growing. Well, I mean, right? Like that's not where you have, do not have control. But you do so it can, it's not easy to do this work, but it is more possible.

Chrissie Ott (1:01:26)
Not a thing.

Becca Kennedy, MD (1:01:40)
than you think. And again, it's pretty much all of it is counterintuitive. So there's no reason that you would know what to do. But you do have agency over the symptoms and thinking about it through this different way. So there's lots and lots of free ways to actually get the information. Dr. Schubiner has a free course on Coursera and that it's on my website, it's called the reign of

pain. His book is called Unlearn Your Pain. It's quite dense. It's written for patients and it has all the answers in there. But again, it is quite dense. ⁓ And again, lots and lots of podcasts, other books, lots of resources on my website.

which is resilience-healthcare.com.

Chrissie Ott (1:02:36)
And are you accepting new patients?

Becca Kennedy, MD (1:02:41)
I am. Yeah, I have a waiting list for myself in this moment, but my team is open and otherwise I am accepting, yeah.

Chrissie Ott (1:02:52)
That's so wonderful. I feel like we could talk for another entire hour about this topic and not run out of material at all. Maybe, maybe we'll do that again sometime. But I have, you know, like I have a handful of people that I'm already excited to connect to you and your team members. ⁓ And I'm really thrilled that Solving for Joy could be a place where somebody learns that this exists and

Becca Kennedy, MD (1:02:59)
Very true. Yes. Yes.

Yeah, yeah.

Yeah, yeah, absolutely. Yeah, yeah, absolutely. Yeah, I appreciate it.

Chrissie Ott (1:03:23)
connects to hope.

Thank you for shifting your belief. Thank you for running into the house fire and thank you for talking about it in public today. It's been such an enlightening conversation.

Becca Kennedy, MD (1:03:33)
Yeah.

Yeah, absolutely. Well, thank you for being open to

it and having me on. really appreciate it.

Chrissie Ott (1:03:43)
My pleasure. We'll talk again soon.

Becca Kennedy, MD (1:03:47)
Yeah, sounds good. Thank you.

Chrissie Ott (1:03:54)
Thank you again to Dr. Becca Kennedy for sharing this story with so much honesty, insight and heart. Dr. Kennedy's willingness to step outside the traditional path and center the patient and their humanity and her own offers a profound reminder and example that healing does not always follow the rules and the textbooks. Sometimes the most radical thing we can do is listen deeply and choose differently.

Next week, I am so excited to share with you a conversation with Dr. Red Hoffman. Red is a trauma surgeon, a palliative care physician, a Buddhist chaplain, and a naturopath whose work has bridged life, death, and everything in between. We talk about grief, compassion, medicine at the edge, and what it means to show up fully human in the hardest moments. If today's episode resonated with you,

I hope you'll consider joining us in person this fall at the Physician Coaching Summit. It's a gathering of physicians and physician coaches who are reimagining what's possible in medicine and in life.

Learn more at the physiciancoachingsummit.com. As a reminder, this podcast is for educational inspirational purposes only and is not intended as medical advice. I am a physician, but not your physician. Solving for Joy is produced by the extremely talented Kelsey Vaughn edited by Alyssa Wilkes and supported with so much love by my amazing wife Sue.

And thank you for listening, for showing up, and for letting joy be part of your journey. Keep solving for joy. We'll see you next time. And if you have a moment, please rate and review the podcast. Share with a friend. It means so much. Take care.