Welcome back to the Healing Pain Podcast with Gina Ryan
Breaking The Cycle Of Anxiety: The definition of anxiety is a feeling of worry, nervousness, or unease about an imminent event or something with an uncertain outcome. If you live with chronic pain for any period of time, you know that chronic pain is likely to cause a lot of the anxiety that you’re struggling with right now in your life. Upwards of 50% of those with chronic pain have been diagnosed with an anxiety disorder as well, such as a Generalized Anxiety Disorder, PTSD, social phobia, panic disorder, the list goes on.
Gina Ryan is the host of the Top 50 iTunes podcast called The Anxiety Coaches Podcast. She’s also a nutritionist who, herself, struggled with stress, anxiety, and panic for over twenty years. On her own, prior to the internet, prior to all these influx of information, she was able to climb out of her own anxiety and heal herself naturally, and now teaches thousands of others how to do the same. She’s here today to help us get out of this cycle of anxiety that so often goes with chronic pain we struggle with.
Breaking The Cycle Of Anxiety with Gina Ryan
Gina, welcome to The Healing Pain Podcast. It’s great to have you here.
Dr. Joe, thank you so much for having me. I love to share the word, the healing word.
Gina is the host of a podcast called The Anxiety Coaches Podcast. You can, of course, find that at www.TheAnxietyCoachesPodcast.com. She’s got such great information there for people who struggle with anxiety. Oftentimes, there are similar struggles and tension and worries and things that people with chronic pain are going through. You’re a nutritionist, which I am too, so we have so much in common, but I’d love to hear how you first discovered your own anxiety and how you were able to climb out of it.
Thank you for giving me an opportunity to share that. It was a long time ago now, but I remember it very clearly because a lot of changes in my life had to happen actually in order for me to climb out. I think it started when I was around eighteen, nineteen, that’s the general time I remember a lot of things happening. It could have been one event, but the way I see anxiety and I think what really happened to me is that there’s stress and there’s a straw that breaks the camel’s back. Stress is cumulative. That happened to me at eighteen, nineteen for whatever reason. I struggled for about twenty years, give or take. You come in and out, it depends on how life is happening, probably the same with pain, it increases or decreases depending. I know there had to be something to that. I was a nutritionist. I owned health food stores. I was the wellness coach for a big spa. I was like, “Why could I not figure this out?”
I had everything at my fingertips, Joe. I had every nutritional supplement available. I was really on the cutting edge back in those days. I really kept up on everything. There are pictures of me and Dr. Atkins and a lot of these other health movers, because that was my world. But I was suffering and so I had to take a bit of a shift. I realized that I was doing great things for my body and I was taking care of my health, but there were some pieces that were missing. I had to shift a little bit and look a little more inside. I looked at my spiritual life. I looked at my emotional life. I had the physical piece working, I was very healthy. That really started to make a difference. I realized at one point that when I could breathe myself into or out of a panic attack, I knew I was on to something. That’s when things started to shift.
It’s so interesting because you mentioned you had all the supplements at your disposal, but I’m sure you’ve tried to experiment with certain supplements. Maybe they did something at some point. Some patients do really well with GABA. They have a bit of an edge to come off with GABA. Ultimately you found that you had to go one layer deeper.
It was, and I have to say those supplements really helped me because they kept me from jumping off the bridge. It’s a horrible existence to feel that day in and day out. I did find wonderful supplements that did great things. I still have people do those kinds of changes, it’s important. I think it’s important to also know that that’s not the silver bullet, that’s not the only thing.
Let’s talk about nutrition just for a second. It’s not going to be the focus of our podcast, but I think a question or two is appropriate. For people with anxiety, what’s the number one and maybe the number two nutrition change that you recommend for them?
It gets real basic. It doesn’t even cost you anything. It actually saves you money, is to really get off of caffeine. I am amazed at the number of people that actually believe and work with me for a long time and not let go of it. When they do, it’s a shift. Again, it’s not the only thing but it’s a huge shift in their cortisol that is streaming through their body from first thing in the morning when they take it. I have to say that caffeine is a big thing. Sugar is a huge, huge piece. I’m a big real-food kind of gal and I’ve seen people make big changes in sugar for many reasons and affecting all the hormonal cascades. Then, supplements such as GABA, anything with GABA in it. I found homeopathics that are wonderful, no side effects, no worries, such as Hyland’s Homeopathic Calms Forté. You can take a little bit more at night. A lot of people with anxiety, Joe, were afraid of supplements even. They’re afraid of herbs. I tell them that you could take this whole bottle and would not be harmed. You know how much of it is placebo and how much of it is homeopathic? It gives them a breath of fresh air and then you can do the other pieces of work that need to happen.
I’m so glad you brought up caffeine actually, because on my podcast I’ve had a lot of people talk about nutrition, especially as it relates to pain. People just skip over caffeine as, “It’s okay because everyone has a cup of coffee in the morning.” I find even those people with “just having one cup of coffee in the morning,” I’m always like, “Can you show me exactly the size of the cup that you’re drinking? Bring the cup in to the session,” and they bring in basically a thermos of caffeine. Then I start to say, “Caffeine is a drug. It’s the legalized drug that some people use and abuse just like other drugs. It affects your nervous system basically on every level. We figure out why people have anxiety. We figure out why people have gut issues because they’re on too much caffeine and all those things. It’s putting one and one together for people, and they say, “Let me back off the cup of Joe,” no pun intended.
Yeah and how all that really works. When your gut is off, when your microbiome is off, your brain is off. It’s a constant loop. Caffeine plays are a very big part in there.
Early in the podcast, you mentioned breathing, you mentioned breath. People with the worst types of chronic pain, they come to me and they are fearful, of course. They’re very anxious. Some are borderline depressed. They don’t want to exercise. I’ve tried exercise, I’ve tried physical therapy. They don’t want to do that. I’ve tried some nutrition. Oftentimes, they talk to me about the importance of getting in touch with their breath and what that really means to them. Can you explain how that’s impacted your work?
Yes. This is one of those things that doesn’t cost you anything except your willingness and the time. It comes into mindfulness because the breath connects our mind with our body. We bring our thoughts, which are our mind, to our body and we can do that with the breath. You probably have this with people with pain and also with their anxiety, is that when they start to pay attention to their breath, they get it all goofed up and then they feel like they’re hyperventilating. I try to bring it back to the most absolute basic place, which is just to relax the belly, which in this culture, we don’t do because we are protecting our core or we’re looking thin. It’s very important to relax the belly. I call it the Buddha belly, and it just lets the diaphragm flatten out naturally. You don’t have to do anything except let go of the belly. Then the breath goes deeper just on its own. You don’t have to count more in or count more out, you just relax the belly. Then on the exhale is where you concentrate and you just extend it. Just try to make it last a little bit longer which slows it down and it starts to change, obviously, the carbon dioxide and the oxygen levels. They don’t need to understand all that or think about it, just slow it down. Then the inhale always takes care of itself.
A lot of people have gone to exercise professionals. Let’s say they’ve had back pain, they’ve been literally taught to hold their stomach in and that’s a way to protect their back. That’s really, really old false information around how to help people with pain. Like you said, when you breathe, you’re supposed to get relaxation and contraction of your belly, of your diaphragm that’s supposed to smoothly and rhythmically go in and out just naturally. Then of course there’s the other part, like you mentioned, people just want to hold their bellies in because they want to look about five pounds thinner and that’s an easy way to do that. That may be okay on a Friday night if you’re at the cocktail party, but for the rest of your life, the belly was meant to breathe. Have you studied Mindfulness-Based Stress Reduction?
Yes. Actually, I have been studying mindfulness before even it was popular back, because obviously, prior to the internet, I got out of this, so it’s been quite a while. I actually started with a lot of Buddhist training and philosophy. I found peace and I found calmness in the Buddhist philosophy, and so that moved me toward mindfulness. Jon Kabat-Zinn, I attribute as one of my early teachers in mindfulness and Sharon Salzberg. I shouldn’t say I’m not officially trained. I did not do Jon’s, because I studied a lot of that before they had that course work. It’s what happens when you get a little bit on in the years here, you get to have been experience things. I had to put it all together, but I read everything and his books are all dog-eared. I have followed that work as a basis for my own life.
It’s a great point because now we have more traditional Mindfulness-Based Stress Reduction programs. Years ago it was really just a skill that was handed down by going to a class or working with a teacher or going to a Buddhist center, and you would learn these basic principles that slowly, Jon Kabat-Zinn, you mentioned is probably the pioneer, starts to integrate this into practice. Some physical therapists have started to integrate it into practice, I use it in practice. It’s out there. I think it’s a great point that you don’t have to take a one-year program on it. You can learn some basic principles that will help your clients, whether they have anxiety or chronic pain. How does medication get in the way of helping those with anxiety? Just like with pain, when they go to a practitioner and say, “Here’s my problem,” oftentimes the first thing that is pulled out is the prescription pad. How does that get in the way of helping someone with anxiety?
I’ve really seen that firsthand when I worked with eating disorder clients, which I did here. When I first came to Maui, I didn’t have a job. Twelve years ago I teamed up with some of the eating disorder centers at in-patient and then intensive out-patient, two different centers. The intensive out-patient center, one of their key goals was to get those clients off of medication first because they really saw that they couldn’t do the work, the deep work that needed to happen. People need to be on medications for various reasons and I have no judgment on it and I work with everyone, medication or not, because we do what we need to do in the time that we’re doing it.
It did show that the deeper internal work and the finding of themselves, which really can start to unfold why you have pain, why you were anxious, and being able to let go of those things, worked better for the clients if they were off of medications. I see it all the time. It’s now such a go-to. When I had anxiety, I went to the doctor. Of course, they didn’t do anti-depressants back in the day. All they could offer me was something to sleep. I was way to have natural ‘60s girl to take that kind of drug, so I passed on that, thank goodness, because that would have been a trap also. I think the medications really get in the way and that’s the first line that most people who go to their general practitioner get when they show up with anxiety. They are offered medication. Many medications, not just one, usually two you walk out with.
It’s interesting how people get two. I have a friend who just fell and fractured just a little piece of her back, her transverse process, so not a part of your back that really prevent you from moving for any lengthy period of time. She was actually given 90 pills of a narcotic. This is from the hospital. 90 pills of narcotic plus a 30-day supply of Ibuprofen. You’re right that people are often given one plus or two to three pills, with little informed consent. It’s probably the biggest part because some of the anxiety medications can be addictive.
There’s no doubt about it. The anti-anxiety, the Xanax, those are highly addictive and no one has told that. That’s why I say, in my group, to people, “How can we have judgment on it? You didn’t even know what you were doing.”
In patients that you’ve started to work with, how long does it take them to start to wean off those medications once they start to do some of the work that you do as an anxiety coach?
I don’t wean them off. I have had to stay out of the drug part of that treatment for them because I’m not a medical practitioner. I’m a coach. I clearly stay out of that, but I support them as their physician is working with them. If they can’t find a physician to work with them, I support them to find a physician that will help them to do that. It can take a little bit of time. It really depends on the person and their willingness to persevere. It’s not an easy journey and it can be a long journey, but the people that have done it are so pleased and they’re usually very vocal about their journey. They’re out there telling people, “Please know what you’re getting into when you start this because you can’t just come off of them.”
I’m talking with Gina about anxiety. She’s the host of The Anxiety Coaches Podcast. She’s an anxiety coach herself. She’s been doing the podcast now for some time. I love doing a podcast, I love talking to people, I love reaching people, it’s so much fun. What are some of the pleasures that you’ve really experienced from being a host of that podcast?
I can’t believe, Joe, how much the podcast has made my work so delightful. I’ve always liked working with people, but to be able to reach as many people as you can reach on a podcast, I had no idea when I took over on this journey. I have to say, even before I talked to you today, I had an email that brought tears to my eyes. I was like, “I’m going to be like bloodshot now.” People that don’t say anything in the Facebook group, they’re not people who belong in the Facebook group. To get these emails where they call me their teacher and their guide, that just hearing my voice helps them to realize they are not alone and that there is calmness in the world, it’s awesome. I am shocked because I never knew that I could do it first off. To be able to reach people by just sharing your own story in the way you know is helpful to get out.
Having great people to help you support that is another wonderful thing as well. When I was on your podcast, we started talking. I think this was when the podcast ended. You started talking to me about your mom. Your mom was having some challenges and she saw a physical therapist and had really, really good success. Can you share that story with us?
Yes. I almost did it earlier on the medication piece, but I’m glad I waited. I’ll give mom full focus, and I do have her permission to talk about this, too. She’s so cute. She was like, “Of course.” My mom had had a number of things. She’s 84. She had been on a number of medications and one of them was a blood pressure medicine that was making her faint and I kept mentioning that. I’m the daughter, she can’t understand what I do for a living, so she was like, “But all of my friends are on blood pressure medicine.” I think they very easily go along with what the doctor prescribe as far as medication.
Long story short, she had some hospitalizations. They get her off some medicines. They see that she’s on too many things. There was still this pain med. This is a tough one, this is why we have to be so careful with these addictive medications. She was on a narcotic for her back pain and then it went to leg pain, so I’m real suspicious right there. They’re like, “No, just keep taking it. It helps you sleep at night.” She had one physical therapist came to the house. It just didn’t tune in with her. It might have been her insurance that they couldn’t keep coming, whatever. She finds this other gal that she goes to and they made a connection. This physical therapist took time with my 84-year-old mother, bless her heart, and helped my mother to see that this isn’t really causing this kind of pain. She explained things to my mother. She helped her understand that she could do other things for this pain, that it didn’t need to be a narcotic.
Lo and behold, very long story short, my mother ends up using melatonin. The physical therapist helped my mother realize, “When you’re waking up at a certain time at night, why don’t you just try the melatonin? See if it will keep you asleep because maybe it’s not the pain, but when you wake up you feel the pain.” She tried it and now, Joe, my mom’s not even on the melatonin anymore. This physical therapist, through her knowledge and her training and her ability to make a connection with a patient, changed my mother’s life.
The therapeutic bond is so important and it’s something that doesn’t get enough attention either in research or really in clinical practice. We’re really figuring out how do we make these bonds with people? If you’re a physical therapist, every half hour, every hour, there’s a new patient coming in. Part of your job, part of your responsibility as a physical therapist or any other practitioner is figuring out what to provide this person, whether it’s nutrition or Mindfulness-Based Stress Reduction. A big part of it is first, make that bond. Make the bond first, then go through the entire history, the physical exam, start the treatment. Then as a through-line with the rest of the treatments, continue to reinforce that bond. It’s so super important. When people feel that bond, they are much more likely to get better. They’re more likely to feel that you have a certain skill that’s helping them, they feel confident. How long did your mom do physical therapy for?
She ended up doing physical therapy with this particular woman for about three months. It wasn’t even a life-long kind of thing. There’s no cane now. My mother was looking at a wheelchair. Now there’s not even the cane. She’s getting better at 84, not worse.
When she started, she was using something to help her ambulate, like a cane or a walker?
Then after two, three months of PT, nothing?
Right, nothing. A lot of it was about the confidence that this woman helped her to find, “I can do this. I’m not going older and older, I’m going to go downhill.” I don’t even know this woman’s name. If I did I’d be blasting it out to the universe here. Anyone who’s a physical therapist, thank you for making a connection with people and being able to help them. You tell me, Joe. Do physical therapists maybe have more time or a chance to make that connection? I know the doctors of regular, general practitioners have no time for patients.
Generally, as a profession, we definitely have more time with people than the average practitioner. You figure the average primary care physician see one patient every eight minutes to one patient every, if they’re lucky, every seventeen minutes, let’s say. The average PT probably is spending somewhere between 25 to upwards over an hour, depending on what type of practice environment they’re in. The better practice environment, they’re typically spending at least a half hour with the patient. They have that ability to make that bond. So often, patients will start out and they’re not sure about physical therapy, “Am I gonna be lifting weights? Are you massaging me? They’re not really quite sure what physical therapists do. After a couple of visits, as they start to obviously, one, feel better and then two, realize that going to this place twice a week and working with the PT one-on-one is a really wonderful thing, “It’s really been a positive thing not only for decreasing my pain and increasing my function, but I just generally enjoy having someone there that’s looking over my health.”
The better therapists are the ones that integrate aspects of not only the physical rehab but also they start talking about nutrition. They start talking about the brain and mindfulness and thoughts and coping. All that really comes together into a really nice blend of what’s called, as you know, the biopsychosocial model of care. When you do that, it releases the magic sauce. That’s what my podcast is about, that’s what my books are about, my programs. It’s really about promoting that type of approach. I love your story and I’m so glad your mom is doing better. Is she 85 now?
She’ll be 85 in December.
Gina, it’s been great talking with you today. Gina is of course the host of the wildly popular, The Anxiety Coaches Podcast. How can people learn more about you other than going to that website?
Everything is on the website so that’s the home. We also have a very active and a nourishing Facebook group. We have 50, 100 people in that group now. Everything’s available by Anxiety Coaches Podcast and the podcasts are on iTunes and YouTube and all the usual places. I would love to hear from you. If you want more information, check us out.
I want to thank Gina Ryan for being on The Healing Pain Podcast this week. Check her out at the AnxietyCoachesPodcast.com. Of course, with every podcast, make sure to give us a five-star review on iTunes. Share this out with your friends and family so we can help spread the message of how you can heal 100% naturally from both anxiety and chronic pain. Thank you very much. This is Dr. Joe Tatta, and we will talk next week.
About Gina Ryan
Gina Ryan is the host and coach of the top 50 Health iTunes podcast T he Anxiety Coaches Podcast . Gina is also a Nutritionist who herself struggled with stress, anxiety and panic for over 20 years. On her own, prior to the internet, she was able to climb out of her anxiety to peace and well being by trial and error and now teaches thousands how to do the same.
After moving to Maui Gina worked as the nutritionist for an Intensive Outpatient Eating Disorder Center and the only Residential ED Facility in Hawaii using her knowledge and wisdom of the mind -body and spirit to help clients clear their food related anxiety, obsessions and compulsions.
Gina currently works as an Anxiety Coach and also teaches Mindful Meditation for Anxiety to clients around the world. She considers her work her calling and is fully immersed in living a healthy, mindful and compassionate life.
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