The Path to Wellness

Dr. Lisa Marie Bobby: This is Dr. Lisa Marie Bobby, and you’re listening to The Love, Happiness, and Success podcast.

[Intro Song: And Miles to Go by November Polaroid]

Dr. Lisa: That bit of audio dreaminess is from a band called November Polaroid. I just came across them recently and I am diggin’ the November Polaroid. They have all kinds of great stuff. Check them out. That particular song is called And Miles to Go. In listening to that song, I thought it so beautifully captured the emotional experience of being on a long long journey with a destination that might not be perfectly clear or certain, sometimes, and embracing that fact, and making peace with it, and continuing to keep going. 

All of this is a preamble for our topic today. Because today, we’re going to be talking about something different for the show. We are going to be talking about the journey, the path back to wellness that I know many people find themselves on whether they want to be or not. Over, probably, the last year or so, I have been hearing from listeners, from clients in my practice at Growing Self, and also have had the experience of just having relationships with people who have been dealing with significant health issues and health issues that vexingly don’t always have a clear cause or a clear path to resolution. It impacts so many different things in their lives. It requires a lot of time, and energy, and faith, and investment back into you and health in order to be well again. 

I’m just seeing so much more of this lately, and hearing from you guys that you need support around this, I was thinking, “How can I continue to be helpful to my listeners?” I thought, “Amy-Noelle.” Amy-Noelle Shih is a therapist. She’s a life coach. She’s a marriage counselor that works with me here at Growing Self. Over the last year or so, while Amy had specialized really in life coaching, and therapy, and couples counseling, she has really developed the specialty around, not even just health coaching, but supporting people who have been experiencing challenging chronic health issues and are finding their way through that tunnel and back out into health. 

I invited her to join me on the podcast today to talk more about this issue and provide you with some, not just ideas for what to do next, but ways of being mentally and emotionally so that you have the strength, and the self-compassion, and the inner resources to be fighting this battle. We’re also going to be talking about how some of these issues can impact relationships, the relationship that you have with yourself, or with your friends and family. If you have a partner or a close friend who’s going through this, this is also going to give you some insight in how to be genuinely supportive to people who are dealing with this very real thing. 

That said, Amy-Noelle, thank you so much for joining me today. I’m so glad that you’re here and also just to have the opportunity to talk with you about this important subject. Thank you. 

Amy-Noelle: Thank you for having me. 

Dr. Lisa: I have so many questions for you, but before we jump in, I was wondering if we could first talk a little bit about your background, in general, but also how you became interested in this particular sub-segment of wellness and emotional health. 

Amy-Noelle: I think I’ve always had an interest in health and looking at just overall, holistically, how we live our life. Even when I work with my clients, I’m looking at everything from a holistic approach and understanding what is going on. What are the deeper issues? Is it something physical? Is it looking at a psychological component, the physical component, the spiritual component? It’s certainly always been an interest of mine to look at all things from a holistic approach. 

I think when I really started to look at my health in a whole new way, I was working with clients and I started to get sick in the past couple of years, I was having all kinds of symptoms with myself, just nonspecific symptoms were going on. I was experiencing tingling, and heart palpitations, and tremors. I was sweating in the night and it appeared that I was having menopausal symptoms. I was having allergies. 

I was going to so many doctors. Each of them were treating me for different symptoms, and looking at maybe I was perimenopausal, or looking at that I had allergies, or treating me for migraines. I started, I was getting sicker and sicker and I wasn’t getting better. It just didn’t make any sense. Then, one day, I had gone to work like any other day. I’m working with a client. I’m actually on a coaching call. I knew something was very wrong. When I got off the phone, I did not have much time. I walked over to my colleague’s office and I literally collapsed. This would be the moment that really became a defining moment that would completely change my life.

Dr. Lisa: If I could share, I remember that day. We’ve been working here at Growing Self together for a while, but that was towards even the beginning of our relationship. I just remember talking to you, and you were in the hospital. It was very intense and very real. It must have been terrifying. You were saying that that was the wake-up call when you were like, “There is something different happening.” 

Amy-Noelle: What I found out was that there was toxic mold in my office. I was exposed to toxic mold. Then I found out, I went to a holistic practitioner who specializes in functional medicine and integrative medicine. They diagnosed me with mold toxicity. I didn’t know anything about mold toxicity. I didn’t know what it was. I didn’t even know that I could have that. I had heard of toxic mold, but I really had no idea and would have not been what I thought I had.

Dr. Lisa: You’re based in Houston. I guess this is a thing in that part of the country. Given some of the flooding and things that you’ve had, that is happening more and more commonly.

Amy-Noelle: Yes. There is an epidemic. I just even recently had a potential client who I may be working with who also, that’s why she came to me because she also has mold toxicity. We’re seeing this more and more, not just mold toxicity, but we’re seeing chronic illness. This isn’t just in Houston. This is really throughout the United States. More and more people are diagnosed with some type of chronic illness whether it is chronic fatigue, Lyme disease, mold toxicity, fibromyalgia.

Dr. Lisa: No, it’s so true. Even in my own network, I have two people in my life that I care very much about, who have been dealing with these fairly debilitating health issues. They’re going to doctors, and the doctors are like, “Yeah, not really sure what’s going on.” There aren’t answers, and they’re really struggling. That would be a nice place to go. 

If somebody is listening to this, in your experience, what are the kinds of things that you’ve seen, clients and people that you work with, who are beginning to come to the conclusion that there’s something more going on? I’m not talking about asking you to give medical advice, but from a psychological or emotional perspective, is there a shift that you see in people from almost just blowing off their experiences and dealing and dealing and dealing to arriving at this moment of, “No, I’m having something more serious going on with me.” Can you say a little bit more about that, just inner journey almost?

Step 1: Listen to Your Body

Amy-Noelle: When I have worked with clients, oftentimes, when they are not understanding, “Why am I so tired all the time? Why is it that I am constantly not feeling like myself?” They don’t know. Oftentimes, when they’re coming to me, they’re sharing that they’ve been to many doctors. They start to feel that no one is listening to them. “Am I crazy? What is this?” Even the people around them may not understand it. They may think they’re hypochondriac, that it’s nothing. Because the thing about chronic illness is that, even if it’s mold toxicity, it doesn’t mean that it’s going to affect everyone who’s in that environment. 

Oftentimes, the reason why we are susceptible to chronic illness is because of other underlying issues that have been going on for some time. When people are first starting to really realize something is really wrong here, and I don’t know what to do. Just having that awareness of recognizing and not dismissing it becomes the first crucial protocol here is to recognize. Because, oftentimes, we’ll try to push it down and say, “We’re so busy.” We have too much on our plate. We still have this mentality that, “I don’t have time for this. Just give me a pill. Just make it go away.” We’re going to a doctor, “What can you do to nip it in the bud?” 

Then, it’s not going away, and it’s just getting worse. The wake-up call is getting louder and louder and louder until you either end up in the hospital or you collapse. You realize, “I can’t turn away from this anymore. I have to look at this. I can’t dismiss this anymore.” This actually becomes the first part of healing: looking at it, noticing it, not pushing it away, not dismissing it, and really just being aware of it, and allowing it to be. This is the place that’s, oftentimes, the hardest is accepting the reality unfolding before you. The reality that’s unfolding before you is saying, “Something is wrong here.” Your body is saying this. 

This is where I, oftentimes, teach my clients that our bodies are speaking to us and trying to speak to us. But we are in our minds and in our stories. Our story says, “I’m so busy. I have two kids to take care of. I have three kids to take care of. I have my job. I have a 40, 50-hour workweek. I don’t have time for this. I can’t take care of this.” Yet, the body’s saying, “But you must.” You must take care of this because it’s only a matter of time where something is going to happen. Whether you end up in the hospital, or like me, collapse on the floor, you have no choice, but to look at this and to accept that this is a real reality.

Dr. Lisa: I’m just thinking as you’re talking, in addition to listening to your body, I’m just thinking about how much strength is required, emotionally, because you also really need to be validating your own experience while, I’m guessing, other people are not validating the experience. I’m just imagining going to your standard-issue doctor who has 12.4 minutes to talk to you. If it’s more complex than that, they’re like, “Yeah. Good luck with that,” and walk out the door. I would imagine feeling minimized, or brushed off, or what you were saying like, “Oh, it’s just perimenopause. Don’t worry about it,” that kind of thing. You need to push back against people with a lot of power and a lot of authority to be your own advocate. I would imagine that feels hard, sometimes, especially– 

Amy-Noelle: It’s so hard. You can’t help but to have self-doubt. You start doubting yourself and thinking, “Am I making this up? Am I some part of this? Am I somehow creating this?” For a while, you may even begin to tell yourself that story. But the symptoms are there and you become so desperate. In this place of desperation, it oftentimes requires finding people who can support you, meaning it means looking outside of conventional medicine. 

I know for myself, that’s what happened. I was going from doctor to doctor to doctor realizing, “Something is not right here.” I remember I even went to one doctor because I was so severely dehydrated. Now, when I look at why I was so severely dehydrated, it was because my body was fighting. It was fighting. I had all these toxins in me and I didn’t know how to rid them of it. My liver was failing. My body was overcompensating. I remember I went to one doctor because I was so… I literally… Now, I know I’m not getting water to myself. 

Then, when I was so severely dehydrated, I remember a doctor had shared and said to me, “Well, if you’re going to…” Because I even said that I couldn’t quit going to the bathroom. I had urge incontinence, “What do I do?” I even had the doctor say, “You’re taking too many liquids, that even sometimes dehydration is caused from drinking too much.” I remember thinking, “This does not make sense.” 

At some point, we have to begin to listen to ourselves. We have to take a stand by allowing ourselves to recognize something is very wrong. We may not know what it is, but that’s the first step: validating and seeing something really is wrong here. “I don’t know the answer, but something’s not right here. I’m going to need a different support system, different support out there to understand this better.”

Dr. Lisa: That’s what was coming up for me, as we were talking that step one is validating yourself. But then, really, it sounds like a very important piece of this journey is expanding your network of support and connecting with people who can, maybe, have a different perspective, and be allies for you on this journey, and be able to offer a perspective or solutions. What you’re saying is just because if you can’t find the help that you need in one place, don’t give up. Keep going. Keep looking and keep seeking.

Step 2: Find a Team

Amy-Noelle: Keep looking. What I do know is that what’s so interesting on my own path is finding that so many doctors who now specialize in chronic illness, they didn’t know we specialize in chronic illness. They actually were in conventional medicine, but what happened is they, themselves, experienced some chronic illness. 

Dr. Lisa: I didn’t know that.

Amy-Noelle: Even Dr. Hyman, who is a pioneer of functional medicine, had mold toxicity. He had heavy metals and he could not find the answers with conventional medicine. He recognized that there was a limitation. He speaks a lot about this. Even in medical school, he said that they were not taught about these kinds of chronic illnesses. They still aren’t taught today. He had to go on a different path, looking for answers, and recognizing that there were limitations in what conventional medicine had to offer. This is what we’re learning. A lot of doctors who specialize in chronic illnesses do so because they are living with chronic illness themselves. There is so much help out there now.

Dr. Lisa: But that was awesome, though, especially for somebody with medical knowledge, but also that has empathy, and actually gets it because they have lived through it. I could just imagine that it feels so good to be connecting with a person who can help you who also gets it.

Amy-Noelle: Yes, absolutely, just having the right direction. When I realized that I was going to all these doctors, and even when I started going to a holistic doctor, they may not have all the answers, but you start to recognize each doctor has something very valuable to offer. Even when I was going to this one practitioner who specialized in integrative and functional medicine, what she had done for me has at least gotten me on the right path. Just to be on the right path. In the beginning, I was taking so many supplements, but realizing that I was still, there was a lot of gray and I did not understand what was going on with me. 

It doesn’t mean when you get with one doctor and you’re given an answer and something starts working, it doesn’t mean that everything is going to be perfect. It’s a chronic illness. What we know is it’s very hard to treat because it looks different in everyone. It’s not understood. It’s very murky. It’s gray. Even when you start to get help, you may have to constantly be searching and looking for additional resources—which I’ve had to do—to piece together a team where I’m able to see benefits and be in a better place today.

Dr. Lisa: What a journey, the buzz words that are popping up into my mind as you’re talking. Persistence is also a really big one. What it looks like is trying something, seeing how it goes, and then modifying it again and again and again until you really begin to create a system that works for you. That isn’t something that you’re just going to be handed. You’re describing an inner process where it’s a lot of personal responsibility, and advocating for yourself, and checking in with yourself because it’s also easy to go to the holistic doctor, and he’s like, “Okay, take 27 supplements and stand on your head three times a day and you’ll be better.” What you’re saying is like, “Okay, I tried that. Actually, that wasn’t the whole answer for me, either.” You need to stay in this empowered place.

Amy-Noelle: Absolutely, yes. What I know is crucial: you need a doctor who will be able to follow up with you, who has a team. Because what is true about chronic illness is that you’re so fragile. Even when you take a supplement, the supplement may begin to make you sick. There needs to be a constant following up with a client, meaning, “Okay, that supplement’s not working. Let’s take you off that. Let’s try this.” Because it’s such a delicate process. 

You need to have communication with your doctor, or their assistant, or some support team, where you’re able to call them, and you’re able to say, “This isn’t working,” or you’re able to email someone because so much about treating chronic illness, that’s what it requires. It requires going back and forth, communicating, recognizing what’s not working, not allowing you to stay on something that’s not working. 

Oftentimes, some doctors are not able to give you this kind of attention. You do feel in the dark. You start to regress and it feels scary because you think you’re doing so much. Then, here you are now regressing again and you don’t understand why. It was very important for me to find a team of doctors, where there was a follow-up. “Who can I call when I need to call someone?”

Step 3: Practice Mindfulness

Dr. Lisa: I’m just imagining there’s the medical side, but then our side of being in a role of supporting somebody who’s going through this. It’s so much support to be able to have a place to be and then this happened. Not again the medical advice piece, but that coming back into yourself. What do you need? For somebody to be able to say, “I think I actually need more support than I’m getting from this doctor.” To validate that, and then go back out there, and have the strength to go back out there because as you’re talking about this, I’m almost feeling that because you don’t feel good. You have low energy. You’re probably hurting. Then, it takes so much strength and energy to say, “Hey, Doctor-so-and-so, let’s try this again.” That’s hard. That is always hard and so to have that support system.

Amy-Noelle: It’s so hard. Because oftentimes you only have a few hours. Oftentimes, people who have chronic illnesses, these are debilitating symptoms. There are hours of the day, where it is debilitating. What I say to my clients who are going through something like this, and what I’m doing when I’m in an episode, this is where mindfulness becomes your support system. Oftentimes, if I am in an episode, or if my clients are talking about this, we are practicing what it means to stay on the breath. 

Something happens when you are experiencing pain. What happens is our mind wants to concoct fear stories of what’s going to happen. We can easily spiral down into a fear place, a fear mindset, and this will cripple us, too. We will begin to say, “Does this mean I won’t ever be able to work again? Does this mean I won’t be able to take vacations? Will my life never be the same?” We’ll continue to go on with these what-if scenarios. 

What becomes so crucial is when you are breathing and you’re staying on the breath. It is okay to have fear. But there is a difference between having the fear and becoming it. As you have the fear, yes, this is scary. You validate that, but you stay on the breath, and you almost are just so focused on your breath, and you’re allowing yourself to notice all your symptoms. It’s almost as if you are detached. What I mean by detached is that you are outside of what’s happening to your physical body, meaning you’re watching it. You’re watching this tremor that you’re experiencing, or you’re watching this chronic pain that you’re feeling. What that does for you is that it just keeps you from moving into a fear place. 

Once you continue to watch it, and this is what I would do, I would continue to watch it and breathe, and watch it and breathe. I wouldn’t go into the fear. I wouldn’t go into the fear. Then, something else happens. This is what I often ask my clients to do is to practice self-compassion statements, meaning to notice what is going well. Anytime, whatever has gotten you through a previous episode, whatever has allowed you to get through an episode, to have the self-compassion statement to say, “I am breathing well. I’ve been able to take a good breath. I see that my body is improving in this way. Today I had less tremors. I know that you can get through this. You got through this the last time. I see that you are working so hard for me.” 

I will even talk to my liver, I will say, “You’re working so hard for me and you are detoxing. You did such a fabulous job the other day, whether it’s detoxing. You’re having fewer migraines.” Because what this does is that you’re taking your mind to the most positive, true perspective. This is not woo woo. This is truly focusing on what is the most positive true perspective here. It’s almost like an IV drip of self-compassion where you are nourishing every cell of your body with this loving compassion. Because what happens is when we go into the fear mindset, not only are we spiraling down into a place where we’re becoming more frightened, but we aren’t able to harness the little energy we have. It drains our energy, which is so precious. 

Dr. Lisa: What you’re saying is so well-documented. When we are having an elevated physiological response, so fight or flight, which is what happens when we’re feeling afraid or threatened, it dumps stress hormones into our system: adrenaline, cortisol. It changes our respiration, our heart rate. Also very well-documented that it results in a suppression of your immune system. Your mind-body is so connected. 

What you’re saying, and just for listeners who don’t know you the way that I know you, Amy-Noelle has many years of experience in mindfulness training. She is a very good teacher and practitioner of this. You’re saying to use those mindfulness skills to notice the emotions, but not get sucked down the drain and have it turned into this total panic mode so that you’re doing everything that you can, mentally, to stay in a good place and not make the situation worse. You’re observing it. You’re being compassionate with yourself very deliberately. Because without that intentional practice, it can mushroom and get even worse, internally.

Amy-Noelle: Yeah, yes. The other part to this is that there’s, oftentimes, an emotional component to healing. Oftentimes, when we allow ourselves to stay on the breath, what we’re also allowing isn’t allowing, we’re allowing the experience to happen. We are accepting this reality. We are allowing whatever to unfold in the moment. 

Oftentimes, what can happen is that maybe a deep emotion will come up. This could be a trapped emotion meaning, oftentimes, an emotion we’ve repressed. This will, oftentimes, come up. It’s important to also be with our emotions, and experience them, and experience this emotional part that is very much a part of healing, whether it’s a trapped emotion, meaning that there may be old pain. There may be a past trauma. Even as you are mindful, it allows for this space of allowing and for other emotions to come up, other felt experiences.

Dr. Lisa: I get that and I could almost see because you’re being put back in a place where you are, relatively speaking, helpless and, in some ways, hurting and having these very basic primal things come up. Also, this is making me think, I am a card-carrying nerd. A new scientific study, I’m going to read that. I can’t remember what publication it was in, but it was a well-done study, where it was taking a look at the sickness response that both humans and animals have, which is an emotional state that goes hand-in-hand with any significant illness or injury. 

The emotional state, if you had to describe it, is very much like depression. It is feeling tired. It is low energy. It is not wanting to do anything, not taking pleasure in things that you might ordinarily enjoy. But also having this more negative cognitive state around, “No, that’s gonna suck. That won’t work.” The whole study was taking a look at how being in that emotional/mental state when we are ill or injured physiologically is very evolutionarily adaptive. Because what it leads to is people not venturing out and expending a lot of energy, and not putting themselves in risky situations where they could get sick or injured further. It’s also mobilizing their support systems. If you’re just laying in bed, and you’re like, “I can’t do anything,” people around you are like, “Oh, she needs help.”

There are so many adaptive things going on, but subjectively, it feels like being depressed. I wonder if you’ve observed that in some of your clients. I know that some of my clients, not chronic health clients, necessarily, but people who have had surgery or something like that. Then, they’ll come back a week later being like, “I think I’m depressed.” Actually, let’s talk about this piece of it because it’s such an important component of healing. But I think that, subjectively, it doesn’t feel like a positive thing because you feel sad and tired. But it is part of what healing involves for many people. Do you encounter that with your clients?

Amy-Noelle: Just going into this place of losing interest and pleasures, losing interest in the things that they once enjoyed, not understanding what this feeling is, not understanding why, suddenly, they’re not feeling so positive? Yes, I absolutely have clients who are experiencing a decline in their positivity and decline in the things that they took pleasure in. 

Dr. Lisa: It’s being able to normalize this is what happens to everyone when we’re sick. It’s part of your body’s way of recovering. Yes, it sucks, emotionally.

Amy-Noelle: Just what’s going on with your body, even I recognize when I was going in an episode, oftentimes, we call everything anxiety. I remember even a couple of years ago when I first started experiencing symptoms, I was on the highway. I was experiencing heart palpitations. I was experiencing what they call air hunger. I couldn’t breathe. Because I couldn’t breathe, I had a panic attack. What is interesting is I dismissed it, and just said, “Why did I have a panic attack on the highway?” Suddenly, I was afraid of being on the highway. But now I realized it was because I truly experienced air hunger where I couldn’t breathe. I was experiencing heart palpitations. 

What I know to be true is that when we are experiencing these symptoms in our body, we don’t feel right. We often don’t know how to language that. We don’t know what that’s called. Oftentimes the umbrella term to everything, the physical symptoms that we’re experiencing, it’s called anxiety. But really anxiety is experienced differently in the sense of just having anxiety because of our thoughts, social anxiety, or anxiety about stressors in our life, this is very different than when you are sick, and something is really wrong with your body. 

Dr. Lisa: Yeah, it’s like a physiological threat. 

Amy-Noelle: This balance is what I think you were speaking of is that they cause you to experience these depressed feelings because nothing is working right. You’re literally having all kinds of things that are out of balance. This feeling, it feels not stable. This causes one to experience what we call depression, you experience this. We may not be producing the proper amount of serotonin. All kinds of things are going on. That’s why it’s so important, that piece of mindfulness because oftentimes, it’s the only thing we can do in those moments, is to hold the awareness because when you hold the awareness, it allows you to not completely be identified with the symptoms. 

Symptoms can be a very scary thing. If we become so identified, meaning all I’m thinking about is, “Oh, my gosh. My heart’s not beating right.” But in the place of awareness, I’m watching it not beating right, and I’m sending it love. I’m sending and I’m saying self-compassion statements. It doesn’t mean we don’t do the doing part. You’re taking the supplements. You’re doing the doing part. But in that moment, you’re just allowing yourself to watch it, to be with it. In this place, we won’t get totally mired in fear.

Dr. Lisa: Almost like cultivating that radical acceptance idea of, “This is happening and I am supporting myself through this moment, mindfully.” I think what you were saying before, too, is that being unwell physically, that there can be physical symptoms, and also emotional symptoms that are all worth paying attention to and honoring, as opposed to pushing away or minimizing. It’s like listening to yourself.

Amy-Noelle: This is my practice of gratitude. As you know, every day I make sure that I notice what is going right for my body. Anywhere where things are going right, in terms of any doctor, how have they helped me? What nugget can I take away from this doctor? Is there a book that I came across? This is what I help my clients do, is noticing. It’s so important to notice. What are the things that are going well with your body, with a piece of information you’ve come across that’s been helpful, with whether it’s the session that’s been helpful, what can you take away from it? It’s because, in this place, this is where we can align with hope rather than aligning with despair. 

Step 4: Detox Your Life

Dr. Lisa: What a good point. Again, what a deliberate practice because I’m hearing, again, that it can be very easy to get almost hyper-focused on what doesn’t feel good, and what’s not working out, and maybe what I have lost or am losing, and instead like, no. Even if you are struggling with this, there are so many things that you do still have and to be deliberately focusing on that. Oh, that’s so empowering. 

Now, and another thing, and I hope that this is okay to bring up. I know that from our just personal conversations and the little bits you shared about your work with clients is that one thing that seems like it’s a really important piece for people who are on a journey of healing is to really become deeply committed to prioritizing their health, and the time that they need to take care of themselves, and making some shifts, from that “Go, go, go” taking care of everybody and everything else mindset to, “No. If I’m going to be well, here’s what I need to do to take care of me.” Can you say a little bit more about that lifestyle transformation you’ve seen with people?

Amy-Noelle: You start to realize, I bet you need to detox your life, not even just your body. If one is experiencing sickness, oftentimes, it will bring them to this place when they are, if they are present with all that is going on with them and recognizing that their health is the most important thing. Oftentimes, they start to realize, “Wow, I need to live differently.” This means setting appropriate boundaries. It means to start getting really clear about what are our core values and what are our non-negotiables. 

Oftentimes, when we look at our values, some values are flexible; that means they won’t compromise something. They won’t compromise our well-being. That’s the difference between a flexible value and a core value, and what we would define as a non-negotiable. Something that compromises our well-being, then it doesn’t allow us to thrive. It doesn’t allow us to live fully. We have to begin to take note of that. 

First, there’s a noticing of that. There’s a noticing of how many hours a day can I work without moving into depletion, without moving into a place where suddenly I am fatigued, and I am getting sick, and I am so tired. It takes great discernment on our part to begin to notice that. It may mean that you start to give your time differently to engagements. It may mean setting boundaries with where you give your time. Noticing, “Maybe, I’m giving my time too much on social media, or maybe I’m working too many hours a week at my job.” 

What’s so interesting is sometimes you even begin to notice things you need to do more of. “Maybe I need to call my sister.” These are all ways to begin to see how you want to live your life differently, and how there is this opportunity to detox your life. Because this will do that to you. Where it seems that the things that once matter, you start to recognize that this is not the most important thing in my life right now. These are the things that matter to me most. There is a great shedding that happens.

Dr. Lisa: I could totally see that, and so necessary. I think that is hard, even for me personally. Knock on wood. I have not had that chronic thing. Even in my own life, I know that I have noticed that if I get exercise on a regular basis, I feel like 10x better in every way. But it’s difficult to set boundaries around that with my family and other obligations. But I could almost see how having this kind of experience, that really does feel like almost a wake-up call. It becomes almost non-negotiable. You have to set these boundaries or you’re not going to be okay.

Amy-Noelle: You start to live in “you have to do this” because you recognize what the alternative will be. 

Having a Health Issue vs. Somatizing One 

Dr. Lisa: I know we’re running out of time. I have a couple of other quick questions for you. Are you okay to stay a couple more minutes? 

Amy-Noelle: Yes, yeah.

Dr. Lisa: One of them is, let’s see, how do I ask this in a coherent way? There are very real as a heart attack, chronic health conditions that are not easy to diagnose. They have subtle, systemic symptoms. They are very real. I watched a very interesting show, again, going back to my nerdiness. I can’t remember if it was on Netflix. But it was a show about people who had undiagnosed conditions that were so debilitating. I think it was even through the New York Times or something. There was a doctor who was fielding these questions and helping people get these diagnoses for these very rare conditions, even through genetic testing, and flying them to Italy. It was very interesting. I wish I could remember the name of the show. 

These are all very real things. There is also, in my experience, an overlap between the way that we can interpret things that have more to do with our way of thinking about things that is maybe not necessarily related to a health condition. There’s an overlap here. For example, I’m thinking of somebody that I worked with, who you could probably say, did actually meet the criteria for hypochondriasis. 

He was having this weird symptom. He was pretty convinced that it was something bad, and he was going to the doctor, and he was a very intellectual person. In talking to him, getting him to describe what was going on for him, what you’re describing is actually the experience of what it feels like to have anxiety. He noticed his heart rate would pick up, he would feel tense. He would feel a little swingy mentally and have a hard time remembering things. This is the experience of anxiety. But instead of being able to say, “Ha, yeah. I think that’s anxiety.” It was really turning it, “No, it must be a health condition” in his mind.

We needed to do a lot of work around this because I do think that there’s a whole body of research and literature around people somatizing psychological symptoms and experiences. That is a very real thing. You see it with people who have, maybe, a lot of stigma around the idea of having something like anxiety or depression, that it manifests into these physical symptoms. It’s not saying that people aren’t having the physical experiences, those are very real. But it’s not necessarily based on illness. 

When they can just embrace this idea of, “This is actually what it feels like to be a human. Or this is what it feels like to be an aging human. Or this is what it feels like to have a little bit of transient anxiety, sometimes.” It’s a life experience that is not an illness or an emergency. This is also definitely a thing. I’m wondering what you’ve seen over the years in your practice, about how do you tease some of that apart? 

The reason why I want to ask about this is because, on the one hand, it can be so easy to minimize yourself, blow it off, and we’ve been talking a lot about how like, “No, I need to listen to myself.” How do we almost interpret things? I don’t want to use the word correctly, but there could be a lot of different explanations for the reason why people feel certain things. How can you help people tease apart: Is this a health issue for which there is a treatment? Or are you experiencing the more annoying parts of what it feels like to be a human? How do we glide through life without pathologizing that or freaking out when it happens? Because there needs to be that piece of it, too. I don’t know if I’m describing that coherently.

Amy-Noelle: It makes complete sense. Oftentimes, the first place I start is looking at their own readiness, meaning oftentimes that beginning work is they just need that validation piece. The validation piece comes in because they’re coming in. Even if the symptoms come from a mindset, they’re real.

Dr. Lisa: They’re real. They are definitely real. Yes. 

Amy-Noelle: If anyone has had a panic attack, you know that your heart is truly beating fast. You know that you’re sweating. These are, yes, it’s real. It produces physiological responses. That first piece is wanting to create the safety net so that we can go into the deeper work. Then really understanding, it requires going into a little bit of the family of origin and understanding a little bit of their background. Maybe they have a story around sickness, and they have a story around, because oftentimes, there could be a story around having to compensate around being someone who was sick when they were growing up, or around some stress in the home. Oftentimes, we have defense mechanisms, and we learned a way of being, in some way, who knows what that is. It can be something different for each individual person that we cope through.

Dr. Lisa: This is such great… I’m even just thinking from a family systems perspective that perhaps, what you’re saying, “Growing up, the only way that I got loved and taken care of is when I was sick.” You’re saying that that can be something to observe.

Amy-Noelle: Yes. To shed some light on, to bring to the forefront so that there is some understanding of that being sick somehow allowed for a reward then, that somehow it was needed then. This is one part of it, is gaining an understanding of where does it stem from, but the other part is developing a capacity to feel our feelings, to be with our discomfort. Sometimes, because perhaps we weren’t, perhaps, in some way, we weren’t allowed to express emotion. That wasn’t the way that our caretakers showed love. This is the part where we had to learn to… We didn’t have our needs met. We weren’t able to emotionally express ourselves. 

Oftentimes, when I worked with clients, and what we would call meta-emotions, feelings on feelings. Oftentimes, I will provide an assessment or a questionnaire around this and oftentimes they may say, “I just try to get on with it.” When we question on, “How do you deal with your emotions?” It’s just, “I try to get on with it, and try to get past it.” In some ways, we are repressing it, and we are not allowing ourselves to feel it. 

We look for something external when we feel any kind of discomfort. It’s like strengthening a muscle, our ability to be able to sit with discomfort, our ability to be able to sit with whatever emotion arises. In some ways, we weren’t taught that, dealing with emotional regulation. There’s so much study around what does it mean to be emotionally regulated? All you have to do is go to a park where there’s a bunch of children and see them cry. We know that it’s very hard to be around a child who is crying. Oftentimes, what we will see, even by well-meaning caretakers, is that they may try to deflect the child from having this experience. 

Dr. Lisa: “You’re fine.”

Amy-Noelle: “Here’s some candy.” Or “Why don’t we come over here? You’re missing all the fun. Let’s go play over here.” What that does is it takes someone out of their emotional experience. In that moment, we’re already teaching them that it’s not good to have a negative emotion. It’s not good to stay here. Emotion was never negative. But now it’s experienced as a negative. We’ve been taught to leave it. We’ve been taught it’s not good to stay there. We may have been, so whether it’s with “Here’s a piece of candy,” or “Let’s go here and play and have fun.” Part of this is we don’t know how to be with discomfort. We don’t know how to be with our pain.

Dr. Lisa: Completely. We talk about this a lot, the emotional intelligence piece of it, that children get rushed through, minimized, and they’re trained to not take information from their feelings or recognize them as feelings. Feelings are physical sensations. I don’t know about you, everybody’s a little bit different. But I know that when I feel really sad or bad, sometimes I will feel that sensation, the emotion of sadness or badness in my stomach. My stomach will hurt. Or when I feel anxious, I feel almost a pain in my solar plexus. When people aren’t familiar with the way their own emotions feel in their body, they can be misinterpreted as symptomatic of something.

Amy-Noelle: Sometimes, I will do a breathing exercise with my clients. Oftentimes, we aren’t breathing correctly. Our breath is very shallow. We’re breathing from the diaphragm. But someone who has a lot of anxiety, when you really think about anxiety, anxiety is a holding in. In some ways, it’s because you’re wanting to avoid experience. Think about it. When you don’t want something to happen, what do we do? We hold our breath. We hold our breath when we don’t want something to happen. It’s a physiological response. We don’t want something to happen. 

This is what we learn to do. We hold our breath. We hold, we constrict, we hold, we constrict. This is what anxiety is doing. It’s holding. It’s constricting. It doesn’t want it to happen. That’s why we want to exert so much control. We don’t want the anxiety. We want to exert so much control. Oftentimes, when I’m first teaching how to breathe correctly, this can actually produce more anxiety. Because what happens is, if you don’t breathe correctly, what happens is if you try to show, if someone now is focused on their breath, it starts to make them anxious when they realize that they’re not breathing. “Oh, I’m not breathing.” Then, you actually panic. 

When you think about someone, the client who can suddenly amplify all of their symptoms, this also may happen is that they feel discomfort, and it feels so uncomfortable. They don’t know what to do with it. Now, they’re thinking about the discomfort. Now, the thoughts around the discomfort, it magnifies it. We’re growing the discomfort. This is where it turns into panic and then you are convinced. “Something is wrong with me.”

Dr. Lisa: Then it’s this whole feedback loop. Again, there are very real health conditions. But I think that this is always important to be thinking about and that’s why this is so hard. I think and why people do require so much support is teasing all of this stuff out can be very complex because it’s multi-dimensional, and it does incorporate your physical health, and emotions, and the way that you’re thinking, and your social systems, and your history. I mean, there’s so much. 

I don’t know if you do this, but as a rule of thumb, what I typically do, and you have a lot more experience with this particular issue than I do, but that I always encourage people, go get it checked out. If you’re worried that there’s something wrong, get the tests. Talk to whoever. Get it checked out really thoroughly. Then, let’s see what we have leftover because that can, sometimes, I think, help just parse apart what is happening, or at least rule out some things, which can just begin to help us shape the focus of what we should be talking about and working on. Because it can be hard. It really can.

Amy-Noelle: You can still check it out like you said. Whether you do have something, or you don’t have something, a lot of the mindfulness skills apply equally. Even when you have a chronic illness, oftentimes, the part of not moving into fear, the part of staying in the aware place, the mindfulness component is very much needed, whether you are experiencing real chronic pain or not experiencing.

Dr. Lisa: Or emotional pain.

Amy-Noelle: It’s all learning how to be with our emotions, with our feelings, whatever is arising.

Radical Awareness is a Gift

Dr. Lisa: One last thing and then I’ll let you go because I could keep talking to you all day. But I’ve heard you mention several times that although your personal journey has been so hard, and you are walking with people who are dealing with very hard, real things that don’t have an easy solution, I’ve heard you say several times that you feel like this has been a gift in some ways. Also that you work with clients towards helping them shift into that space.

Can you say a little bit more about what you mean by that? How this type of life experience can, in some ways, eventually be a gift? 

Amy-Noelle: Well, in these moments where there’s nowhere else to go but to be with your pain, it requires one to go deeper into being present with whatever is going on in their bodies. It requires this hyper-focused awareness. When we are able to be that way, oftentimes, the gift is that maybe an emotion comes up, maybe an unmet need comes up, maybe a deep need comes up that you haven’t answered in a long time, maybe there’s a self-discovery and realizing that I need to live my life differently. 

Every time you are in these moments where you’re having to practice radical awareness, you’re having to be present with everything that’s happening in your body, you’re having to allow these emotions to arise, you’re opening up a space where wisdom comes through. This is where the gift is, is that you start tuning into your body. There is body wisdom. 

Your body begins to show you what it is that you need, how you maybe need to live your life differently. Or you may recognize something, how you want to change the way that you live your life. In these moments, there’s insight comes, wisdom comes. Then, you find yourself when you reengage with the world, you find yourself that you are changed. These shifts become the gifts in the way that you are changed, in the way that you decide, “I would like to spend more time doing the things that I love. I would like to not go to some of these engagements that aren’t fulfilling.” You start to realize, “What are some of the things that I don’t want to do anymore? What are some of the things that I do want to do?” 

In some ways, yes, you are getting more clear about how you want to live your life. This is the way it’s been a gift for me. 

Dr. Lisa: It’s beautiful.

Amy-Noelle: With so many of my clients, too. 

Dr. Lisa: How wonderful for them. I’m just thinking to have the support of you, because of your own life experience and perspective, to have so much compassion and empathy for what they’re going through, but also a guide to help them move into this really positive space. Even though this has been a challenging situation, let’s take a look at the gifts that it has brought you.

You’re saying to really make important meaningful life changes because of this that are really more authentic and healthy for you. My goodness. That’s amazing. To end, this might be a nice moment for us to pause on this beautiful idea so thank you. 

Amy-Noelle: Thank you.

Dr. Lisa: Well, thank you so much for coming and talking to me about this subject today. I know it’s near and dear to your heart and I hope that this conversation has been helpful to our listeners. 

For those of you interested in learning more about Amy-Noelle Shih, you can learn more about her on our website at growingself.com. Amy, I think that you have some things coming out on the blog in the next couple of months, too. We’ll stay tuned for that and we’ll be sure to put it all out on our Growing Self Instagram which is @growing_self so you can keep track of Amy-Noelle and what she’s up to. 

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