The Practice of Therapy

Gordon Brewer: Perfect. Well, hello everyone and welcome again to the podcast and I'm so happy to get back on the podcast. My good friend Dr. Melissa Teon. Welcome Melissa. I'm glad you're here.
Dr. Melissa Tiessen: Thank you so much, Gordon. I'm so happy and honored to be back.
Gordon Brewer: Yes, and, and Melissa is doing some incredibly interesting new work and I'm gonna let her tell you all about that.
But Melissa is a start. You know, every time on this podcast. For people that don't know you, tell folks a little more about yourself and how you've landed where you've landed.
Dr. Melissa Tiessen: Yeah, sure. So, uh, I am a clinical psychologist. I work in private practice. Uh, actually I see people exclusively, virtually in Ontario, Canada.
Uh, but I live in Manitoba just to keep things interesting and, um, I have been a psychologist, a registered psychologist for. Over 15 years now. Always hard to believe. Mm-hmm. When I think about that. Mm-hmm. Mm-hmm. Uh, grad school reunion is being organized for this year, our 25 year reunion since starting.
Mm-hmm. So I don't know how that happened 'cause I'm only 29, so.
Gordon Brewer: Yes. Yes. Anyway.
Dr. Melissa Tiessen: And, uh, yeah, I, in my clinical work, I focus primarily on treatment of chronic neuroplastic symptoms. And I also have a side business with my dear colleague, Dr. Karen Dick, which is focused on, uh, therapist self-care and wellbeing.
And of course, Gordon, er kind enough to have us on your podcast in the past to talk about that.
Gordon Brewer: Yes, yes. Well, Melissa, I, yeah, it's so good to catch up with, with you again and, um, this, um, you know, I think probably the people that are listening have, have at least heard the term neuroplasticity, if I can get it out of my mouth.
Uh, but this is something specifically related to, to pain and so. Tell us about it and maybe give us a, a good overview of what this, this kind of cutting edge kinda research is all about.
Dr. Melissa Tiessen: Yeah. And so. That's a great point, Gordon, that many people are already familiar with the term neuroplasticity, especially working in mental health.
And so that's a great place to start because it really highlights exactly what this approach to the treatment of pain and other symptoms is. So of course, neuroplasticity refers to the changeability of our brain and our neural pathways. And so what Neuroplastic pain refers to is essentially. Pain that isn't caused by tissue damage or some sort of structural issue in our body, and instead is caused by how our brain and nervous system are wired to respond to threat.
And so this is such an important concept because it really introduces this kind of new possibility that when people are experiencing chronic symptoms, and of course this doesn't apply to every chronic symptom, but it actually applies to a surprising, surprisingly greater number of chronic symptoms than most people realize.
So once people understand that this idea can in fact apply to. All kinds of chronic symptoms in our body. It opens up this brand new possibility that these symptoms can be changeable again, the plasticity part of neuroplasticity.
Gordon Brewer: Right, right. And I know you and I were chatting just before, um, we started recording and it's, you know, I think, uh, those of us that are familiar with EMDR, which is really, um, about reprocessing, you know, memories and traumatic events.
How, how are they similar? In, in all of this.
Dr. Melissa Tiessen: Yeah, so it's interesting that, and I can maybe talk in a bit about some of the specific techniques that are used mm-hmm. Mm-hmm. With, uh, treatment of neuroplastic pain. But I absolutely see EMDR as falling under that relevant umbrella because yeah, essentially EMDR is helping us to reprocess not only, I would argue, not only on that cognitive and emotional level, but also on a body-based level.
Right. The traumas that, uh, somebody has experienced, whether Big T or little t and, and, and of course part of what. Is is some of the premise of EMDR is that our, our, our brain has sort of gotten stuck in these patterns. And so EMDR is helping us to get unstuck so that we can start to relate to our lives in this new way.
And that really is a lot of what's happening with treatment of neuroplastic symptoms as well. It's about helping our brain to get unstuck from these. Patterns. These really, it's another, another term actually for neuroplastic pain is learned neural pathway pain. And sometimes I actually like that phrase even better because it really emphasizes to me the learning aspect and the neural pathway aspect.
Right? And so importantly, if these pathways can be learned, they can also be unlearned. So even though we might feel like we're stuck, there's ways to get unstuck.
Gordon Brewer: Right. So with with, if somebody is coming with this type of pain, can you kind of describe. For every, everybody how it's, I know you mentioned that it's not specific to any sort of physical Yeah.
Injury or something physiological, but what does it, how does it kind of present itself and what does that look like?
Dr. Melissa Tiessen: Yeah. And so this is really the first important step, right? Is this approach that is even relevant for somebody, because of course, if somebody does have a structural problem, and what I mean by that is, is there a tumor?
Is there some sort of fracture that hasn't healed? Is there. An infection that hasn't resolved or some kind of disease process. And so that obviously these things happen all the time. Even tumors absolutely happen. And so we wanna ensure that something that does have one of these structural causes and does have kind of a clear mechanism for treatment can be addressed, if that is possible.
Mm-hmm. Of course, when people are coming to me as a psychologist or coming to any other. Mental health professional or a coach who works in this field, they've probably already done all kinds of investigations that have been able to, at least to a certain extent, rule out that yeah, there's, there is no tumor, there is no fracture, there is no ongoing infection or disease process.
Thus, again, there isn't any like clear indicator of tissue damage or sometimes just to confuse things a little bit. There might be some suggestions of tissue damage, like somebody's got, uh, findings on an MRI that they've got a disc bulge, for example, in their back. But those findings don't always necessarily correlate with the symptoms that a person is having.
So that's the first thing ruling out. Is there anything kind of physically present, observable in the body that could be the reason for this person's symptoms. But so often there isn't anything that's explanatory. Which can be incredibly frustrating for sure. Mm-hmm. And so many people are told, we don't know what's causing your, your pain or your other symptoms.
There's not really anything we can do. You just have to learn to live with it. Right. Like, such demoralizing messages really for anyone to receive. Yeah. Um, but from a neuroplastic perspective, I always sound kind of kooky and cruel I think, when I say this to people, but it's like, that's good news because mm-hmm.
It probably then suggests that. It's more likely that neuroplastic processes are at are at play because if somebody doesn't have indicators of structural damage, tissue damage, disease processes, but they're still having symptoms, then. That's a great time to start to be curious about. Okay, so what's the evidence that a neuroplastic process is happening or a brain-based nervous system-based process?
So this is where then what we're trying to do is rule in neuroplastic processes. And there's a few ways that we do this, and it's kind of by looking at as we are always doing in mental health. Mm-hmm. Looking at a person's, uh. Not only current circumstances, but also their history. And so what we're really trying to get a better sense of is not only the kind of precipitating factors for like why did the pain start in the first place, but what keeps it going?
The perpetuating factors. Mm-hmm. And what might have been predisposing factors in a person's history that might, again, kind of make them have the kind of nervous system that's gonna be more likely to respond to potential threats in their environment and then respond. By generating pain. And again, the pain is absolutely real, just that.
Mm-hmm. It's not caused by tissue damage. It's caused by these brain-based processes instead. So we're ruling in by looking at things like, uh, how, how does the person's symptoms show up? Do they, do they actually change quite a lot throughout the day or do they move to different parts of the body? Um, are they triggered by things that would otherwise be innocuous, like light touch or.
Sunlight or something like that. Uh, and these actually, there's a whole system that's called the FIT Criteria, which stands for Functional, inconsistent, and Triggered. So these, those are kind of the guidelines that we use just to help us try to make that determination between. Structural and more likely to be neuroplastic.
And it's really about finding personalized evidence for each individual. Right? It's not about me saying to somebody, uh oh yeah, you, you've got neuroplastic symptoms. This is what we need to do. It's really about like this process of self-discovery to understand. Mm-hmm. Oh yeah, this is, this is like the clear evidence in my day-to-day life that it's actually highly unlikely that there's something, there's some sort of dangerous disease process going on in my body.
Uh, and I just wanna add as well that the other thing we're also looking at then is in terms of those predisposing factors, and this is where I think it becomes super relevant to those of us as therapists. We're we're looking at things like what were your early life experiences? What are some of your personality characteristics that were learned from those early life experiences?
So it doesn't have to be abuse and neglect, but it can just be growing up an environment where we got reinforced for. Taking good care of other people, right? Mm-hmm. Like that kind of the, the common joke that most of us have been therapists ever since we were children, right? Yeah. Growing up in an environment where we get reinforced for having high standards, for being really conscientious, for being people pleasing, all of these kinds of things.
They can be great qualities, but they also just sort of create a nervous system that is going to be, uh, hypervigilant perhaps. Mm-hmm. Is going to be really attuned to other people's needs, but maybe less attuned to our own needs. All those kinds of things. So, uh, and we're also looking at what did somebody learn about emotions, because this is a really important piece in this model too.
Mm-hmm. Because if somebody learned, it's not okay to be sad, it's not okay to be angry, it's not okay to express a difference of opinion, any of these kinds of things, that's also setting their nervous system up to perceive. Mm-hmm. Sadness is threatening, anger is threatening, difference of opinion is threatening.
Mm-hmm. Et cetera, et cetera. Right. So that's all gonna feed into just kind of this like perfect storm of conditions. Mm-hmm. Right?
Gordon Brewer: Yeah. Right. Yeah. I, I was just thinking, I think probably all of us have had, uh, um. Have experienced somatic symptoms to, um, you know, anxiety or extreme Exactly. Mm-hmm. Um, you know, situations in which, you know, a body, we feel it in our body that, that pit in the stomach kind of feeling.
Yeah,
Dr. Melissa Tiessen: exactly. Yeah. And this is the point, like these symptoms are just part of being human, I mean mm-hmm. From, from this model, anxiety is a neuroplastic symptom as well, because. Ultimately, pain and anxiety, they're both serving the same purpose, which is to try to keep us protected, right? Mm-hmm. It's like, mm-hmm.
Something is threatening. So we need to have a response to that to keep ourselves protected. Right. It's the fight, flight, freeze response.
Gordon Brewer: Right.
Dr. Melissa Tiessen: And when it comes to chronic pain and other persistent symptoms, it's just kind of like the system's sort of working against itself now. Right? Right. This thing that's intended to be really helpful to be protective actually becomes the thing that's hurting us even more.
Mm-hmm. Ultimately, because. Sadly, pain is painful. So even though it's trying to, it's trying to be a signal of like, hey, there's, there could be something bad going on here. Um, unfortunately it can start to become the problem itself, right. Especially when we're talking about things becoming chronic and persistent.
Gordon Brewer: Right? Yeah. And unfortunately, um, pain is such a subjective thing in that, you know, mm-hmm. Um. I can't just look, you know, could baby tell by Yeah. Facial expressions or whatever, but you just can't look at someone and say, okay, they're in pain. Mm-hmm. Mm-hmm.
Dr. Melissa Tiessen: Yeah. And I, I think that's the other important piece that, like, even the, the International Association for the Study of Pain, they include in their de definition of pain that it's a, uh, sensory and an emotional experience and that it's connected to actual.
Or a potential tissue damage. Mm-hmm. So like even in that definition, we've got the recognition that there's, there are emotional processes at play and that pain isn't only about tissue damage, of course, sometimes it is. Mm-hmm. But it can also happen in the absence of tissue damage. And, and I think this is also really important, especially when we're talking about mental health populations and mental health professionals, even if pain exists in the absence of tissue damage.
It doesn't mean that somebody's making it up or faking it or imagining or malingering, right. It doesn't mean any of that. And kind of back to your point, Gordon, that mm-hmm. Just because we can't see, it doesn't make it real, like it's absolutely real. And just because it's being generated by our brain doesn't make it less real.
It's absolutely real. It can be incredibly debilitating and it doesn't mean. That it's tissue damage that is the cause. Mm-hmm. There can be something else being our brain and our nervous system and how it's interpreting threat that truly can be the cause. Right. Which I know is like, when I first learned about this, I was kind of like, what are you talking about?
It seemed kind of mind blowing at first 'cause. Right, right. It can be a big paradigm shift, especially from more traditional biomedical models of what. What's going on in my bodies? Yeah.
Gordon Brewer: Right, right. So can you, I was just curious, can you give us maybe some case examples of maybe some folks that you've worked with?
Dr. Melissa Tiessen: Yeah, I, if it's all right, I'm gonna give you example of myself.
Gordon Brewer: Okay. So that's you prerogative. Yes. Uhhuh. So
Dr. Melissa Tiessen: at the beginning of the pandemic, I injured my eye. Um, I just accidentally hit my eye. In the garage one day had my glasses on, so my eye was protected, but it, it got injured. And, um, and so this led to, uh, what started to become excruciating stabbing pain in my eye.
Hmm. Uh, it was like, it was like a lightning bolt in my eye. Thankfully, it didn't happen all the time, but it would especially happen in the morning, like waking up, especially if like bright light was coming into the room. Uh, it was, it was like, it, it was actually like a flashback in a way. It was like I was re-experiencing the original injury when I would have those symptoms interest.
So, uh, of course being the pandemic, I didn't, I didn't go to a doctor or eye doctor right away 'cause mm-hmm. We were like being encouraged not to do those things unless it was a real emergency and I didn't seem to have any, you know, vision issues or anything like that. But I had this persistent pain that kept showing up in my eye.
Eventually, after a few months, I was able to get it checked out by an odd doctor she said. Your eye looks totally fine. Like both of my eyes looked exactly the same, so, okay, great. Mm-hmm. But I kept having the symptoms and it was like, yeah, I don't understand why this keeps happening. Even though she's saying, you know, basically structurally there's nothing wrong.
So thankfully, actually around that time, that's when I started getting more into. Learning more about and training more in this area of neuroplastic symptoms, and I was able to understand that it was my brain perceiving threat that was keeping these. Symptoms going. Mm-hmm. And also, really importantly, it was predictive processes, keeping the symptoms going.
And that's another really important element of this model. Mm-hmm. That our brains aren't just reacting to what's going on, but they're actually predicting because predicting is more efficient and our brains got a tough job. It's got a lot of things. It's on, its to-do list every moment. Right. And so if it can predict.
And more often than not, right, if it's got a decent batting average with its predictions, it's just gonna keep making those predictions. 'cause it's just faster, simpler, just way more efficient. Requires less resources. Mm-hmm. To be predicting than coming up with like a new response in every single moment that we encounter in our lives.
So that's part of what was going on with my brain. There was this basically conditioned association that had been created basically, right? Mm-hmm. Just Pavlov's dogs. Yeah. Where I would experience the trigger, right? So it's not like sunlight coming into the room was actually causing my pain. It was the initial injury had created these conditioned associations, but sunlight was triggering.
The pain to basically recur Wow. In, in my eye. And so what I was able to do was use this information to, number one, understand there wasn't anything structurally wrong with my eye. Right. Even though the eye doctor had already told me that. It's just human nature to like continue to wonder Well, right. I don't know.
Maybe there is something, something. Yeah, yeah, yeah. Right. And especially because it's, it's my eye, like the inside kind of of my eye, right? Mm-hmm. You
Gordon Brewer: can't,
Dr. Melissa Tiessen: can't see that on like a bump on your arm or something, so, right.
Gordon Brewer: Right.
Dr. Melissa Tiessen: Totally human nature to kind of doubt, well, maybe there is something going on.
But number one, I was able to understand there isn't something structurally wrong with my eye. I was also able to start to better understand like this pattern of, okay, yeah, I didn't have the pain all the time, but I did have it at certain times of the day, right? These particular triggers. And uh, I was also able to.
Start to just kind of sit with those sensations in a different way. Mm-hmm. Because of course, I, I could now understand they weren't dangerous. Mm-hmm. It was just my, it was just basically my brain being over reactive. Mm-hmm. Overprotective more importantly. Yeah. And I could also reassure my nervous system, like even before I went to bed, Hey, you know what?
You're safe. It's okay. Even though. The pandemic was still there doing its thing causing all kinds of stress and havoc. But at least in those moments, I could reassure my nervous system that it, it didn't need to be trying to protect me with these particular symptoms. Right. It didn't need to be trying to get my attention By creating these symptoms, I could basically tell it, Hey, thank you body for trying to keep me protected.
Mm-hmm. But I don't need the protection in this way.
Gordon Brewer: Right. Mm-hmm. Is that, was that process for you, is it, was it more of, um, um, a cognitive change or was it more of a somatic change that you in, in.
Dr. Melissa Tiessen: Taking
Gordon Brewer: care of that for you?
Dr. Melissa Tiessen: Both. Or
Gordon Brewer: both maybe. Yeah.
Dr. Melissa Tiessen: Yeah, yeah. Yeah. And I think it kind of, it always needs to be, and it, and probably really all three, like somatic, cognitive, and emotional, that's when we're gonna get the best results.
Mm-hmm. Because, right. So much of this, and I think my example really highlights it because, you know, like I was saying, most of the time, my symptoms showed up. When I was like waking up from being asleep. So, and I think this is where there's a really helpful parallel with panic attacks and panic disorder that so many of us working in mental health are gonna be familiar with.
Right? One of the hallmarks of panic disorder is having a panic attack out of the blue, or waking up in the middle of the night having a panic attack, right? And so people will argue, well, how could that be psychological? I wasn't even conscious, right? I was sleeping. How could, mm-hmm. How could my thoughts be impacting.
You know? Mm-hmm. Or how could this even just be stress? I, you know, I was asleep. I was like having a good dream, maybe. Mm-hmm. And, and of course it's because for sure stress plays a role, but it's not just about that, it's also about the conditioned associations that get created. Right. And so a person can have a panic attack outta the blue or in the middle of the night wake, you know, it wakes them up.
And it's, and it's happening because there's something in the body that has been previously associated with having a panic attack. Right. And we just have right natural variations in our physiology as we're sleeping. And that can be enough to just trigger that association and then that response that sure.
The body has learned, right? So it's very, very, very similar to. The model that we use for anxiety especially, um, panic attacks and panic disorder.
Gordon Brewer: Right, right. Yeah. So really kinda challenging that part of our brain that's saying, okay, danger. Danger.
Dr. Melissa Tiessen: Mm-hmm. When
Gordon Brewer: in reality there is no danger.
Dr. Melissa Tiessen: Yeah. Yeah.
Gordon Brewer: Mm-hmm.
Dr. Melissa Tiessen: And it doesn't mean that there isn't something to pay attention to. Mm-hmm. It's just that we need to help our brain and our nervous system recategorize those experiences and understand that. Yeah. Uh, bright light coming into the room isn't dangerous. Mm-hmm. But. Maybe the existence of the symptom and the persistence of the symptom.
Mm-hmm. Maybe it actually is still really relevant to pay attention to, but not in this like hypervigilant, I need to get rid of it and that's why I wanna pay attention it kind of way. Mm-hmm. I need to constantly be monitoring it way, but in a, hey, let me be curious about,
Gordon Brewer: right. Well
Dr. Melissa Tiessen: why is the symptom showing up?
Right? What is it maybe trying to communicate? What is it trying to tell me? What is it trying to signal? So, and I often talk about this as almost like. The advanced stage of this process, because it is definitely not easy to start off with. Like, oh, let me, uh, you know, let me welcome the pain and just mm-hmm.
You know, sit with it and have tea with it. It's like, yeah, that is gonna be really challenging, especially when symptoms are really debilitating. But it's also true, in fact, I should say, and it's also true that. Symptoms are often communicating something important. And so if we can be willing to be open to that possibility right there maybe is something really important that we can learn from that.
And I will say, even though my lightning bolt of my eye symptom doesn't happen nearly as often as it did five years ago, six years ago, sometimes it does pop up and when it, when it does. It's a really great opportunity for me to pause and ask myself, Hey, what's like going on? Especially what's going on in my life that maybe I'm not giving as much attention to as I should, and that this is basically like a signal that my, my threat detection system is sorting.
Getting a little bit overloaded and so, right. Maybe.
Gordon Brewer: Yeah.
Dr. Melissa Tiessen: Maybe I wanna give it some extra attention.
Gordon Brewer: Yeah. I, I know just talking with people that do have panic, um, panic attacks or panic disorder, I just, I, I kind of compliment them. Uh, you've got a, an amygdala that's just working really well.
Dr. Melissa Tiessen: Yeah. Yeah.
And
Gordon Brewer: it can't, it can't determine between what's, what's just a difficult situation versus a, a dangerous situation. It just responds the same way.
Dr. Melissa Tiessen: Exactly. That's what I often say to people, that our brain. Uh, like first of all, as you know right. Our, our brains are wired for survival, in fact. Mm-hmm. Wired first and foremost for just regulating our body, but that includes our survival.
Our brain doesn't care about our wellbeing, really. Right. Like it just cares that we stay alive. It kind of doesn't care if we're happy mm-hmm. And alive. Mm-hmm. It's just, it's like, hey, keeping you happy was not in my job description, just keeping you alive. It's in my job description. Oh
Gordon Brewer: yeah. Right.
Dr. Melissa Tiessen: So. Uh, if we can understand that our, that's what our brain is trying to do.
It's just trying to keep us, it's trying to keep us regulated. It's trying to keep us protected. And it's just gonna do whatever it can do. And part of that is often being like extra conservative about what might be a threat. Mm-hmm. So our brain, right? People think maybe like if they think about this at all, that our brain is, is assessing threat in terms of like not a threat, maybe a threat, definitely a threat, but I would argue what's actually going on is not a threat and maybe a threat.
And Sure, definitely a threat falls into that case, but like the much bigger proportion is, it's like better safe than sorry.
Gordon Brewer: Right. So it's
Dr. Melissa Tiessen: just kind of put everything in the maybe a threat category, uh, because of course for our survival purposes, way more costly to think that something isn't a threat and then it actually is.
Gordon Brewer: Right. Versus the
Dr. Melissa Tiessen: reverse.
Gordon Brewer: Right? Yeah. Right. So, um, what are, what are the typical interventions and what do they look like? Mm-hmm.
Dr. Melissa Tiessen: Yeah. So that's a really important question. And I it also speaks to, I, I would say, so how is this maybe a bit different from our more traditional approaches like CBT or even ACT or, or more like a relaxation, stress management kind of approach.
Mm-hmm. And so. The, you know, those traditional approaches offer really great, um, models and strategies for people. And what I would say is that this approach adds this really important piece of the learning mechanisms, the predictive processes, and, and the role of our subconscious, which includes emotions themselves, are symptoms themselves as potential sources of threat.
Mm-hmm. So what these approaches are doing, first and foremost, they're starting from the assumption that there again, that there isn't tissue damage. Whereas our more traditional, like CBT or even ACT approach is probably not being quite as strong on that assumption. Mm-hmm. It's, it's kind of going a little bit more with, well, yeah, maybe there is something damaged in your body.
You're not gonna be able to change that, but let's help you think about it differently and live your life as best you can despite those symptoms. Right. And there are situations where that is. Very relevant, right? Like if somebody's got, um, incurable cancer, that's probably the way to go about it, as opposed to, right?
Mm-hmm. Oh, we can, let's just rewire the threat processes and the cancer's gonna go away. Again, cancer's, cancer's a structural diagnosis, so, mm-hmm. Uh, so that's a different category. But if we. So if we know that a key difference then is we are starting from the premise that, uh, there isn't structural damage and thus.
The symptoms can be reversible, and we're starting from this knowledge that the reason the symptoms persist again is not because there's something wrong in the body, but because it's how the brain is operating. Yeah. Then that can become our target, and so essentially the whole goal of any of the approaches that can be used is to help an individual learn to relate differently too.
Any uncomfortable internal experience, whether it's yes, the pain or other symptoms themselves. Mm-hmm. Or also emotions. What we've, you know, what we've learned about how to be a good person, how to be a good therapist. Mm-hmm. Any of these things. And I hopefully, as my example, my personal example, highlighted what I really did was I learned to relate differently to those symptoms that I was having.
Mm-hmm. Um, in my eye, both in the minute. And in the moment, and also more globally, seeing it from this, kind of taking a different meaning from the symptoms. So, uh, the most popular approach, uh, in terms of a, a treatment is something called pain reprocessing therapy. Mm-hmm. And, uh, that basically sh includes, uh, this.
Psychoeducation always starting with that about just making sure that people understand how pain operates and then helping people to get out of this fear pain loop that gets created, right? Because we get, we have symptoms, we're get, we are getting freaked out by having the symptoms, especially then getting messages like, you're never gonna stop having these symptoms, and then that's gonna cause.
Uh, increased fear that's gonna cause increased symptoms because again, the symptoms are just a reaction from our nervous system to perceived threat. Mm-hmm. Well then symptoms themselves are. Becoming threatening. And so we just get caught in this vicious cycle of fear. Yeah. Pain, more fear, more pain, et cetera, et cetera.
Mm-hmm. So treatment is really about getting out of that loop. And so pain reprocessing therapy offers a variety of practices and perspectives for helping us to do that. Uh, there's also an approach called emotional awareness and expression therapy. And, uh, this is. It has overlaps with pain reprocessing therapy or PRT, but it also explicitly focuses on the emotional pieces.
Mm-hmm. And helping people to better identify and express emotions that maybe they've been suppressing, that they've felt they don't have permission to connect with. Mm-hmm. That it's dangerous to connect with those emotions. Uh, so still doing the same thing. Helping us learn to relate differently to these uncomfortable internal experiences.
It's just sort of going about it in a slightly different way and just kind of emphasizing more the emotional learning, whereas pain reprocessing therapy, to put this into generalities at least, is emphasizing a little bit more just kind of the, the. The learning around the physical symptoms and understanding Sure.
We don't need to be as afraid of them. Again, it's very similar to like what we would be doing with, uh, treatment of panic attacks.
Gordon Brewer: Sure, sure. Yeah. Yeah. That's a, this is, well, Melissa, this is just fascinating stuff and I, I, I know we've gotta be mindful of our time, but, um, tell folks, I know you've put together a course specifically for therapists that might be dealing with this particular issue.
Um, so tell us about that.
Dr. Melissa Tiessen: Yeah. Thank you so much for raising that, Gordon. So, of course, I, I just wanna acknowledge there's all kinds of fantastic trainings I've done. Most of them at this point. Uh, if somebody is interested in actually getting trained, uh, to do pain reprocessing therapy or emotional awareness and expression therapy, um, internal family systems is a great approach for this too, that I also use.
But, uh, so I do not at all profess to be an expert in teaching other people how to do this work with their own clients. But what I recognized is that I think there is a really. Unique need for mental health therapists, ourselves, health professionals, ourselves to, to have some resources that are specific to those of us who might have some of our own chronic symptoms.
And I mean mm-hmm. I shared just one example of my own. Sure. I've had other chronic symptoms over the years as again. All of us have to a certain extent because it's just part of being human. Mm-hmm. So I, I created a course that I have affectionately called You Are Not Broken. And it is, especially for other health professionals who might be struggling with their own neuroplastic symptoms.
And what I've tried to do is incorporate. In more detail, a lot of the things that we've been talking about today, as well as the emphasis on some of the unique factors that are really gonna be relevant for, for health professionals ourselves. And I just want to, uh, to note that I actually created the course as an audio course.
Okay? Because I think that. A lot of us have, uh, screen fatigue at this point. Right. And, and so much of this work is really about nervous system regulation. And of course, I mean, being a podcaster, uh mm-hmm. Fellow podcaster, uh, there, there is so much value in just hearing somebody else talk. And there is kind of this unique intimacy that comes from listening to podcasts, right.
As opposed to watching videos. And it is the kind of thing that you can do. In concert with other activities of your day. So, um, it's my favorite
Gordon Brewer: way to do things. Yeah, yeah, yeah.
Dr. Melissa Tiessen: So I explicitly made the, the course in an audio format so that people can listen to it while they're walking, while they're laying down.
Doesn't require sitting at a computer, uh, or even looking at a phone. Don't need to be looking at a screen. Just need to be listening and, and hopefully it also. Helps the experience feel a little bit more like, um, like there is this connection that can also actually be part of the quotes treatment. Right.
You know, it's not mm-hmm. Not exactly the same as one-to-one therapy, but there's of course this like co-regulation that comes from mm-hmm. Uh, hearing other people's voices, so, yeah. Yeah. Yeah. So it was, it was a intentional decision on my part
Gordon Brewer: to make it way. Oh, well that's so cool. So where can people find it?
Dr. Melissa Tiessen: Yeah, just, uh, through my website, dr. Melissa tson.ca. And, uh, I also have a free newsletter if somebody just wants to hear some more of these kind of stories about how pain works and how we can use our brains to help us. Make
Gordon Brewer: a difference. Yeah. That's great. That's great. And we'll have links in the show notes and the show summary for everybody to get to this easily.
But well, Melissa, I'm sure I will have you back again and tell folks your podcast again.
Dr. Melissa Tiessen: Oh, yes. Thank you. So, uh, again, with with my colleague, Dr. Karen Dick, we have a podcast called Intentional Therapist, putting you in your schedule. And it's all about trying to re. Rewrite how as therapists, we think about self-care, uh, because again, there's so much in our training that kind of
Gordon Brewer: mm-hmm.
Dr. Melissa Tiessen: Makes it hard to actually care for ourselves the way that we should and to care for ourselves, the way we tell our clients to care for themselves. So,
Gordon Brewer: absolutely, absolutely. It's really about.
Dr. Melissa Tiessen: Giving ourselves more permission to, to do what's gonna be best for us. Right. Which
Gordon Brewer: right.
Dr. Melissa Tiessen: Is very, very relevant to neuroplastic symptoms too.
Yeah.
Gordon Brewer: Well that's great. That's great. Mm-hmm. Again, we'll have links to the podcast and everything in there. And yeah, thank you Melissa. Hope, hope to have you back on again and, um, thanks again for joining me.
Dr. Melissa Tiessen: Yeah. Thank you so much, Gordon. I, I hope this information will just spark some curiosity, at the very least.
Yeah, for
Gordon Brewer: I think it will. I think it will. Thanks.
Mm-hmm.