How to Treat Concussion Symptoms
with Dr Titus Chui on The Healers Café with Dr. Manon Bolliger, ND
In this episode of The Healers Café, Dr. Manon Bolliger, ND, chats with Dr Titus Chui, best selling author, award winning international speaker, and Functional Neurologist that specializes in Post-Concussion Syndrome
Highlights from today’s episode include:
Dr Titus Chui 14:25
Number one first and foremost is giving people hope that even regardless if you’ve had a concussion, there are things you can do to heal. Healing is always possible. And that I’m a personal testament to that, to my whole journey. Number two, what I find with a lot of people, especially if they’re already aware that they have a concussion. A lot of people I work with, patients, they have been to other doctors, and the doctors run their tests and then go, “There’s nothing wrong with you, it’s all in your head”. So not only does that person have to deal with the physical and mental, emotional stress of their health challenge, then on top of that they’re dismissed by their practitioner, not because there actually isn’t anything going on, but it’s because of their own lack of understanding around what actually happens with a concussion.
Dr Titus Chui 17:22
I think a lot of people have had concussions, that might not be the number one root cause for their symptoms. But I’ve worked with so many patients over the years that have changed their diet, they’ve taken supplements, there may be practicing yoga and meditation, yet they’re still struggling. And I usually find that the missing ingredient number. one missing ingredient I see, at least with the patients I work with, is this whole picture of brain training. How to start to use, apply neuroplasticity, to rewire their brains and get their lives back
Dr Titus Chui 21:42
But the bigger framework that I’ve developed over the years, what I call root cause neurology, is the three pillars of brain health. That’s one of the core foundations of my work, and what I did to heal from my concussion, and how I’ve helped many patients. The three pillars are like the physical brain, right, which we talked about earlier, the communication pathways like your cerebellum, and different things like somatic-based therapies like TMJ work, chiropractic adjustments, vestibular rehab, that all works on sculpting the neural pathways.
About Dr Titus Chui:
Dr. Titus Chiu is a #1 bestselling author, award-winning international speaker, and Functional Neurologist that specializes in Post-Concussion Syndrome.
He teaches people how to heal their brains and reclaim their lives after concussion, through personalized brain training programs, online masterclasses, and immersive wellness retreats.
He is the #1 bestselling author of BrainSAVE! Learn more about Dr. Chiu's unique approach to brain health at www.brainsave.com.
Core purpose / passion : I love teaching and sharing knowledge about the brain to others so they can take their lives to the next level.
About Dr. Manon Bolliger, ND:
Dr. Manon is a Naturopathic Doctor, the Founder of Bowen College, an International Speaker with an upcoming TEDx talk in Jan 2021, and the author of the Amazon best-selling books “What Patient’s Don’t Say if Doctors Don’t Ask” and “A Healer in Every Household”.
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About The Healers Café:
Dr. Manon’s show is the #1 show for medical practitioners and holistic healers to have heart to heart conversations about their day to day lives.
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Dr. Manon 00:03
So welcome to the Healers Cafe and today I have Dr Titus Chui, did I say that correctly?
Dr Titus Chui 00:11
You got it.
Dr. Manon 00:12
Okay, and I’m really excited because he’ll be talking about the root cause of concussion care and how to get to understand what that is, whether you have symptoms, all of that we’re going to explore all this. But let me just tell you a little bit about him. He’s the number one bestselling author, award-winning international speaker, and functional neurologist that specializes in post-concussion syndrome. And he teaches people how to heal their brains and reclaim their lives after concussion through personalized brain training programs, online master classes, and immersive wellness retreats. And well, let’s start with that. So how did you get into all of this yourself? And what made you interested in this and follow this field?
Dr Titus Chui 01:08
Yeah, so it’s been quite a journey. And again, thanks so much for inviting me, it’s great to meet you and chat with you. So over 20 years ago, I was in a terrible car accident, and I was actually on a scooter on my way to work. This was way before I knew anything about neurology or holistic medicine, or any of that. I was living overseas teaching English. On my way to work, I was hit by a car, and I flew like 10 feet off my scooter, broke three ribs, dislocated my shoulder, and suffered a concussion. And so from there, I tried a lot of different things, especially at that time. The most kind of pressing symptoms for me was the chronic pain from the shoulder and the neck. And I tried things within conventional medicine and nothing worked, and so I had to go searching outside the box. And I’m so glad and grateful that I did. Because I was able to turn some of the darkest times in my life into this. It was almost like, I think about it in terms of like, metaphorically, like big pictures, like the universe of slapping me and being like, ‘Hey, you need to change directions’. I didn’t see that at the time. But that’s when I look back on it like, oh, my goodness, yeah. Because I think at the time, I wasn’t living into my higher self, right. And there’s a lot of things that I was struggling with.
Dr Titus Chui 02:32
But anyway, so after that, I went outside the box, I went back to school, I got a degree in chiropractic because that was one of the things that really helped with the chronic pain. My brother, he adjusted me and bam, like the lights turned back on, in terms of pain, like it just dramatically decreased, gave me hope, right. And it also just totally blew my mind into this whole world of natural medicine that I didn’t even really know about. And so I went back to school and became a chiropractor. And along the way, I just fell in love with the brain, neurology. And it was interesting, because at the time, as a chiropractor, I was just so interested in learning about neuroanatomy and physiology. But I was like, “How am I ever going to use this practically for my patients?”. But sure enough, I went to this one seminar as a functional neurology seminar. And all of a sudden all came together. How not only was chiropractic, like, it was not only complimentary to understand neurology, it went hand in hand, right? Because chiropractic first and foremost, the way it works is by changing neurological pathways on one specific level, like changing the cerebellum, there’s research that looks at how it activates the prefrontal cortex, right? So along the way, I discovered neurology, and I just really loved it first and foremost, it was like this way of me understanding frameworks. Like what makes me tick as a human being, what makes us tick collectively, but also very much as a clinician thinking through really difficult cases. Because up to that point is you probably know, there’s a lot of different protocols out there, some of them very effective, especially ones that allow more fluidity, and critical thinking, and I found neurology to really give me that strong foundation. And so from there, I work with all kinds of patients who, like with conditions, and that didn’t fit these other protocols, but then I just go back to my understanding of neurology and kind of build my own along the way. And obviously, when I first started, I wasn’t very good at the building process, but as you know, as you go through time and you develop the skills, not only is it science, but it then becomes an art. So, yeah, that’s kind of how I fell into all this.
Dr. Manon 05:06
It’s interesting because so many times it’s a personal experience that you don’t find solutions for. Because I think a lot of people who have concussions don’t realize that they are suffering from it. And …
I think like your own story when the biggest pain is the shoulder, that is what you are after. Can you kind of bring us through a little bit, what were the steps in which you realized it’s actually a concussion? And how do people recognize that they’re suffering from a concussion?
Dr Titus Chui 05:47
So that’s a great question. Because just like I mentioned, like you brought up, initially, I was like, ‘wow, this pain is terrible’. I wasn’t able to do all the things I love. So I was looking for an answer for them. Thank God, I found it, and as I went through school, chiropractic school, and then I got a master’s in nutrition, and I did a postdoc in neurology, I would learn all these tools. And then I bring them back to my patients and their health would improve. And then after I got those adjustments, a lot of my health improved. And then I learned about diet and supplements. And so I’d experiment on my own health, and a lot of health issues that I had, prior to that car accident growing up, like brain fog, or just I wasn’t very motivated, and I had bad skin and was getting sick all the time. When I started to experiment with those foundational like lifestyle, dietary supplement things, those things just disappeared. And so it was like this deeper discovery process. And so about, let’s see, I would say maybe five years after I graduated, though, right?
Dr Titus Chui 07:00
Even though I think those health problems that I had, that were nagging for my entire life, those started to disappear. Like when I made some foundational changes. Over the course of that time, I would think, probably around the time that I graduated, but then gradually, over the course of about five years, I started to develop these darker psychological symptoms that I never had before. I started to develop anger issues, like sure before I get irritable, but it’d be more uncontrollable. I started to develop, in some situations got really bad, like paranoia, and just a lot of these more mental health issues that I never had growing up. And so it’s really interesting to me, like I said, before, you know, working with patients, I go to all these seminars and learn about the brain and advanced practices, and I bring it back to my patients. I started to experiment on my own brain with those, and those symptoms started to improve. And all of a sudden, is like this light bulb went off and I’m like, or turned on rather, it’s like, ‘Oh, my goodness, I think a lot of that stuff developed from that massive car accident I had 10 years prior’. And then along the way, when I kind of had that realization, I was just like, ‘Wait a second, I actually had several minor head injuries prior to that’. Like growing up I could remember to, and then even after that car accident, there are a few situations, right? And then it all like, it was so, I mean, I don’t even know what the word is just kind of ironic, that I’m this guy, this functional neurologists, helping so many patients with their concussions and I didn’t even realize that you probably have like these newer symptoms that I didn’t really have issues with. At least in part, I think a big part was from that, especially that massive car accident, right? So that’s the thing, in my book, I talk about it. It’s a silent epidemic. I think a lot of people go through life with these unexplained symptoms. And it might not even be neurological or psychological. I’ve worked with patients who develop autoimmunity after a concussion. That’s the whole brain, gut connection leading to expression of autoimmunity need as an example. I’ve worked with a lot of patients who develop chronic digestive issues after having a car accident. And prior to my understanding and a deep dive into the world of concussion care. I was just like, ‘Oh, that’s interesting’. But now I understand the mechanisms underneath that, the science so that we can develop really specific protocols. So yeah, so that was my journey. It was like this awakening, interestingly enough. And then I realized that ‘Oh, my goodness, I think a lot of people out there who have these chronic cases challenges’. After that happened, every time I do an intake, it’s like ‘Do you have a history of concussion?’. And that allowed people like, ‘No, I never’. I’m like, ‘Do you have a history of concussion? Like, were you in a car accident?’.
Dr Titus Chui 10:16
‘Oh, yeah, when I was 15 years old, I was in this really bad car accident, but I suppose it was just whiplash, and then I fell off my bike once and landed on my arm, but that’s when all my symptoms happened’. So it’s like, as you know, being a clinician, it’s like that concussion is just one of those stressors. When we take it we explore. I think it’s a really underrecognized one because you don’t even need head trauma like I experienced to have a concussion. You can, like I said, you can have whiplash. And because our brains exist in this kind of goldfish bowl, it sloshes around, you can. I’ve had patients like I described, and they fall off their bike, and they catch themselves right on their arm. And then all of a sudden, after that they developed on immunity or these neurological symptoms, and they’re like, what’s the connection? Again it’s that physical trauma to the brain.
Dr. Manon 11:15
And it’s interesting, too, because, from a patient perspective, you know that something’s not right, but you go after the pain first. And then you find potentially a solution for the pain, ideally, without drugs with more side effects. But you’re not necessarily told, ‘Do you have a concussion maybe?’ And putting this together is so, so important, especially when we’re looking for solutions
Dr Titus Chui 11:51
Yeah like getting to the root cause. For so many chronic health challenges, sometimes there’s more than one root cause, these triggers that we’re talking about the stressors on the nervous system. But I find again that concussions, even really mild ones, may be built up over time, those are just kind of like checkmarks to that added stress on the nervous system.
Dr. Manon 12:16
So you have a book, and I’m just making sure that the title, I have it right. “Brain Save” Yeah. Okay. So in your book, what is it that you’re helping people be able to do? The ‘Save’ means you can save a brain before it’s ruined.
Dr Titus Chui 12:41
Dr. Manon 12:43
So what is the focus there, and how does it help people?
Dr Titus Chui 12:50
Like I had said before we got on this call, prior to shifting my energy speaking directly to people with concussions, I used to teach other practitioners about neurology, but I realized, I want to give this directly, share this information, and teach a person who’s struggling with some type of health challenges. In this case of the book, post-concussion syndrome. I want to give them the tools to at least get back up on their feet. So the book specifically is written for that person out there. I wish I had this book, honestly, after my car accident over 20 years ago. So it’s directly, it’s like, okay imagine that you had a concussion as an example. And I’m like your best friend. But I’m also somebody that totally understands, who’s also had a concussion, but understands the ins and outs as a professional. And so that’s kind of how the book reads. It’s really a conversation, the whole goal, right is several fold, but one of the major ones is giving people hope, right? Because a lot of people think that after a concussion or brain damage, there’s nothing you can do, based on this really old thinking that the brain doesn’t change. Obviously, there’s a lot more information out there, but I still see a lot of doctors even though they might have read about neuroplasticity, in medical school, and how you apply neuroplasticity to your patient.
Dr Titus Chui 14:25
Number one first and foremost is giving people hope that even regardless if you’ve had a concussion, there are things you can do to heal. Healing is always possible. And that I’m a personal testament to that, to my whole journey. Number two, what I find with a lot of people, especially if they’re already aware that they have a concussion. A lot of people I work with, patients, they have been to other doctors, and the doctors run their tests and then go, “There’s nothing wrong with you, it’s all in your head”. So not only does that person have to deal with the physical and mental, emotional stress of their health challenge, then on top of that they’re dismissed by their practitioner, not because there actually isn’t anything going on, but it’s because of their own lack of understanding around what actually happens with a concussion. So one of the major goals of me writing that book, too, is to be like, ‘hey, what you are dealing with is real’. It actually…you are not crazy, and it actually is all in your head. But it’s a very physical reason why you have these symptoms. And sometimes I remember as I was in the process of writing the book, one of the reasons why I wanted to build that into the narrative, working with patients, I just remember these times, or I’ll do an assessment and exam and I’ll be like, ‘here’s why’. I break it down. They just crying. Please, the first time in 5 10 15 years, someone validates their experience, and not just writes them off.
Dr Titus Chui 16:10
That’s another reason why I wrote the book is just to tell people, ‘What you’re experiencing is real. And, more importantly, there’s…well not more, but just as important, there are actually things you can do about it. So at the end of the book, and part three, there’s a six-week plan that walks people through some of the foundational steps that they can take, at least to get themselves off the ground. And the great thing is, depending on where they’re at in their healing journey, I’ve heard from some people, I love it, I hear from people all over the world like on social media or messaging me, they’re like, ‘After I tried that one thing, my energy levels”. I just love that. So some people, it’s just like one little thing. And it’s this foundational approach, where for other people who have a more severe situation, at least it helps them get off, get energy, then to be able to seek out further treatments, or more advanced things as needed. So those are the three main reasons and I would have to say one last thing about that, is also just to bring awareness, because kind of like what you alluded to and what we’re speaking to here, I think it’s a silent epidemic.
Dr Titus Chui 17:22
I think a lot of people have had concussions, that might not be the number one root cause for their symptoms. But I’ve worked with so many patients over the years that have changed their diet, they’ve taken supplements, there may be practicing yoga and meditation, yet they’re still struggling. And I usually find that the missing ingredient number. one missing ingredient I see, at least with the patients I work with, is this whole picture of brain training. How to start to use, apply neuroplasticity, to rewire their brains and get their lives back. It is a completely different approach because the brain is unique in that not only does it require nutrients, and requires rest, and movement, and all that, but it also requires activation to a very specific neurological pathway.
Dr. Manon 18:16
I’d be very curious if…I was just gonna share a little bit about my own practice, and the reason I got so interested in concussions, is because either people were diagnosed with it, and it’s exactly the tale you tell. It’s like, well, there’s nothing, they don’t have hope. But they have something else. So they’ve come in with a concussion and some problem. And in the work I do, which is called Bowen Therapy, and then I’ve sort of added plenty to it, and work with trauma and emotional trauma as well because I find that a lot of things add up together. And so it’s really wonderful to sort of undo all of that and get to the root cause but what I have found is that symptoms of concussion disappear with this work and then retrospectively they go back but without the scans or without other ways. Everything’s changed, but they don’t, they can’t tell their doctor, “Oh, I’ve changed, like everything’s different now. I feel so much better”. They have the energy they have, and a lot of this is work that I do with the actual TMJ joint.
Dr Titus Chui 19:41
Oh, huge. Yeah.
Dr. Manon 19:42
Yeah. So I was just wondering how, and sometimes the coccyx which you think oh, well, that’s on the opposite side. So what is your…how do you explain the work you do? How does it work? Yeah, what can people learn on the level?
Dr Titus Chui 20:01
So that’s awesome. Yeah, I love the fact that you mentioned the TMJ, because even from a biomechanical perspective if someone’s had trauma to this area, it can create symptomatology. And so what’s really fascinating though, from a neurological standpoint, in your prior, where it’s like the TMJ is one of the most important joints in the body because of the semantic topic representation in the brain. And for those of you out there who have no idea what I just said, meaning, the amount of brain cells dedicated to the perception of your jaw, as well as the control of your jaw is massive, And so I find a lot of people, part of my process, too is identifying, number one, what’s the root cause for this person. And for some people, it could be like a TMJ that’s off, I find another access point that’s really powerful for people with a concussion, especially if they have motion sickness, vertigo, or dizziness, is the inner ear. So doing different types of inner ear movements or eye exercises and different types of vestibular. We call this vestibular rehab, like combining that with TMJ work. That’s massive. And when you talk about the coccyx yeah, absolutely. It’s like, just, you know, trained as a chiropractor, like I was saying earlier, one of the ways in which chiropractic works, when we do an adjustment to the spine or to a joint, it powerfully activates this nerve impulse and action potential into the cerebellum. But we can be really intentional based on what we find in the analysis. And so whenever I think about…that’s just one aspect of concussion care.
Dr Titus Chui 21:42
But the bigger framework that I’ve developed over the years, what I call root cause neurology, is the three pillars of brain health. That’s one of the core foundations of my work, and what I did to heal from my concussion, and how I’ve helped many patients. The three pillars are like the physical brain, right, which we talked about earlier, the communication pathways like your cerebellum, and different things like somatic-based therapies like TMJ work, chiropractic adjustments, vestibular rehab, that all works on sculpting the neural pathways. Just like we’ve talked about, that’s one of the number one missing ingredients I see in any care plan. Because medicine is so biased towards biochemistry right? Now, it’s important, and what I mean by biochemistry, like diet and supplements, medications, even. So that’s what I call the chemical brain. So the second pillar is if we’re thinking about the physical brain as, like the roots of the tree, the soil is the chemistry. So the chemistry that actual physical brains exist in, very much determines the function of our physical brain, like the communication, how fast it is, or how slow it is, if it’s muffled. So I find that in addition to looking at the physical structures, and we can do that through neurological exam findings, and then we can fix that through different types of somatic-based therapies, using the senses. Whether, somatic base work, or we can also use light therapy, sounds, smell, taste, and we can also use the vestibular senses was proprioceptor. So things like band balance exercise. My point is, all that works to the physical structures to create neural plasticity. Now, I’ve worked with a lot of patients too, though, and myself included, that had that work that we’re blessed to have found someone like you or someone that like me, or a vestibular therapist or chiropractor. Maybe the chiropractor didn’t even know about the concussion, but they’re just like, ‘Well when I adjust this, things improve’. But I’ve had patients who were the opposite, they actually were able to connect with therapists that worked on the physical structures, but they’re still struggling, and then I do an inventory on their health. And I’d be like, ‘Whoa, you’ve had this digestive issue for years prior to your concussion’. And it wasn’t until we identified that, and there are different ways of doing it. You can do it through physical exam findings. You can do it through self-assessment quizzes, and there are advanced lab tests out there now that explore your microbiome and explore if you have leaky gut or small intestinal bacterial overgrowth. So all those things, my point is, they’re windows into the chemistry and so sometimes it just has to be personalized, that was actually the case for me. I did a lot of the brain training myself. I did like higher-tech electrosurgical devices, low-level laser therapy to target the neural networks, meaning to strengthen the physical brain. But I got better but then I hit a point plateau, there was still a thing…I don’t know how to describe it. It’s more like this. You know Viktor Frankl, he has that saying between stimulus and response we have that space. My space was very small, stimulus-response. Even after all the brain training I did, and I identified a gut infection through some lab testing on myself. I put myself on a gut healing protocol, bam, that’s what took my health then to the next level.
Manon Bolliger 25:33
Many people don’t realize that our neurotransmitters are actually also in our guts, your gut actually does this. So as my background is as a naturopathic medical doctor, and we do that too, and it’s like, if that’s missing, I think it’s interesting. There are so many ways to actually help people. That’s why I say if it’s not working one way, knock on another door, or don’t give up because so many people have a piece of the pie but not, they don’t see the whole picture.
Dr Titus Chui 26:14
So it’s like for me, I did a lot of the physical stuff. And then the next step for me was the gut stuff. And after I did that, that space started to grow, between stimulus and response. I was just more present in my life, less irritable, and that healing continued to happen. So that’s the second pillar, right, the chemistry. And then the third pillar that I look at when it comes to brain health and concussion recovery, is the emotional brain. And what I mean by that is, like, the thoughts that we think, the beliefs that we hold about ourselves, about our healing, about the world. As well as our stress management practices. Do we have downtime, like, all those different things that nurture our emotional health, all three things, all three pillars need to be intact, I found for a person to really truly experience that deeper healing. Physical, chemical, emotional. You make a great point, it’s like if something isn’t working for you, like for those of you watching out there, knock on another door, right? Because that’s the thing. Now, the key is personalization, you have to find what works for you. And so I can be telling you guys right now if those of you watching, you’re struggling with a concussion, you’re like, ‘Oh, I’m gonna’ do a gut healing protocol’. And you do it. And you’re like ‘Dr. Chui, that didn’t do anything for me’. Probably because your gut wasn’t involved, right. And so the cool thing is, outside of just working with a practitioner that has a window into what the most powerful access points are, your body also has clues. So as an example, if you’re struggling with a concussion, and you have constant gas and bloating, you might want to look into the gut healing protocol, right. And there’s also physical signs as well, like, the skin on the back of your arms. If you have bumps on it, it’s a sign that you might have a gut issue or food sensitivity. So those are all clues that we as trained practitioners look at, but you can also start looking into those things yourself as clues as to ‘Hmm, maybe I should explore gut stuff’. Or it’s like, ‘Oh, no, I’ve already done all that, but when I stand up, I get a little lightheaded, or when I move quickly, and my heart races more so than it should’, that might mean that you need to explore the physical structures, like your brain stem as an example. So those are just little like tidbits for those practitioners, right? There are three ways where you can kind of piece it together yourself, but obviously, right. I’ve worked with a lot of patients who’ve tried putting it all together themselves, maybe because they were discouraged by a practitioner who just didn’t get it and dismissed them. Or maybe they just don’t have access. You know, at some point it is when you can connect with someone who’s been through that. That whole process can be accelerated, like tenfold. That’s one of the reasons why I wrote my book and I actually just released a brand new masterclass, a six-module masterclass. Because I wish I had the resources when I was going through it back in the day, because number one, I would have even realized, ‘oh, my goodness, some of my health issues are from a concussion’. I didn’t even know that. But then number two actually having practical resources and actions that I could take on my own. So that’s one of my missions. In addition to, like I said, going through the process and working with many patients over the years, I love that process. And as I went to school, I also continued, developed this…discovered this deep passion for teaching too. ‘Wow, how can I combine the two? I’m gonna write a book!’ I’m going to teach the person who’s struggling with the concussion, teach them how to fix their own brains, at least the first few steps to get themselves from a crisis situation to start feeling better. So then they have the resources to continue the exploration as needed.
Manon Bolliger 30:22
Action. I’m curious on this point because I totally agree with everything you’re saying, and bringing people hope. And hope, it’s not phony hope. It’s not like, I think somebody said to me, hope is dope, but doesn’t do anything. And it’s like, no, it’s not true. It’s like because we live in a world in which our medical system is not healing based. It’s really disease management. And so it is a paradigm shift when the customer, the patient decides, “Okay, I actually want to get, not just mask all this discomfort, and pain, and make new stories about how inept I am now, or how upset I am”. Or whatever the story is, they really want to get through this when their healing journey is also their life journey.
Dr Titus Chui 31:25
Exactly, and there is that shift. Exactly.
Dr. Manon 31:28
Exactly. And then, you know, you open up to so many things. One of the things, though, that I found fundamental in my work, and I’m just curious for you, is the work with the parasympathetic system, or vagus nerve, but the idea of shifting people that are in the sympathetic overdrive. And I found with concussions, whether its whiplash, the cause, or any sort of acrobatic guarding where the brain still gets knocked up, they still experienced a deep stress, a fear of what could have happened, especially with car accidents. And I feel like until we address that fear, that emotion, but not just the emotion, the physiological impact of that. It’s much harder to heal. So how are you seeing that?
Dr Titus Chui 32:30
Oh, yeah, absolutely. We can talk about the parasympathetic versus sympathetic, right? Those are really important parts of this conversation. Because when you’re stuck in the fight or flight mode, you’re all about survival, but not about healing. So the parasympathetic is all about the healing response. But in addition, like what I found in my research too, actually before we get there, one of the core areas is the brainstem. When we talk about within the nervous system, there are multiple control points of the autonomic nervous system. Everyone, a lot of people talk about the brainstem as being one of them, and the vagus nerve that’s really popular these days. So that’s one point, right? And specifically, the top part of the brainstem. Let me show this here is what we call the mesencephalon, or the medulla. So this is the brainstem, for those of you who are watching, here’s the outer covering, and when I flip it around this like the deeper structures inside. And then the brainstem is situated in between your brain and your spinal cord. So I’m pulling that out. And one of the core like nodal points of that sympathetic parasympathetic balance is your brain stem. The top part, your midbrain or mesencephalon, is kind of like, it puts the accelerator on your fight or flight response. Whereas the bottom part, the medulla, it puts the brakes. So these two kind of work hand in hand to modulate that stress response versus that resting, digesting, and healing, right. And so that’s where the vagus nerve comes in. And by the way, the vagus nerve actually has a dirty little secret, and it’s actually just a communicator, it’s a connector. More importantly, it’s actually your brainstem, the medulla, and the organs that the vagus nerve connects with. So I know a lot of people. Everyone’s like, so hot about the vagus nerve, but as a function neurologist, like, I’m kind of geeking out here nerding out a little bit. More importantly, is the brainstem structure because that’s what controls the vagus, right? And then from there, like I was saying before, this is one big checkpoint in the whole autonomic balance, between being focused and alert and in the fight or flight versus resting, digesting, and healing. But that’s just one structure. There are other structures involved. The cerebellum as an example, we talked about that earlier through Chiropractic and other somatic bodywork. The cerebellum communicates powerfully to the brainstem. And so that’s another access point that we can use to help modulate the whole stress response after trauma. But then from there, we can go even further. I’m gonna go back and put the brainstem in its rightful place. Who controls the show? Like the kind of the boss of it all is the prefrontal cortex. So many of you out there watching this probably heard it, whether you’re a practitioner or not, the hypothalamic-pituitary-adrenal axis, the circuitry of the stress response. Guess who sits above the hypothalamus? The prefrontal cortex, so that’s where things like meditation, and biofeedback neurofeedback, come into play. The thing is, though, and what I’ve seen in my practice, and you can probably attest to this in your experience when it comes to things like fear after trauma as an example, we can try to talk ourselves out of it. Like, let’s say I was in a car accident, here’s a good example…years ago, when I was in that car accident, prior to that I was in a massive earthquake. I’d never been in one before, but I actually developed PTSD afterward, after the earthquake. Because I’m from Chicago, the Midwest of the United States. Yeah, we get rain and snow. Those are natural catastrophes. This massive earthquake, I was so traumatized after that, but I didn’t realize that. But one thing that clued me into that I remember afterward, but I didn’t put the two and two together. I never was afraid of flying. And then I developed this fear of flying. What? Am I just like, “What, where did that come from?”. But then it all of a sudden, it hit me because I was on this elevator one day, and the elevator is going up, right, and when it stopped, it went like this…it jiggled. I had the same fear response. It wasn’t flying. It was in an elevator. But what the two had in common was this motion. So my nervous system because the earthquake was that strong, it was going up and down. It was imprinted in me that this motion is dangerous, I’m going to be afraid. My point in describing all this regardless of you know, I’ve been in car accidents, all this trauma that was honestly more traumatic, for me, at least in terms of the fear than the actual car accident. Like I got on a scooter, like probably like three months later, but part of that is probably causing damage to the frontal cortex. Very good discernment.
Dr Titus Chui 37:53
But that being said, you know, we’re all works in progress. So from my point of view, I could sit on that elevator, even though I realized, had that insight into that, I could be on the airplane and be like, there’s nothing to be afraid of, there’s nothing. I can try to engage my prefrontal cortex and say there is nothing to be afraid of the statistics of blah, blah, blah, and blah, blah. Doesn’t matter, because who’s running the show at that point? It’s the brainstem. It’s the limbic system is what we call the reptilian brain. In particular, I find that a lot of people after trauma, and it could be both emotional or physical, their midbrain, in particular, gets stuck in overdrive. How do I know? Because one of the things the midbrain processes is lights and sounds, and also the startle response. So I see this time and time again, after an especially physical trauma, people just get really jumpy, like noise. They’re like, Whoa, right? Or they become really sensitive to light and sounds. That tells me that their midbrain is stuck in overdrive. That’s so, I’m glad you brought that up. Because you know, a lot of people then think like, ‘Oh, so if I’m afraid of driving now, because of this, I just have to face my fears’. Sometimes that’ll help, right? Or I just have to think happy thoughts, or just have to visualize my beautiful reality. Now those are things I do now in my life. But when I was in the midst of it, the rock bottom, I tried those things and it didn’t work. I felt terrible about that, right? I’m like, everyone else is thinking positively working for them. But then what I realized ‘Oh, it is because it was these subcortical structures, meaning underneath the brain, the brainstem, the amygdala, the cerebellum to name a few. That’s where when I focus the energy on for myself and for my patients, that’s when the breakthroughs start happening. Because in the battle between your brainstem and your prefrontal cortex, which is relatively new, because of a newer structure. This one is all about survival. Who do you think is going to win? Right? And thank God because if your brainstem didn’t work, it’s responsible for vital life-giving functions like breathing, right? So, but that’s the thing in trauma, those things that help us to survive on a base level they will, but at what cost? So I agree with you, I think facing those fears, but what I found in my practice, that whole like three pillars approach, physical, chemical, emotional…if people are struggling with fear or some anxiety after trauma, I don’t find that this top-down approach doesn’t work.
Dr. Manon 40:41
Dr Titus Chui 40:42
It’s like lifting heavy items. It’s like, it’ll help kind of move things along, but it’s like this uphill battle. Whereas if we start with the body, if we start with the senses.
Dr. Manon 40:52
Oh, it’s so exciting. No, it’s true, because for me, I mean, it’s my reality as well. And people say, ‘Oh, no, just think better’. Whatever, like, no, it’s really physiological. And it’s like, turning a switch off and telling the body it’s safe. And then it starts to rewire. And then you can talk about all the things.
Dr Titus Chui 41:20
The language of the brainstem is not about compassion, and patience, and gratitude, and positivity, it is survival at all costs. So you have to speak to it on that level, but the great news is, and you alluded to this earlier, one way of doing that is by activation of the vagus nerve, more specifically, the medulla, which is just as old a structure as the top part. And so you don’t have to, then it becomes, like I said a switch rather than this painful, like just cognitively, mentally, emotionally draining affirmations or positivity. Which don’t get me wrong, I practice all those things now, because now it’s like my prefrontal cortex is no longer strangled by my brainstem, and allows me to tap into those higher functions or higher expressions of humanity, right. But, if we’re stuck in this survival mode, it’s so hard to break through that until, like you said, you start flipping that switch.
Dr. Manon 42:28
Exactly. One more case just comes to mind, but this is now in modern medicine, and this is the conventional approach to a person who had a concussion. A young woman and she came to see me and she was put on antipsychotics. And that’s because her brain wasn’t right. And so they look at it like that’s the problem. And I know, when I treated her, it only took three sessions, literally, switch this, and then, because I didn’t prescribe those drugs, I always refer respectfully back to the person who did. I said, “Go check whether there could be a way of weaning you off?”. Because all of the symptoms she had went away. And that was exactly that switch. And that’s it. And that’s all that she needed, and she had put off like she was going to get married, she had all these plans.
Dr Titus Chui 43:36
Kind of put your life on hold, right?
Dr. Manon 43:38
Absolutely. And, you know, she wasn’t even sure she could offer her life with her partner, and just said, ‘Maybe I just set you free’. The consequences of the lack of knowledge.
Dr Titus Chui 43:51
Exactly. And that’s what again, like I said, one of my missions is to get that information out there directly to the people that need it, you know,
Dr. Manon 44:00
Dr Titus Chui 44:02
I love that story you shared because alluding back to what I said earlier, I think a lot of us unless we really are in it either as a practitioner working with patients or as like myself, not only a practitioner but actually gone through that process personally. We’re taught that the brain you’re given, like, even your personality, there’s you know, we can definitely have a conversation about that. But it’s like, this is what you have, and if there’s damage, there’s nothing you can do. And that can’t be further from the truth, you know, but the interesting thing is, not only is it possible to heal through the miracle of neuroplasticity, it’s not my opinion, it’s just scientific fact. Not only is it possible, it can happen rapidly, just like we’re describing. I’ve had similar, I had this one patient who after her concussion for two years she developed insomnia. She didn’t have one solid night’s rest throughout over two years. And through my assessment, I determined that a big part of it was this midbrain because she had a lot of the jumpy symptoms like the Star Wars response and sensitivity to light and sound. All we did was different things to activate her vagus nerve and activate that lower part of her brainstem. Within three days, I think it’s three or five days, she had her first solid night sleep. And that’s what we’re talking about. Like once you find that switch, not only is it possible to heal, but it could happen much more rapidly. That doesn’t say she was done right, there are still like, chemical things, and stress hormones, and other things we needed to work on. And more foundational lifestyle stuff, but it was just kind of like that.
Dr. Manon 45:57
It’s almost like the journey begins.
Dr Titus Chui 45:59
Yeah, exactly. You can feel that as a practitioner that you just know, your intuition, and your experiences. But also, the great thing is, through the neurological approach that I use, there are physical signs of that. Because when we talk about sympathetic, parasympathetic, right pupil dilation is a sign of heightened fight or flight response, or like, excess sweat depending on the type of sweat, heart rate, pulse. There are actually objective findings that are clues. And again, when I tell my patients that they’re just like, right? Because that’s the thing like you talked about, you alluded to this earlier, how some people it’s just like, they run the test, and there’s just like, nothing wrong. The great thing is there are clues, right? There are windows into these physical structures that you can see. Size of the pupil, right? Sometimes I work with patients who have what we call dysautonomia, imbalance, or dysregulation of their autonomic nervous system, they might sweat more on one side versus another. Guess what, that’s a clue. And once we start normalizing that, then we know we’re moving in the right direction. So it’s awesome because there are concrete things, but I’m sure just like, you, right, as we do this over time, we develop that intuition too, right? Where we just know, but the fact that there are these physical signs, so as I love teaching my patients about that they can start checking in on themselves. Oh, right. I feel like I’m moving in the right direction, you know,
Manon Bolliger 47:35
So our time is up, it just flew by.
Dr Titus Chui 47:39
This is a great conversation.
Manon Bolliger 47:43
When I post this, if you have a link to your book, or where people could purchase it, or your course if you’re training practitioners, please share with me and then I will list that and let you know when we’re live.
Dr Titus Chui 47:58
Manon Bolliger 48:01
Thank you so much.
Thank you for joining us. For more information, go to DrManonBolliger.com.