Is Past Trauma Leading to Chronic Pain with Deana Tsiapalis on The Healers Café with Manon Bolliger

a deeper level. Plus, I do work with a lot of people who live with pain, and it just kind of came together it really I just felt like I fell into this path.

Manon Bolliger  02:28

Interesting. So like, this might be a what’s that called…a bird’s eye view. Right? So it’s the top right?

Deana Tsiapalis  02:37

Eye level. Yes.

Manon Bolliger  02:38

What would you say are the the the biggest misconceptions about pain? Where do we get it wrong?

Deana Tsiapalis  02:48

Oh, quite a few places. But on the big picture, and I just had this conversation with my stepmom about 20 minutes ago. There’s a real disbelief when they see someone who’s smiling and, you know, carrying on with life doing their best to carry on with life, that they’re fine, that they can get up and walk and why do they need that handicap parking spot? You know, there is that real uneducatedness about our society or unawareness from our society around chronic pain. We’re really good at understanding acute pain, you know, we get that part. But we don’t understand fully as a society, what chronic pain is, and what the lived experience is for those who live with chronic pain, chronic illness is very much the same. So that’s sort of on the society side. And then medically we have some challenges, actually, a whole lot of challenges around how we deal with chronic pain. It’s starting to shift. But we have some work to do for sure.

Manon Bolliger  03:46

Well, can you expand on that?

Deana Tsiapalis  03:48

Yes, absolutely. So again, our medical system is really good at understanding treating the acute response to pain and that is, you know, getting a diagnosis. You know, if you sprained your ankle, you break a bone, you need a shoulder replacement, hip replacement, those are all the acute issues that you know, our society understands and our medical model handles quite well. But because chronic pain is so very different from acute pain and how it happens and how the brain interprets pain and how the nervous system becomes involved it is very different and so we don’t treat that part well and we don’t treat beyond just the biological. We treat the biological only and we miss completely the psychological the social spiritual, you know all this other pieces that come with chronic pain.

Manon Bolliger  04:47

And so, okay, which is a big part. I’m gathering your is what you’re sharing about that. So when it’s focused on the physical only, what are or the what’s actually the problem with the most of the therapies that are out there for pain?

Deana Tsiapalis  05:07

Right. So it is important that they address the biological aspect, which is great. You know, if you have a physiotherapist or massage therapist or your specialist or your physician, you know, they’re gonna do the deep dive to understand what’s causing that pain. Is it a red flag that we need to rule out? You know, yes or no. But once, you know, we figured out that the scans are showing that everything’s fine. Like there’s no more tissue damage, but there’s a whole lot of pain being experienced, then we need to, we need to kind of do a deeper dive and understanding of okay, so why are you feeling pain? Still? Is it because of a red flag? Or is it because we now know that perhaps you experienced acute trauma or chronic trauma, when you were a child. Perhaps there is a lot of stress in your life currently, that is leading to more pain, perhaps you’re in a relationship that’s not as secure, perhaps, you know, financially, you’re struggling. I mean, there’s everything matters when it comes to chronic pain. And when we don’t necessarily treat that part of pain, pain won’t go away. And so, you know, there’s a big piece that we’re missing. And then there’s that social piece, which is that isolation and that loneliness that a lot of our community feels because they can’t get out as much with their friends because of the pain. They’re fearful to participate in life because of the pain. It’s just what pain does to us.

Manon Bolliger  06:33

So why do you think that that’s not looked at as much as it should be?

Deana Tsiapalis  06:41

Very good questions. First and foremost, I believe that our good doctors and nurses are doing their darndest, I don’t think it’s a problem of them not wanting to help. It’s just there…for the longest time, really over 100 years they were not trained, they don’t have that chronic pain awareness, just like they don’t necessarily have trauma informed care. It’s not necessarily as person centered the care as it could be. A because they don’t have the time, you know, our system is set up where your quick fix you’re in, you’re out, you get a quick conversation. I know you know that well with your practice. And also, just that unawareness, you know, veterinarians actually get more chronic pain training, then do sort of our older generation of physicians, again, it is starting to change. But even still, if you were to ask a good portion of our physicians, they would say, I really wish I had more chronic pain education, or more exposure to how to treat the multi aspects of pain.

Manon Bolliger  07:45

And in the type of practice you do, so it’s a combination of counseling, but an education, but also, when we say physical health, are there modalities that you use for pain management, or?

Deana Tsiapalis  08:03

Great question again, yes, so I’m a little biased, I am also a certified Pilates instructor. And I love Pilates, because you can modify the movements to the smallest degree. And so it really becomes about remedial movement as opposed to, you know, I don’t often tell people, I’m a Pilates instructor, because just that word brings up a lot of alarm bells, they have images in their head, that they’re going to be hanging upside down from something that’s really not looking very comfortable. And their brain interprets that as this is not safe. And so but what we can do is really just teach them how to move safely, but also do the pre work to make sure that they’re sort of changing, working towards changing their beliefs or thoughts on their capabilities and shifting the fear a little bit, because that’s often what holds people back from moving is the pain or the fear of the pain.

Manon Bolliger  08:59

Do you like…because I mean, it’s interesting. I was trained, as you probably know, as a naturopathic doctor, which is really not that different in the philosophy you would think it should be or it could be but really isn’t. You know, we still are so called science based.

Deana Tsiapalis  09:22

Yes.

Manon Bolliger  09:23

And the science on pain is very lacking to say the least.

Deana Tsiapalis  09:29

It’s true. And when there is information or data to be pulled, you know, it takes 17 years, the research is just coming out that takes 17 years to go from the initial start of the research to clinical practice. That’s a long time. You know, it’s no wonder it’s not getting filtered down. And then on top of that, there’s not a ton of research. It’s starting to change however, it is slow.

Manon Bolliger  09:54

And for a lot of naturopaths they’ll do things like you know, look at inflammation.

Deana Tsiapalis  10:00

Yes.

Manon Bolliger  10:02

Reducing inflammation, it is true that a lot of people’s pain improves greatly. Or if you make lifestyle changes. You know that those parts are true. And I’ve seen that to be true. But I have…yeah, I think what I got really when I got really interested with pain is because of the trauma aspect of it.

Deana Tsiapalis  10:27

Yes.

Manon Bolliger  10:28

And that’s where I woke up and went, Oh, my goodness, we we don’t understand it.

Deana Tsiapalis  10:34

It’s so true. And it’s, there’s a large portion of the community who will go to the doctor and the doctor, you know, will summon up enough courage because they’re not trained in this to say, hey, is there any experience with trauma? And a lot of times they’re left thinking, why on earth is he asking me, or she asked me about trauma. But it absolutely as you’ve seen time and time again, is just such a part of the experience.

Manon Bolliger  11:00

Yeah, no. I do. Have you heard of Bowen therapy?

Deana Tsiapalis  11:06

Yes.

Manon Bolliger  11:07

Okay. Positively. It seems like.

Deana Tsiapalis  11:09

Yes, absolutely.

Manon Bolliger  11:12

Because it’s not that well known. But I have found so many times people would go to physio. Which I’m not saying it’s wrong. But it is really good rehabilitation. It’s after. But when a person, let’s say has a car accident, and there’s trauma in the body?

Deana Tsiapalis  11:30

Yes.

Manon Bolliger  11:31

If you start working as if the trauma wasn’t there, their body is not ready for it. You have to have therapies that address actually the trauma.

Deana Tsiapalis  11:43

Right. You’re right, because if we keep treating without addressing the trauma, you’re right, not much is going to happen. It’s almost like if you have you know, a woman who’s in an abusive relationship, and you address her pain, you know, biologically, but then you send her back home, that pain does not resolve, right? Yeah.

Manon Bolliger  12:06

Yeah. So what do you do then yourself or what have you seen useful to address trauma?

Deana Tsiapalis  12:13

Right. So, I am not a therapist. However, as a coach, we can sort of take their perspective, as you know, if you need to see a trauma informed therapist, absolutely go and see a trauma informed therapist, they’re going to allow you to do that deep dive into the past. Then we can sort of pick it up from there and take them and help move them forward. So I’m a big believer in the polyvagal theory, and dealing with the nervous system and teaching our clients who have lived trauma and are currently living with pain, to be able to at least navigate their nervous system a little more safely. And with a little more know how than just sort of reacting and not understanding why they’re responding this way, or why they’re shutting down. So I do believe that’s one of the first places we start is to just really teach them how to move through their autonomic nervous system with a little more confidence.

Manon Bolliger  13:08

Yeah. Like you’re like, modulate a little bit there.

Deana Tsiapalis  13:12

Yeah. Right. Right. And yeah, you would understand that completely with the work that you do you. Yeah. And so it’s a little unique from person to person, obviously. But on the whole on the big picture, you know, there’s that awareness that Oh, wow, you know, there’s a little bit of control that I actually have. This is fascinating.

Manon Bolliger  13:35

And do you find that, because, you know, we do live in a, in a society where we’re very much programmed to believe a whole bunch of things. And some of that is true, and some of it is not, you know. I have found a lot of people are sort of programmed to think they cannot actually heal.

Deana Tsiapalis  13:58

Right.

Manon Bolliger  13:59

Is that how are you finding that to be?

Deana Tsiapalis  14:01

Very much so. It’s almost like they’ve given up on their capabilities, and or they’ve not been shown or taught how impressive their body really is, you know. You know, the message, the rhetoric, often, especially anxiety is always the best example I give, you know, to understand how that really serves us and has for 1000s of years, it’s just it sometimes goes a little too far. So we don’t want to get rid of anxiety. We just want to be able to work with it and walk beside it as opposed to be taken over by you know, feelings of anxiousness. Same with pain, pain serves us well, it’s actually there for a very important reason. It’s just it gets a little out of control. And so we need to work with it. So yeah.

Manon Bolliger  14:46

But do you think that I mean, I guess I’m looking in my experience, you know, because when I started I didn’t actually know what could be healed. What the body could really do. You know, it’s like you start you don’t know you read books, and in books, most things that are incurable, you know. And then yet in practice, I found a different reality, I found that that the body was way more powerful than I had ever given it credit for.

Deana Tsiapalis  15:15

Right. Yeah.

Manon Bolliger  15:18

How are we…because it’s a fine line, you know, there’s like pain in which these people feeling it need to be trusted, and they acknowledge, you don’t want to say, oh, it’s in your head, you’re not doing it like I would never go there. And we’re also living in a society where people don’t have hope.

Deana Tsiapalis  15:37

Right. Oh, yes.

Manon Bolliger  15:39

There are actually therapies and things that could get to a root cause or it could really clear that. They don’t just have to manage it. Do you know what I mean? How it’s…

Deana Tsiapalis  15:53

Absolutely. And that’s a great, I love that you brought this up, because…

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Deana Tsiapalis  17:06

I’m always you know how you mentioned you feel like you’re just starting, you know, or not that you’re just starting. But when you started, you were just starting. And I always feel like I’m in that I’m just starting because there’s always so much to learn, right? But we’re always still learning about what our bodies are capable of. And the word healing, unfortunately, I feel like it’s been hijacked. You know, by the medical community. So there’s a lot of people who just don’t believe that they can heal. Now, healing can take many different forms, as you know. You know, healing relationships, healing, spirituality, and healing tissue. So, I do find, and I’m hoping as I continue to learn and grow in this business, that I can be a little more bold in my approach, but I feel like I’m being a little protective when I use the word healing, because I feel like…and that’s a problem. As a coach, I need to, you know, really showcase that, yes, you can heal, I need to help you understand that you have more capabilities, more capacity than you think you have. But I’m also very protective to to say, well, there may be people who don’t heal, but have they done all the things that they need to do to get to the point of healing? Right. So it’s a really interesting conversation.

Manon Bolliger  18:20

Yeah, it’s interesting, especially as you guide people, you know, it’s like the, the limitation of experience or, you know, access to right that we individually have is our belief system.

Deana Tsiapalis  18:36

Right. Right.

Manon Bolliger  18:38

In a sense, it’s like until I had seen, you know, frozen shoulder heal very quickly, I always thought, Oh, that’s such a painful thing. I hope nobody ever gets it or comes here until, you know. And then it’s like, oh, please come in. Because, you know, you don’t have to experience what you have. Right? So this therapy is great. I’m just saying, we all have different things from our collective experience, where certain types of conditions work really well with certain types of therapies. And, you know, I wonder if there’s enough effort to put all that out so that people first believe that their bodies can heal. You know, like we see what’s happened with I mean, how they, how as a society, we accepted that our immune system was so useless.

Deana Tsiapalis  19:35

Right. Yeah, that’s the messaging. We keep hearing. Right. You know, there’s nothing more to do or there’s, yeah, I do. I think that’s one of the gaps we need to fill. And that’s what I worry about is that the messaging is just so dire. No wonder a lot of people don’t have hope. Because the way that the messaging comes across, whether you’re getting your diagnosis or your images, you know, talked about with your physician, there’s a lot of directness to the conversation and the way and words words really matter. You know, when you’re told there’s nothing else we can do. So many people just go, Okay. Well, my life now.

Manon Bolliger  20:15

I know exactly. I mean, you know, I’ve had patients with MS. And I actually had Ms myself, right. But it’s like, Ah, you’re done? Oh, well, you know, it’s a question of time until you’re in a wheelchair. And it really is just, you know, does it need to be this way? And you go to support groups, and a lot of them have that sort of, it’s as if there’s this collective suffering because the outside world doesn’t know it’s even worse with fibromyalgia and conditions that are less visible. Where you feel like you, you know, you must be lying, but you’re not. You’re objectively in pain, right?

Deana Tsiapalis  21:02

Yes. And you’re just having to spend a lot of energy covering up all that pain. Yeah, which is so sad.

Manon Bolliger  21:11

It is. I was gonna say it goes both ways. Because it’s like, then it sort of becomes a cesspool of negativity. Actually, if that wasn’t like that, people would say, well, you know, why can’t you heal it?

Deana Tsiapalis  21:31

Yeah, well, no one, no one’s said that to them. That’s the sad part. And you’re right. And I mean, I know, there are people saying that, but if they don’t have that belief in them, and it’s also, you know, I don’t want to put this completely back into those who are suffering with pain, it’s not their fault. It’s definitely just the way the brain and the nervous system, right works. And so if we can then start to work with building that safety, which I think will help them to increase the amount of belief that they have in themselves, like, it’s hard to go from a place of, there’s nothing more we can do, to believing in yourself, believing in your capabilities and your body’s capabilities. So it’s a lot of work in between, right.

Manon Bolliger  22:12

Yeah, no, that’s why it’s an interesting field. You know, and I think that is, I mean, in my humble opinion, is one of the fields that has the biggest amount of work that can be added to it.

Deana Tsiapalis  22:26

I agree. And, and, and the challenge of trying to gently nurture people to a point where they believe that this is a possibility as well, you know, that’s always right,

Manon Bolliger  22:38

That is part of the relationship that, you know, gets forgotten with so many therapeutic interventions, right? Whether it’s drugs or even physical stuff, you know, sometimes patients get hurt. No explanation of why you have to have pain. No don’t know, you know, anyways, it’s a it’s a very interesting thing. So what, what has been the most like, remarkable, you know, eye opening experience in your…how long have you been doing this?

Deana Tsiapalis  23:15

I still feel like I’m starting, but I’ve been doing it for officially five years unofficially about 12. So, you know, to call myself a chronic pain coach, that’s been about five years. Took me a while to figure out that’s actually what I’m doing. But yeah, I think, Oh, that’s a great question. Because I think I get most excited about the eye opening the aha moments, the revelations that people start to have when they start to learn how pain works, and what things they can actually do for themselves, as opposed to have done to themselves that they can start then mitigating the pain differently. Walking with the pain differently, I think those little aha moments like, Oh, this is tied into my partner’s death, you know, like those…those for us, as you know, inside the business, understand that those are big deals, but a lot of people just don’t have that knowledge. When a flare up is coming and coming on and it’s coming on hard. It’s because it’s the one year anniversary, you know, of this passing of your loved one. And, of course, it was difficult. So just those little aha moments I live for.

Manon Bolliger  24:37

Yeah, well, it’s consciousness, right? It’s becoming conscious of, you know, how complete we really are. You know how it’s really mind body soul it’s all of it.

Deana Tsiapalis  24:49

It’s complete. That’s a great word for it. It’s just complete, complex, but complete. Yeah, absolutely.

Manon Bolliger  24:59

Complex and um, it’s quite now there’s a lot of people suffering from not just shingles because of the immune systems being hindered with the strategies, let’s just call them bio weapons. I’ll just get right to it. But, so a lot of people are suffering, you know from that. And then it’s I think it’s about 20% get what’s called post herpetic. It’s like the nerve nerve pain that comes afterwards.

Deana Tsiapalis  25:33

Oh, from shingles specifically?

Manon Bolliger  25:35

Yeah

Deana Tsiapalis  25:36

Yeah. Yeah. No. Neuropathic pain.

Manon Bolliger  25:40

Yeah, no neuropathic pain.

Deana Tsiapalis  25:42

Yes. Yes.

Manon Bolliger  25:44

Have you had the not the pleasure to work with it, but have you had people with this? And any thoughts on?

Deana Tsiapalis  25:54

Now, neuropathic pain, yeah, is tricky, because I find I’ve not had a lot of experience from those coming out of COVID with neuropathic pain, I actually had shingles when I was really young. And I was not supposed to have shingles when I was really young. But we, you know, we traced it back and realized it was a very stressful time. Why else would a 12 year old get shingles? Right? But, yeah, and as far as the neuropathic pain goes, I always feel like that is a group that tends to struggle with understanding how powerful their body really is. And that healing is capable, because I, for whatever reason, I don’t know that I’ve can clearly articulate why. But yeah, I actually think you would probably be able to answer that question better. You’ve probably seen more people than I have around.

Manon Bolliger  26:45

I haven’t, its interesting. I’ve lost my practice in Canada, because in Canada, we have certain regulations, where if you don’t do certain things you can’t practice. So. So I actually don’t know, I just know that it’s rapid. Really had found case and I’ve used homeopathy. But I thought there might be other things yeah, that could other management tools that…

Deana Tsiapalis  27:20

And I’m sorry, I probably should say I think one of the things I tools I will tend to lean into when it is neuropathic pain. Sorry, I don’t know why I didn’t mention this earlier. But it’s really again, working with the nervous system. So what sort of control can we do? So you know, the whole sensitization around pain, that hope, hypervigilance if we can find ways to the whole mindfulness piece, the whole meditation piece, or at least just listening to something, even if you don’t want to call it meditation, we have a session where we can calm down that nervous system. And also, that’s where the polyvagal theory really comes in beautifully to is, how can you sort of pinpoint where you are? You know, are you currently feeling that energized state of that fight or flight? Or are you feeling like you’re in shutdown? And if you are, you know, what can we do to help bring you back to more of that energized state? Or how can we help you to conserve a little more energy? So you’re not getting into that shutdown state, you know, at least to help the nervous system, not overreact and get into that deeper felt sense of neuropathic pain.

Manon Bolliger  28:35

Yeah, yeah. I think you’re saying it’s awareness in part.

Deana Tsiapalis  28:41

Very much. Yeah. And just being, you know, taught that, you know, your body is really doing this for a reason. And it’s pretty fascinating, what it is doing and how it’s doing its best to protect you, right?

Manon Bolliger  28:58

What is the reason?

Deana Tsiapalis  28:59

Right, so, right, as far as pain itself, we know that pain is a protector. So you know, and I’m sorry, you’ve you probably know all this already. But it’s your body’s way of really trying to just keep you safe. It’s what we’ve done for 1000s of years. It’s your brain interpreting safety or danger. And so pain is really very effective. It compels us to do something or not do something.

Manon Bolliger  29:29

Yeah, but you wonder though, you know, when people are in it, chronically. They analyze…it’s different. Right. It is different.

Deana Tsiapalis  29:36

It is your absolute right. It is the system now backfiring, almost like an automatic immune system, you know, going a little wonky. It’s over protective. And that’s, yep. To work with that. So.,

Manon Bolliger  29:50

Yeah, that’s, I mean, that’s what I am thinking too. I mean, on that level, it’s, you know, and whether you work with it through the body or through the mind doesn’t matter. In the end, that’s where we’re trying to get to.

Deana Tsiapalis  30:03

Exactly. And it’s good to do both, you know, you’re doing your top to bottom approach and bottom up approach. And the fact that you’re combining the body with the brain. It’s fantastic. We should have been doing all along, but we haven’t. So, yeah.

Manon Bolliger  30:19

Whoever…I think was Decart. Actually.

Deana Tsiapalis  30:22

Yes, yes. Right. Yep. Way back

Manon Bolliger  30:26

Sold the spirit to the church so he could have the rights to the body.

Deana Tsiapalis  30:32

Oh, I didn’t know that.

Manon Bolliger  30:35

Came from my TED talk.

Deana Tsiapalis  30:39

Yeah, good idea.

Manon Bolliger  30:42

Okay, well, I guess final final words and how people could potentially work with you or I don’t know, I forgot to ask you where you’re even located.

Deana Tsiapalis  30:52

Oh, that’s okay. I’m just outside of Toronto, a little suburb called Oakville. But I’m primarily online. So you know, we do a lot of group coaching. I have a free community that people can come in and it’s really not a support group. I do not want this to be like a Facebook group where people are just talking about their pain. This is creating deeping deep, meaningful relationships and connections to help them sort of help each other. As opposed to me trying to be the expert coming in and saying, Well, this is what you should do. They already have that enough. So it’s a free group. We’re just getting started. They can come in and yeah, like, pain 2 possibilities is the name of my company. The website is also pain2possibilities.com. All the information is in there. Yeah. So couple different programs online that they can work with me through as well.

Manon Bolliger  31:51

Excellent. Okay. Well, thanks very much for spending your time letting us know what’s available.

Deana Tsiapalis  31:57

Well thank you for this awesome conversation. Seriously. It’s always nice to talk to someone in the business because there’s so much to talk about. Yeah, so thank you so much.

Ending

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