Episode #111

How CBT Can Affect Physical Symptoms

The brain is a very powerful organ, and it can affect us in unexpected ways. This can include physical symptoms stemming from mental health challenges.

How do your thoughts impact your physical health?

How can you use CBT tools to retrain your thoughts and improve your physical health?

Join me, Dr Julie Osborn, as I share with you the fascinating research and real-world tools for using CBT to help with physical symptoms.

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Full Episode Transcript

Hi, this is Dr. Julie. I'm a Doctor of Psychology and a licensed clinical social worker specializing in Cognative Behavioral Therapy. I'm here to bring the power of CBT into your own life.

Thanks for joining me on this podcast. I hope everybody's doing well. I always appreciate you guys listening and hopefully learning and doing better.

I wanted to share a really great review I got on Apple.

And the listener said,

“Needed these podcasts. I'm struggling with Bipolar II, Depression, Generalized Panic Disorder, and a myriad of physical health problems right now.

“I can't afford talk therapy on top of all the other doctor bills, even though it's been recommended by my psychiatrist and primary care doctor. I also don't particularly want to medicate myself to deal with the depression and anxiety. I'd rather learn coping strategies.

“That's where this podcast has come in handy to me. It's helping me to understand how to deal with these issues in a more constructive manner rather than just popping his anics. I understand I can't stop my medications, but at least now I can start to use healthier coping strategies in my daily life and hopefully taper the medication down eventually.

“Thank you so much, Doctor. You are very helpful.”

I appreciate that very much. I'm glad you're taking your medication as needed, but you're also wanting to use coping strategies and not just say, pop his anix, as you said. I think it also gives you a sense of control over what's going on in your life and not just dependent on the medication. So medicine plays a part, but you also play a big part, and obviously that's what you're doing now. So again, thank you for listening. I appreciate all you guys giving reviews on Apple. It just helps the word get out so more people can learn and benefit from CBT. So today I wanted to talk about one of the aspects of CBT, which is physical symptoms. So just to review real quick. So cognitive behavioral therapy is that your thoughts create your moods, which affects your behaviors and your physical actions. Those four are connected like a mobile. You can't have one going out without the other. They all happen in seconds. Last but not least, you also have your environment. You want to look at your environment and see how that's affecting you as well.

Now, my experience with working with thousands of people, and also my own experience, which I'm going to share in a minute, is that the physical symptoms is usually what brings us to our knees. It's usually what gets people help because we can deal with a little stress, or I'm not in the best mood, or I can avoid things, but we have physical reactions, physical symptoms that are really affecting us coping and living our life on a day to day basis. That's what usually gets people's attention. It's not that it's good or bad, it's just what it is. Whatever gets your attention to get you get some help is fine with me. But I want you to start recognizing and understanding just how powerful your brain is that can affect you physically. There's also a term called psychosomatic. You might have heard of that. If not, it means that your physical symptoms are purely psychological and not actually have a medical basis to them. So if someone says, Oh, they're having psychosomatic symptoms. That's what we're talking about. So I just wanted to throw out that term there. But with CBT, I always ask, What are your physical symptoms when you're having these negative moods?

Now, there's also positive ways that the way that you think can also help you physically, right? So just for example, to give you an idea, so we're looking at the bigger picture is, I know that there's research out there that has discovered that our thoughts, our beliefs, and our attitudes do have an impact on our health. And maybe you've heard where athletes, they'll have them focus or think about certain parts of their muscles, and they start to work a little harder. They'll be able to test that through different avenues that the doctors work with them to see that just thinking a certain way or say when a coach is in the locker room and they're really getting the athletes all excited that their hearts start to pump a little harder. They get this really good adrenaline and they really want to go out there and win. And those are all physical reactions that they're feeling. There's also something called the placebo effect. And there's benefits from that, too. And that's why I'm bringing it up. So what the placebo effect means is that our expectations that a medicine or treatment is going to help, which actually increases the likelihood that it actually does help.

So when we believe that a pill is going to help us in itself can really lead to improvement, even if the pill really isn't helping. And they've had tons of research where they've given people sugar pills, and the person's like, Oh, I'm better when it was just a sugar pill. But the point is that the research regarding your brain has found that the placebo effect comes about partly because our beliefs affect our brain activity, and that can lead to real changes in physical responses. Based on how we're thinking about things, our brain is going to affect us physically. Again, there's some good ways. If you're training, again, if you have a coach, that thing to get you going. If you can do some imagery about running that marathon and getting over the finish line. The research shows you can get your body going and reacting to how you're thinking and believing about how well you're going to do. That's the good part. The negative is what I want to talk about today because that's what affects my clients, maybe you, people that you know that you love, to be able to understand more about what's going on and how you can make changes.

I'm going to share a couple stories about how powerful your brain is when it comes to physical symptoms. And of course, I always say you always want to rule out if there's actually a medical problem. A lot of people with panic attacks end up at the emergency rooms. They think they're actually having a heart attack. So if you're feeling like you're having a heart attack, please go get checked out. Just don't assume it's panic if it's really that horrible. But if somebody tells you it's panic, believe them, because I've just had too many clients that have gone to the emergency room, literally four or five times. The doctor keeps saying it's panic, you need to go get therapy, and they don't show up. They don't show up. They just keep going back to the doctor because they just can't believe, which I understand, they just can't believe that this could all be psychological because it's just so powerful. I'm going to share my story. My story goes back to I'm trying to think 1983. I moved out to California from Buffalo, New York. I graduated high school. I moved out here in 1982. I came out here because I have family here.

My mom's here and my siblings. I love California. A nyways, I came out, I started college, wasn't really into it. Then I started working. A lot of people may have heard of Mrs. Phil's cookies. Back in 1983 is when she exploded and her company just grew and I got a job and I was just having so much fun. I just basically stopped going to school and I was just working full-time. Then over time, I left that job and I ended up cleaning houses and I was also working at a car wash, which is very physically demanding, which I didn't realize. I was living in this really cool, renovated garage in Newport Beach. I went to the beach every day after work and take a nap, and it was good. Life was good, and I was living my life, but I was working hard and I was just getting by. One morning, I woke up and I thought I had the flu, and I was sweating. I kept changing pajamas, you guys. I went through lots of pajamas. I couldn't even get out of bed. I thought, Oh, my God. I'm so sick. I'm so sick.

I could not afford to go see a doctor. I was broke. It must have gone on for two or three days. Finally, my mom said, Come on, I'm just taking into an urgent care. You got to get checked out. That's ridiculous. I went with her and the doctor takes my temperature and he's like, Oh, your temperature is normal. I look at him and I'm like, Okay, Doc, there's no way my temperature is normal. I've been sweating for three days. I can barely get out of bed. I can't go to work. He took it again and he said, Yeah, it's normal. There's nothing wrong with you. You're fine. He checked everything, checked me all out. I was just like, Wow. Now my personality, which I was lucky at the moment, insight does a lot for me. So in that particular moment, it all hit me like, I wasn't coping with life. I was broke, barely could pay my bills, working my butt off, two very physical jobs. And my life really wasn't going anywhere. I didn't know what I was going to do. So we left the doctor's office. All my symptoms went away. Once I realized, Oh my God.

This is all in my head because I'm not dealing with the stress in my life. I'm not making decisions. I'm not being honest with myself. I end up going back to my mom's, and I remember calling her one of my brother and I said, Hey, in three months, would you drive back to Buffalo with me? My dad at the time, who was still in Buffalo, was the only person that could really take me in and support me and have room. I realized I need to go back to college and do something because what I was doing wasn't going to sustain me long term. I was lucky. My wonderful aunt and uncle that were out here in California, let me live with them for three months. I just worked and literally counted my pennies and paid things off. I left and went back to Buffalo and went to college. That's when I started college. I was about 20 at that point. I remember when I would be stressed, maybe for the first year, just going through changes and starting college and all that, when I would get stressed, that heat, that feeling of heat would come over me.

But I was like, Okay, I'm stressed. What is it that's bothering you? Then I learned that instead of like, Oh my God, I'm feeling this way. It was a way my body was sending me a message to say, You know what, Julie? There's something you're not dealing with. You're stressed. What do you have to do? Then that eventually went away. I'd say now when I'm stressed, I definitely feel it in my shoulders. Sometimes I'm like, Okay, if I'm not aware of what I'm stressed about, I use my tools, I used to do my thought record. What am I thinking about? What am I thinking about? What's going on in my life? Until I figured out. And then when I address it, my physical symptoms go away. I use it as a reminder that my body is just trying to communicate to me. I really believe that with people having panic attacks, stomach issues, whatever's going on, your body is communicating because you are not paying attention. That was my story. That taught me how profound that the way I think and what's going on in my life and my beliefs and my stress can take me to my knees.

Another story I wanted to share, which was very profound to me as well, is many years ago, me and my husband, we weren't even married yet, so it must have been around 1993 or something. We went to a conference that was called Recovering couples Anonymous. I've shared in other podcast, my husband's in recovery for 30 years now. We thought, Oh, this is cool. We're very into personal growth. We still are. And we like going things together. So we're like, Let's go check this out. So we really didn't read much about it. We didn't know the details. We thought, Okay, we're a couple. This sounds good. So we go and it turns out it's a conference for couples. One of the people in the coupleship were sex addict. We were like, Whoa, I didn't really know much about sex addiction. It wasn't something that was talked about a lot back then. It was just more books, getting educated. But anyways, that's why these couples were together. They worked through that and the sex addict got in recovery. We were like, Wow, these people are incredible. I can only imagine how difficult that was to work through.

But the story I remember, and I'll remember forever, is one of the wives got up to tell her story. She said that her husband was a sex addict, but nobody was talking about it. She knew it was going on, but nobody was addressing it. Of course, he was a traveling salesman. You can only imagine. Every time he's leaving for a business trip, I just can't even imagine how she felt, how she coped with that. She just put it away. It was too much to deal with, right? Because if I deal with it, I have to do something about it. One morning, he's getting ready to leave. She's making the bed. She collapses. And from her neck down, she is paralyzed. She cannot move. They call the ambulance, they take her to the hospital. She was in the hospital, I think, for about three days. And then, thank God, it all came back. And that feeling of being paralyzed went away. And that is when her and her husband went and got helped. That was so significant. And that was her body saying, Obviously, I'm taking you to your knees. She went paralyzed because of the stress.

I was like, What? That story blew me away. Again, it was another story of, Wow. We need to be honest with ourselves, get out of denial, and deal with things in our lives. I know that's a really severe case, and what she was dealing with was a huge crisis, but I'm talking about anything in your life. If you're you have chronic pain, back issues, insomia, so physical sensations. Let's go over some of those also. The things I've mentioned already, but crying a lot. Again, insomia is a big issue for a lot of people. Eating too much, eating too little, having difficulty focusing, concentrating. These are things that can be physical, but I'm talking about more pain stuff. Things that take us to the doctor, things that put us on pain pills, things that are having us go to PT all the time, things that are focusing on your body pain instead of like, Okay, what's going on? If this is not a real physical thing that's been diagnosed, what's going on in my life that's affecting me this way? And this is for those of you out there with panic attacks, too. It's all physical, right?

You're hard, you're stressed, you're anxious. When you're anxious, you're not breathing really the best. You're not getting full oxygen. You want to breathe on a normal basis. Not that you're going to pass out, but when you're panicking, the oxygen isn't getting in as well. And that makes your heart beat faster, which then you start to panic even more. That's where you might feel a little dizzy because you're not getting enough oxygen. Then you're like, Oh, my God. I'm dizzy. I'm going to faint. It's all physical, right? Then you get just so overwhelmed. Instead of being like, Okay, why am I panicking? What's going on in my life that I am having a panic attack? Or I'm just so uncomfortable, or I have stomach issues all the time. If you have diarrhea a lot, all of these things can be from stress, and you got to be honest with yourself so that you can get better. Again, when I now feel like I was telling you it's mostly my shoulders, I feel the stress, I just slow down and say, Okay, what's going on? How can I handle the stress in my life? Is there something I need to just do on my own?

Do I need to go talk to somebody? Because maybe I need a work something out with somebody that I've been avoiding. Whatever it might be. But it's real. It's real, you guys. There's many, many people, I think, they're getting treated for things that are probably psychological. That's that when you understand that and you take inventory, what's going on with my body? How do I feel? And if I've gone see doctors and they're like, There's nothing wrong. I'm not sure why your back keeps bugging you. Or I don't know why you know your back keeps going out, or your neck's always sore, or you have headaches all the time. The headaches is a huge one also. What can I do so I can get better? And part of that is recognizing, Oh, this is what happens to me when I am stressed. And if I ignore it, it's just going to take me down. I've always said, not a medical doctor, but I've always said, if we could put stress on everyone's death certificate, I think that could be the cause of death for everybody. Your stress affects heart disease. I believe it can cause about anything that we have in our lives because chronic stress affects us mentally and physically.

I want you guys to feel better. I know with cognitive therapy, we talk a lot about, what are your thoughts? What are your thoughts? Which is obviously the big part, right? But because your thoughts create your moods, which affects your behaviors and your physical reaction. When we can figure out, Oh, okay, my physical issues I've been having for a day, a month, years could be from the stress I'm not really addressing. What am I thinking about my life? What are my beliefs about my life? What things are getting in the way? Is it my work environment? Is it my home environment? Is it my social environment? Is it people in my life that maybe I shouldn't have in my life? Is it that I don't have enough people in my life and that I'm lonely and I'm isolated? What is it? Is it money issues? Let me talk to someone that can help me with that. Maybe I'm making enough money, but I'm spending too much, or a lot of people don't know how to budget. That's okay. You can go learn. There's lots of stuff out there to teach you how to make a budget, how to think about how to spend.

Do I know maybe I want to talk someone to even invest, so I'm thinking, I got to work for the rest of my life. That's stressful. So I'm throwing out so many different scenarios that maybe you'll relate to one of them. But it doesn't have to be these catastrophic things. You might have a lot of grief in your life that you've just never really dealt with that you're trying to avoid. You think you don't have time to be sad, so you just keep moving forward. But your body is sad, your body is tight, your back hurts, your stomach hurts. You know, you got headaches, whatever might be happening. It can affect your vision. I am telling you, there's so many things. Don't minimize what's going on with you because you deserve to feel your best and to be happy and to feel good. Right? So this is a part that we're like, Oh yeah, I cry a lot, or, Oh yeah, I'm having a hard time falling asleep, and we maybe just don't pay enough attention to it. But when you start to start using your CBT tools and you start looking at the situations in your life and you start addressing your hot thoughts and you start feeling better, your physical reactions are also going to get better.

I see it all the time. People feel physically better. Their energy, that's a physical thing, right? Your energy could be depleted. You start feeling better. You have more energy to do things. You might start exercising more. You start sleeping better. Your appetite is more normal. I don't have enough time in this podcast to just give you 10,000 examples because there are 10,000 examples. You always want to personalize the CBT to you. We're not here to generalize. What's going on in my life? What are the situations from the past, present, future that are weighing on me that I need to deal with? What is that? My environment was so much about my life. My work environment, it was too much. My financial environment, I couldn't support myself anymore. I had no direction, regard in my future. For me personally, I need to go back to college and be educated so that I could do what I do today. My environment needed to change where I went home to stay with my dad for a little bit because he could give me that stability that I needed and have to worry about paying rent. I could work and save my money and all of those things.

Moving in with my aunt and uncle for a few months gave me time to breathe and the support that I needed so that I could take care of business in California, go back to Buffalo and not have to worry about bills back here. So mine affected many different parts of my environment. And I've never forgotten that because I'm never going to allow myself to get back to that. So I'm not perfect. Again, of course, I have my physical stuff, but not to that degree. And I see it all the time. Or a doctor gives you a diagnosis and then you start having worse symptoms. Or here's another great example. I have clients that might go get them. They're going to get them medication, and they run to Google and they look up the side effects, and now they have every one. My mom actually, now that I'm talking and I'm remembering, my mom was guilty of that. She'd read it. I'm like, Mom, don't read Google. She'd end up with every side effect you possibly could have. That is psychosomatic. Oh, it says I might have headaches. Oh, I got headaches. It says I might have diarrhea.

Oh, I got diarrhea. This happens all the time. Remember, if you are taking medications, everything is possible side effects. Some people have them, some people don't have any. Some people have them a little bit, and then they go away. But you can bring things on. Your brain is super powerful, you guys. Give your brain some credit and really take inventory if you have any physical symptoms going on that maybe you never even thought, Wow, this is more about my mental stressors that I have in my life. I'm trying to push through. It says a lot of those great things about you, right? That you have a lot of tenacity and you want to do a good job, maybe a work, you really want to try to make this relationship work. But it's not in all of those categories, and you need to step back and say, Okay, do I need to leave the environment, change the situation, work on the relationship, whatever that is, work on my health. It's not easy stuff because it can be so small in our lives. It might just seem like it's hard to pay attention. I want you to pay attention before it gets to where I got or that woman I shared with you where she was paralyzed for a few days.

We don't want to get to that place. We want to catch you when it just gets started. One way to do that, if you're using the Mind over Mood book, there's a chapter on depression, there's a chapter on anxiety. In those chapters, they have what they call Mind over Mood depression inventory, Mind over Mood anxiety inventory. I have my clients do these inventories every single week to get a score. We follow their numbers throughout therapy. These inventories give you all the symptoms. We don't diagnose people with it, but it gives you symptoms of depression, symptoms of anxiety. Especially on the anxiety one, there's a lot of physical symptoms, and you can start rating. Maybe it'll even make you think about, Oh, I didn't realize this was anxiety. I can tell you in the inventory for the anxiety, the one that is most surprising is increased need to urinate. People are like, I never even thought of that. I said, I know, most of us don't. But when we're nervous, we tend to go to the bathroom more. I've had that experience myself. Little things like, I didn't even know that was a thing. I'm just sharing that you want to pay attention.

There's other scales out there I know that you could probably find. Other books have other scales to assess where you're at regarding your anxiety or depression and help you understand what's going on with your body as well. I'd love to hear from you. Maybe you had a light bulb moment listening to my podcast, like, Oh, maybe this is physical. Or somebody's been telling me, not that this is physical, I'm sorry, that my physical symptom is really psychological. People have been telling me that, and I've been pushing it away. Maybe there's some truth in it. It can hurt to do a little inventory yourself, do a thought record, take a little time to think about it, maybe go find a therapist and talk to someone about it, so you can get some relief, so you can feel better.

You guys know where you can find me. At my website: MyCognitiveBehavioraltherapy.com.

I'm on Instagram as My CBT Podcast.

And Dr. Julie Osborn on Facebook.

Please keep sharing your thoughts, your concerns, your questions. I love hearing from you guys and your feedback. Please pass this along to others who might find it helpful.

And as always, make decisions based on what's best for you, not how you feel.