An Emerging Revolution in the Treatment of Chronic Pain

According to the Centers for Disease Control and Prevention, chronic pain—pain lasting at or beyond three months—affected over 20% of U.S. adults, or 51.6 million people, in 2021. Symptoms were severe enough to substantially restrict daily activity for 6.9% of Americans that same year. And with chronic pain comes soaring medical costs, pharmaceutical over-reliance, and addiction.

Mounting multidisciplinary research suggests that most chronic pain is not of structural origin. In other words, most chronic pain can not be directly attributed to injury or physical abnormality. Neuroplastic pain results from the brain misinterpreting signals from the body as if they were dangerous. We habituate to pain, creating behaviors that either avoid pain or alleviate symptoms.

Encouragingly, those undergoing a psychological treatment known as Pain Reprocessing Therapy (PRT) are showing vast improvements in pain management without pharmaceutical or other medical interventions. One major study found that two-thirds of chronic back pain patients were pain-free or nearly pain-free after four weeks of PRT interventions. In addition, patients showed visible changes in the prefrontal brain regions associated with pain after therapy. While psychological treatments are effective in managing chronic pain, this does not imply that the pain is imaginary.

My guest today, Miriam Gauci Bongiovanni, suffered needlessly until she discovered the concept of neuroplastic pain. Today, now pain-free, she works from her home in Malta as a Certified MindBody Practitioner and Trauma-Informed Coach. But beyond her skills as a wonderful teacher and educator on chronic pain, I found her story of embracing a nontraditional career fascinating. Today we dive in on everything from how our personalities and fears inform our pain cycles to living a good life.  

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A Therapist on Satisfaction in Sport, Life, and Love

If you haven’t noticed, the concept of achievement and even competitiveness has weighed heavily on my mind as of late. A gift of the nontraditional life is the opportunity to step back and see the world around us with a degree of unusual clarity, far from the treadmill. For years I valued athletic and professional progress in ways that weren’t making my life better, but I thought they were. I searched for and implemented solutions to the wrong problems. Meanwhile, what truly mattered—mainly my relationships—withered on the vine. The journey toward rectifying these tendencies continues today.

My guest today, Lincoln Stoller, is a former mountaineer who now specializes in psycho-, hypno-, and neurofeedback therapy, in tandem with numerous other counseling and coaching services. Lincoln holds a PhD in Theoretical and Mathematical Physics from UT Austin, including a post-doc assignment at UC Berkley. Lincoln eventually moved from quantum physics to create a management and automation software platform for businesses, learned to build Norwegian log homes, traveled and lived abroad in far-flung foreign lands, and is even a certified pilot. To say Lincoln lives well outside of the bounds of normalcy is probably a half-truth at best. As he says in the interview, we should “just keep doing out-of-the-box stuff. And if people aren’t calling you a little crazy or a little nutty, then you probably aren’t exploring enough of the boundaries.”

Today’s conversation revolves around the high-risk potential of hard-charging performers and achievers, whether they exist in sports, business, or other areas of life. While these individuals hold our collective attention and admiration, Lincoln outlines how their psychological roots run shallow. They often struggle to stay satisfied with themselves or those around them. Lincoln might even say he holds an anti-hard-man philosophy. I think you’ll see why.

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All Work and No Play Makes You…Normal

Play Clipping Chains

The concept of play conjures the image of my three-year-old (and blonder) self, plastic shovel in hand, amorphous stains down the front of my pants. And certainly slobber. Lots of slobber. That three-year-old was certainly not concerned with social hierarchy or status, lacking a whiff of ambition to put the best version of himself forward. He played with a shovel in the sand because something needed to be dug and that was all that mattered.

As we age (and start to exhibit bladder control) the nature of play changes but is not altogether lost, at least not at first. Instead of digging in the sand, we might play a game of Twister, something I played as late as my college years. I challenge you to toss out that board on the floor—putting your head through someone else’s legs—and try and stay serious and stoic. It’s impossible. You’ll be giggling like a child. And that’s the point. We need more play.

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Four Years of Financial Independence: The Slow Growth

For four years I’ve watched something slowly bloom. In my old life, the “before time” you might call it, I moved from task to task. If I wasn’t working, I unknowingly made a practice of turning recreational or hobbyist pursuits into something that, from an outsider’s perspective, looked an awful lot like work. Goals and accolades were everything, and the more quantifiable, the better. But the farther I’ve separated myself from this life in space and time, the more clarity I’ve gained. 

Grasping for metaphors, I was tempted to explain this budding awareness as a slowly growing flower. But for perhaps all the wrong reasons, I hesitated to describe my growth and awareness as floral, preferring to drop the metaphor. But I can’t quite shake it, because I have watched something slowly grow. It’s not me that has bloomed–again, all the wrong imagery–but it is the world I could not see then. I could not see the flawed logic buried in the cold and wet earth because I identified with it. It was my life, so I could not reject what protected me. And four years later I’ve watched something slowly take root.

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QA12: Will A Life Of Financial Independence Meet Expectations?

We’re back to the digital mailbag to answer your questions!

For this week:

  • An update on markets and our personal finance situation
  • The role of dividends in growth and withdrawal assumptions
  • Expectations vs reality on a life of financial independence
  • Our experience with health insurance without employer-sponsored plans
  • Real estate investing: an update on our experiences and economics as remote landlords
  • Health insurance considerations for long-term travel
  • Short- to medium-term savings goals (like a house) versus saving for retirement
  • Loss of purpose without a traditional job
  • So much more!
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“The Rewards of Being in One Place for a While” (Meghan Walker and Callan Cooper)

By popular demand, I’ve decided to extend a travel series centered around the topic of building community or maintaining our need for social interactions when away from home. Community building is especially complicated when abroad, where cultures and languages vary considerably from our own. My guests today, veteran travelers with considerable expat experiences, are perfectly suited to discuss this topic.

Meghan Walker, a previous guest who writes at awaytofi.com, spent many of her formative years living abroad in Kenya and New Zealand. Her husband, Callan Cooper, is an expat living in the United States from New Zealand, where they met. Meghan and Callan joined me in my home in Colorado for a rare in-person interview, where we discussed in detail the beauty and challenges of international extended travel, careers, evolving travel philosophies, and financial tactics that can have you living a similar life much sooner than you think.

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Tyler Karow: The Tiny Future of Affordable Housing

I’m a little unsure of the best way to frame this introduction. In some ways, this is a story of embracing climbing for all the right reasons. Pursuit of technical mastery and love for the outdoors over the gamification of grades and emphasis on physical training. On the other hand, this is also the story of early adulthood in the modern era. The narrative to pursue something like climbing full-time is strong in the outdoor world. But most I encounter eventually find that climbing alone leaves us yearning for meaning and purpose. My guest today, Tyler Karow, spent nearly three years on the road pursuing climbing. Today he balances considerable climbing achievements with a secondary passion for building and a desire to be a part of the solution to America’s affordable housing crisis.

Karow is a 29-year-old climber known for his big wall accomplishments in Yosemite, Patagonia, and around the globe. His resume includes a ground-up free ascent of Golden Gate (5.13a) on El Cap, and Yosemite’s Triple Crown in under 24 hours, only the eighth time this feat has been achieved. Notably, Karow climbed the Triple while working a full-time (plus) job. He holds a B.S. in Civil Engineering from the University of Southern California and is a licensed civil engineer and general contractor. With this background in engineering and construction, he envisions a career helping to build prefabricated tiny home communities. This emerging approach to construction helps to reduce the cost of new housing and more efficiently add supply to a stressed housing market.

This episode is an Oreo of sorts, with a focused discussion of Tyler’s climbing achievements and work/life balance in the beginning and end. The middle of this discussion takes a deep dive into the affordable housing crisis, the complex nature of new construction, and Tyler’s vision for the future of American affordable housing.

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James McHaffie: From Bold Climbing to Novel Writing

James McHaffie needs no introduction, at least in the United Kingdom. His approach to bold onsight climbing, particularly free solos, is unparalleled. He’s repeated the hardest sport climb in Wales, Big Bang (9a), sent Britain’s hardest sea cliff, Dave MacLeod’s The Longhope Direct (E10 7a), and made the first ascent of The Meltdown, a 9a slab in the slate quarries of his home in North Wales. And now he’s written a book. But unlike many books released by elite climbers, this is not an autobiographical account of hard climbs in the face of relative adversity. Caff, as he prefers to be called, has written a fictional account of Eleri, a young woman amongst the slate quarries of North Wales who in the aftermath of a family suicide takes aim at British politicians who pushed for austerity and the conditions that led to such suffering. 

This conversation was such a gift. I can see even through all that rage that James is brimming with humanity, a trait sometimes in short supply. I hope you’ll enjoy this one as much as I did.

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The Problem with Bucket Lists and How to Be Happy with Less

It’s often said that happiness equals what you have minus (or sometimes divided by) what you want. When our wants are many, what we have is of little consequence. That is why there are hordes of unhappy millionaires and high achievers who quietly suffer (yes, suffer) under the weight of lofty and insatiable desires and ambitions. Western ideals place great importance on the “haves.” And despite an anecdotal feeling that my greater social circle is less materialistic, I’m less certain that we’ve diminished our appetite for having things. The things look and feel different. Less like fancy watches or cars or gaudy showings of riches and more like spreadsheets full of countries and crags unvisited, food not tasted, status not yet achieved, or routes not sent. We believe subconsciously or otherwise that by checking items off our bucket list we will arrive at some sense of blissful satisfaction. But biology and evolution suggest otherwise.

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