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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The Psychology Behind Poor Investments and Other Important Decisions

When we make important decisions, we are often not as rational or objective as we’d like to believe. The base rate fallacy is the tendency to misjudge the probability of a situation by not accounting for all relevant information. This cognitive bias affects everything from first impressions to voting preferences to broad market behavior.

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Uncertainty Is Forever (And That’s Good News)

Uncertainty is a fact of life, yet we yearn for known outcomes. Every day we make decisions. Some decisions are small and inconsequential, while others are profound and life-altering. Sometimes events happen regardless of our decisions. And above it all and looming like a nervous wind is uncertainty. Uncertainty is forever.

But those who learn to sit with and embrace uncertainty are resilient and innovative. Those who try to fight uncertainty spend more money and live with less contentment.

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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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The Blue Dot Effect: Pessimism in a Beautiful World

As I’ve recently mused, financial independence won’t solve life’s problems. We will never “arrive.” We will never achieve perfection. An impactful 2018 study, nicknamed the Blue Dot Effect (a stand-in for the more lumbering “prevalence-induced concept change” title), helps us to understand the mind’s tendency toward finding problems, even where none exist. The results have broad implications for individuals and members of a progressing society.

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Lean Out: The Achievement Paradox with Dawn Baker

Today on episode 57 I’m pleased to welcome Dawn Baker, a board-certified anesthesiologist, wife, mother, climber, coach, and now the author of a new book about the perils of, as she puts it, an intense need to achieve. And Dawn has walked the walk. After years of hard-driving pursuit of linear improvement in both career and climbing, she suffered crushing fatigue and malaise, and ultimately faced a major health crisis during her residency. If that wasn’t enough, she was then plagued with infertility problems. The result was expensive and demoralizing rounds of in-vitro fertilization, an approach that ultimately proved successful and led to the birth of her daughter.

The need for achievement and success is so pervasive in our culture. And this interview is not just for downtown or medical center careerists. This is as much a discussion of climbing and our hobbies, which can so often derail into something quite different from our original healthy and recreational pursuits.

Today, Dawn’s life with her husband and daughter is so different. Through evaluation of her core values, married with a strong financial position, she now works “very part time,” and has moved with her family to a homestead in the high plateaus of southern Utah. But in choosing to step away, or lean out, as Dawn says, we risk our position and standing in the social hierarchy. This is much a discussion of status as it is of lifestyle.

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Five Lessons from Three Years of Financial Independence

One evening, circa 2011, I sat over dinner with my future wife in our small and sweaty Houston, TX rented bungalow. I was and still am an occasional cheap bastard, so the air conditioning was almost certainly set to engage on an “as-needed” basis, far from anything resembling comfort. The concept of financial independence wasn’t on the radar.

During downtime at work—I told you I was distracted—I was scouring numerous free WordPress blogs documenting the travels of zealous climbing dirtbags. They were camping and climbing and making whatever money they needed along the way. People were even starting to live and travel in vans, something I associated with sixties and seventies surfer culture. I wanted that life.

At this point in my late twenties, I was maybe barely a year into my career as a geologist in the oil and gas industry. But I could see the writing on the wall—this would not and could not be my career for the next 35-40 years. In fact, at that moment, I couldn’t see myself lasting my target three to five years until I expected to return to school for a career in academia. And there was a new problem: I’d kind of grown obsessed with this new hobby of rock climbing.

Twelve years later, I finally found a very different path to a life of freedom, if such a thing even exists. After three years of financial independence, what follows are some key lessons I’ve learned along the way.

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