REAL TIME HEAL: Long COVID, Fear, and the Nervous System with Marisa Renee Lee

Welcome to the Cure for Chronic Pain Podcast with me, Nicole Sachs. You are here. Hello my friends. I hope today is a good day. This is Nicole and you've reached my podcast, The Cure for Chronic Pain. Let's get to it. You know how I feel about real time heals. I freaking love them. I love taking what we talk about in theory and bringing it into real life into the nuance, into the questions and the places where people actually get stuck. And today's conversation I'm sitting down with someone who's story is both deeply personal but also incredibly relevant right now. So today I'm joined by Marissa Renee Lee. She is walking the path of this work and she is also a writer and advocate and someone who has had to spend a great deal of her life navigating grief and loss and the complex ways emotional worlds can live in the body. Marissa has worked at the highest levels, Harvard, Wall Street, the White House, but what she brings today to this conversation is something much more personal. A willingness to look honestly at her own experience as she moves through long COVID and a lifetime of accumulated stress and trauma. And you guys know, I mean that's what we do here. You know we wake up when we wake up no matter what our lives have looked like and we are able. We have the privilege. We get to pause and get very real with ourselves. And to me it is a bridge to everything that we want in life. Presence, joy, relationships, connection and of course, living without chronic pain and illness and anxiety in our bodies. What struck me most about Marissa is that she already understands this work. So even though this is a real time heal, she gets it. She knows the connection between her emotional life that she's lived, her physical symptoms, but like so many of us, she's trying to live it in real time without a script, without a clear path and without the control that her personality naturally leans on and so many of us can relate to that. So today we go deep into what it means to feel safe again in your body and how fear and control can quietly keep the nervous system stuck. And of course what it looks like to begin loosening these patterns in a real and sustainable way. I also want to mention, because I'm very excited about it, Marissa has a new book that just came out this past week called Waiting for Dawn. And it's a beautiful offering for anyone living with uncertainty, anyone who is waiting, for pain to ease, for grief to soften, for life to feel like it's opening again. And I just think so many of us can relate to that. You will get the same depth and honesty from her in this conversation as you'll get in her book. And I really recommend you pick that up wherever you get your books. Before we jump into that, just want to remind you a couple things. We are building our community and our offerings on Substack. Just go to NicoleSax.Substack.com. We're going to have a new edition for our paid subscribers, which is weekly lives. Every Thursday, I'm going to be there live. Sometimes I'm going to be picking one of you guys for a real time heal and we're just going to jump on Substack live and do it. Sometimes Lisa and I are going to be riffing on a topic or answering your questions. Sometimes I'm just going to be there sharing with you my most immediate and relevant advice and guidance around this work. But I love Substack. I'm very excited about it. I haven't been excited like this in a long time. Maybe since when I first got on Instagram because it's such a great medium for teaching and for sharing with you. So anyway, I hope you come over and check that out. And just remember we are getting closer to our June Omega retreat. That is at the Omega Institute in Rhineback, New York. It is an amazing, wonderful place. It's so accommodating. So if you're a person suffering from any sort of chronic condition that makes it hard to walk around or makes it hard to sit or you need special accommodations, they are on point. I mean, that staff is amazing. They will ride you everywhere in golf carts. They will get you a special chair. They will set up pillows and blankets on the floor. Like it is the chillest situation and it's like going to summer camp and it's also a week that can really change your life. So if you're interested in anything, if you need any guidance, just go to NicoleSax.com. NicoleMega is at the retreats tab. If you need a one-on-one coach, we got the coaching tab. We got the membership. We got the courses. Just make sure you get the help and the support that you need. We are here for you. All right, my loves. Take a breath, settle in and see where you find yourself in this one. Enjoy this conversation with me and Marissa Renee Lee. We are here today with Marissa. Welcome, Marissa. Hi, how are you? I'm great. I'm so happy to be here with you. It has been a good minute since I did a full-on real-time heel on this podcast, but they are some of my favorite things to do because essentially if somebody is listening and it's the first time they're hearing this real-time heel, this is something I started many years ago. I thought it was super fun because I was a therapist in private practice and I was obviously seeing people all the time in just the four walls of my office and I thought, wouldn't it be fascinating for someone who I have never met, who I know nothing about? Come onto the podcast and lay it on me and see if I can be helpful. It started this sort of internal series called Real-Time Heel on the Care for Chronic Pain Podcast and Marissa reached out and she had a really interesting story and she's got a book coming out and it's all very exciting, but it's also confusing and she could use some guidance and so we decided to hop on for a real-time heel. So Marissa, as always, I'm going to hand it to you, give me the information I need to help you. Okay, excellent. Like I said, I'm just, I'm so happy to be here in a call and so grateful for this opportunity. I've listened to a few of these myself and found them incredibly helpful. So I will start with present day. I have long COVID. I have been sick with long COVID officially for almost two years and it actually goes back a few months before that to January of 2024 when I got a COVID booster and unfortunately, I was one of the people who had some side effects that were really unpleasant and unfortunate. And so after I had that experience with the booster, I was in the process with doctors trying to figure out what's going on. Let's get Marissa back on track and then I got actual COVID in April of 24 and I have been sick ever since and I'll just share your work deeply resonated with me because I am someone who has always believed in and seen the connection between the emotional and the physical. When I was 13 years old, one day my mom got sick and she never got better. It turned out she had multiple sclerosis but it would take us about three and a half years to figure that out and you know, you're a kid and your rock star working full time Sunday school teacher PTA mom suddenly gets sick and can't get out of bed most days is in and out of the hospital. No one can tell you what's wrong. No one can tell you what to expect is mom going to live or die. That stress it caused all of these stomach aches. You know, I know gastro intestinal issues are pretty common mind body connection problem. And so from the time I was 14 until present day on and off, I have been on medication for my stomach because it just it started and you know, it was the 90s. Nobody was saying let's take this kid to therapy and try to figure it out. They just gave me a prescription. And so that is kind of the beginning of my story. And then as I get older, unfortunately my mom got sick again. I was graduating from college and found myself back in my hometown in an oncologist office with mom and dad. She was diagnosed with stage four breast cancer in addition to her multiple sclerosis. I took her off to help them, you know, sort of manage and navigate her illness. And in the process of helping to care for her and then, you know, losing her about three years later, at which point I had just turned 25. I actually lost my fertility. By the time I was 27, I was diagnosed with primary ovarian insufficiency, which, you know, the easiest way to explain it is my body went into menopause in my early 20s. Wow. Overies completely shut down. They literally resembled those of a 75 year old woman. There was no reversing course. There were no eggs to be harvested, you know, nothing along those lines. And I just had to figure out how to live with it. And so, you know, I've always kind of had these health things that have come up as life has gotten hard traumatizing, stressful, et cetera. And my long COVID experience happened just a couple of months after about a year and a half to two year period where I was diagnosed with a lot of cancer. where my mother-in-law was dying from stage 4 breast cancer, of course. And in the middle of it, my cousin went missing. Her name was Amani. She was young and black and not super educated or well off, and people just weren't paying attention. And so, along with some friends, we launched a nationwide campaign to find her. And we did, but unfortunately, she had been killed by her husband. Yeah. And so, you know, all of that happened. And then a couple of months later, surprise, surprise, you know, Marissa is sick. And still just trying to crawl out of this hole. I will say, I am much better today than I was even six months ago. And I credit that in part to your work, which I discovered through another long quote of COVID patient in August of last year. And she said, you know, I really think this can help you. And I was already in a place where I was looking at EMDR and, you know, kind of trying to figure it out for myself, which I have no qualifications to do. It shouldn't have been doing. And she said, you know, I think you should read her book. I think you would really appreciate it. And she sent me a couple of podcasts links. And it was, what is the gentleman's name, Gary in New Zealand? Gary, what a dear. Oh my gosh. You just sounded like such a sweet man. And so since then, I've listened to just a number of interviews where people are now on the other side of long COVID. And I feel like I'm like getting so close. And I just, I just want to be done. And so I took the opportunity. Probably number one. Yeah. No. I know. I know. It's do the work, patience and self compassion. And then what am I forgetting? I'm missing one. Because I believe, believe. And I believe, yeah, I'm trying. But the only reason I have to take that opportunity to tease you is because I can't tell you how often I've grappled with my own internal desire and pretty much every person I've met, my children, my partner, every conversation I have, there is an innate human reflex. To say, what gets it done? Yeah. Get her done. You know, how do I get the A? How do I check the box? How do I move to the next chapter? And unfortunately, this paradigm, and I'm going to pause here because I'm not ready to lay it on Yithic. But one of the things about this paradigm is a real compassionate unlearning of what we perceive human life to be and what we perceive success to be and our attachment to outcomes and what that even means and how that creates what I call fall safety, like safe, in the unsafeest way. If we can be like, okay, I wash my hands of this one, it's done. So all that to say, keep going because I need more. I need more, but I'm going to get to it. So just real quick in terms of symptoms at this point, you know, the big ongoing one is sleep and just, you know, fatigue and energy level. I will tell you today I said, I'm going to do something that is going to make Nicole proud. I'm going to trust my body and that I'm strong enough to go outside and just like spread some salt. I live in New York and it's, I mean, we're just buried under snow here and I did it and, you know, it felt really good. But I'm having a hard time getting back to a place where I am able to really trust my body. Um, headaches, I'm not sure if I mentioned that and that, I want to say that's pretty much it. It was a lot more severe like headaches so bad that not only was I not sleeping, but when I did sleep, there's one morning where I woke up and I had bitten off a piece of my night guard in my sleep. Like Nicole, I was in so much pain, so heavily medicated and none of it was sufficient and I was still trying to function because I'm sure this will come as a huge surprise. You know, super type A overachiever dual degree from the Wall Street. Yeah, White House. Like, you name it. I've done it or tried to do it or I'm planning to do it. So this has been, um, I mean, it's just been an incredibly humbling experience to suddenly for the first time in my life, not be able to work. Like I have worked through some really terrible personal tragedies and like, you know, there were weeks where I couldn't even open my computer. Yes. Yes. Okay. Well, the first thing I want to say to you and I say it often, but I mean it equally as of every single time is you, honey, are going to be just fine. Right. And you're not just going to be fine. You're going to be better and you're going to be more open and more aware and more awake and sometimes that's going to hurt really badly because it's really hard to be awake and aware and open, but you're going to be free. And I have no doubt, I have no doubt. So like, let's start with that, which is that I already see in you the openness and the willingness and the surrender that is necessary. You're just, first of all, you need to be certain that you're safe. You've gotten, yeah, you've gotten really confused in the relationship with your body and trusting yourself and that can feel really unmooring. So we're going to, we're going to shore that up as well. And then it's just about really understanding in a very clear way, exactly the path to breaking free of those self limiting beliefs and those fears and those limitations. So let me ask a couple questions and then we're going to kind of move forward with sort of a path for you. So my first question is, when you are dealing with a lot of things, you're going to have dealing with your symptoms day to day. How much is it currently limiting your life? Like, paint me a little bit of a picture. I mean, obviously, did you just say you went to Harvard? Yes. Okay. So this is a girl who can't achieve. Okay. So obviously, very smart, very driven. I know you've written a book. So, you know, you're not, you're not completely locked in to whatever it is that the symptoms are trying to protect you from, but help me understand how you're functioning day to day. So I mean, I'll be honest, my functioning increased dramatically when I encountered your work in August. And you know, I did go through the period that you describe, you know, when you first start doing this work where like it was rough for a couple of weeks. And then I just felt something shift and I have been able to live better since then. So thank you for that first and foremost. At this stage, it's more like a constant thing that I have to manage as opposed to, you know, where I was six months a year ago where like there were days when the morning routine with my son, you know, just getting in breakfast and getting him to school, I would have to then get back in bed for hours. Like, I'm not in that. I'm not listening. You know, it's, it's more I, I still cannot exercise. I am someone who has worked out five, seven days a week her entire life. I cannot travel the way that I want to. I can't maintain my social life the way that I would like to because I just don't have the energy or the stamina. And then I also sometimes frankly feel limited. And I don't even know sometimes if it's like, am I limited by my actual bodily capabilities or am I limited by fear? Like, I'm not sure. And so the way that I'm managing myself now, you know, every morning there is a handful of supplements every evening, same thing. I do acupuncture, I do breath work and I rest do some sort of like rest or recovery type activities for three hours a day every day, at least. And that allows me to get the book done, you know, I also have a consulting practice and active roster of clients and take care of my kid, spend time with my husband. Like if I do the rest and all of the recovery, which is a lot of work, I can mostly function. Okay. So like 70% helps me. Marissa, that really helps me help you. So I am going to apologize in advance because I can tend to be a little bossy. But I am, I know you are here for this. So okay, so before I get bossy, I'm going to just give a bit of a primer. You kind of, it's kind of funny because you're saying, oh, I know that there's, you know, do the journal speak and I know that there's patients in kindness, but what's the third one? And the reason that that's funny is because it really gives me a wonderful invitation through a smile to talk about what it means in the under the umbrella of belief. Because you know, when I first kind of figured out this concept of three legs of the stool, believe do the work in patients and kindness for yourself and like the concept of a three legged stool and without all three legs being solid, the stool will not stand. I pick the word believe and as I've been saying a bit on the podcast lately, it's not that I have second thoughts about it, but I think the word belief needs some expansion because the word belief when you first hear about it might be confused with faith or confused with I need to accept something that doesn't make sense, but I just need to jump in the net will fall and it's and follow rather and it's not as that isn't true, but Really what belief is and under the umbrella of belief is a real reeducation and unlearning to relearn about the brain science about why the human nervous system seeks these symptoms as a lesser painful option then the emotional overwhelm the store trauma the emotional overflow of the reservoir truly truly. And I've been doing this for a million years 25 years and now all of the scientific studies out of Harvard in fact Michael Denino out of Michigan. I know what's happening in London at one of the very elite hospitals. It's all about catching up with the the research is catching up with what I have seen anecdotally for years and years, which is a human nervous system, dysregulated in sustained fight or flight for whatever reason will be a symptom generating machine because the symptoms are by their very nature protective. So if we look at this through the lens of evolutionary biology, the human being was created with pain as its most protective resource because pain is the indicator that we need to pause and take care of ourselves. So if you think about like the dawn of early humanity, if you cut your arm and you were not aware of exactly where you had to look and clean and care for, you're we would become you know a septic you would you would die. And so it is about understanding that pain is protective we need pain because pain helps us slow down and take care of ourselves. But when we are stuck in this neural pathway that is looping and looping for pain oftentimes or fatigue or anxiety or depression or panic or OCD, there are so many different symptom imperatives for every kind of element that cover you know people think of Dr. Sarno is the back guy, but toward the end of his career and certainly when he and I were lecturing together and and he and colleagues, he had expanded it to everything migraines fibromyalgia, you know all sorts of stomach disorders pelvic disorders because so many of these things are coming from the same place. So all of your subset of symptoms, although they are real, although you are not hysterical, you are not making it up, you're not even exaggerating it. These things are capital are real, but the question is through the lens of neuroscience, why, why are these signals firing because when we can go into the foundation, the core, the understanding of mind body science, what we learn is this pain. So I'm going to use the word pain, but let me just for your purposes say headaches fatigue brain fog, okay, I'll just pick three things that I'm sure are. Those symptoms are equivalent to the pain that that early human felt when the arm was cut, it's exactly the same. So I'll explain. Your nervous system senses a predator, the predator is anything in your life that's causing your emotional reservoir to overflow that's leaving you in sustained fight or flight. So back in the day, the predator was the saber tooth tiger, right? So you are perceiving of the predator and now your nervous system has gone into fight or flight and you have choices, you can fight, you can flee, you can freeze. And your incredible miracle of a human body and brain is going to put you in the optimal position to survive because survival, of course, is the main job for the most primitive parts of the nervous system. They need to keep us alive without being alive. We can't achieve anything else. Okay. Now, let's say in the process of doing that, let's say you're running from that predator and you step in a hole and you break your ankle. It's amazing about your brain is you will be able to run pain free on that broken ankle until you reach perceived safety perceived is a very important word here. If you got into a cave and you thought that predator was going to run right into the cave behind you, you will not feel pain, you will run, you will climb, you will continue on that ankle. If you get into that cave and you perceive that predator to have been, you know, off your scent, your ankle will explode in pain. Why? Because now the wisdom of the body has switched the greater predators no longer the actual predator, which is following you now the greater predator is your own body and its brokenness. And if you don't fix that ankle, you could be lame forever. If you're lame forever, you can't move with the tribe. You can't move with the tribe. You die. So then that's the next level of predator and it's going to go right there. How do we protect her from that? She's in pain. Stop slow down. Get whatever care you can get to secure your own survival. Now the reason this is so much more complicated for every person who comes into my world is the predators of the 21st century are all very subtle and they are all very amorphous and confusing and vague. Meaning a broken ankle is one thing, a cut on your arm is one thing, but when the predator is your mother, when the predator is your child, when the predator is your body image, when the predator is your self-worth, when the predator is your generational trauma, when the predator is these impossible to solve for things that the brain cannot make sense of what happens is we get stuck in fight or flight because life is an onslaught of predators. Your partner wants to talk to you and you get that feeling of like, oh God, what did I do wrong? They don't like me. Or your kid, despite all your best parenting is just disrespectful and you feel bad about yourself and your failing or your mother every time it's the same thing with the criticism. We could go there for every person listening, no matter who they are, here's one of those things and they're going, yeah, that's the thing. And it's everywhere and it's constant and a lot of the predators are internal meaning the call is coming from inside the house. You know, it's like this shame that you had when you were 14 and you never really got to it so it's repeating on you all the time, it's infinite. And so the reason this is important is for everyone to understand. This is why the pain is not in your head and this is why you're not hysterical and this is why you're not at fault. The three most common misconceptions of mind bodywork. The reason is this, because if you're bringing your nervous system C, you're repressed emotional world overflowing all these feelings, associated with all those things as a greater predator than your physical pain, it will choose your physical pain every time because pain is protective. And when you have a migraine or when you're too fatigued to leave your bed, you are, and I call this safe in the unsafeest way, protected from the big bad world that's always hurting you, that's always triggering you, that's always reminding you of the places that you feel raw and unprotected and unheard and unseen. And this is the state that we live in all of us. So how does that land for you? I mean, as 1000% accurate and the number of things that have come up for me through doing the journal speak work where you know I'm addressing some current stressor and then it ties back to and I like that you keep using the word safety because I just I think about this all the time. You know, it'll go back to these moments in childhood that were really challenging and you know, I have amazing parents, you know, my mom hasn't been with us for a long time, my dad still is that they were both wonderful and they couldn't have been more loving and caring and supportive of me and my younger sister, but we just we didn't talk about these things in in those types of ways and I think it just made it hard to actually face how hard the thing was, you know, suddenly having a parent just have their life completely changed and the whole dynamic of the family completely altered. So yeah, this the safety piece I just I keep coming back to it over and over again as I do this work that you prescribed. Yes, yes, and it's so important to honor that because the thing about safety is it's become a bit of a buzzword you know always and like in in our society, but if you really kind of slow down and think about the concept of it. If we don't feel safe, we can't do anything. You know, I mean if the human brain has informed us that our lives are in danger which as crazy as it sounds that's the stakes in its perception about this emotional overwhelm and the store trauma it's going to slow you down and shut you down little by little until you know oftentimes people find me they don't leave they haven't left their bed for like a year. Except to be basically helped to the bathroom and back I mean this is not like hyperbole this is what's happening and and so you know all that to say that's what exists under the umbrella of belief because even though the work that I teach is life changing it can only be so life changing if you don't consciously build that bridge between knowing that as you systematically. Take a ladle in the reservoir and dump it out and get it to a manageable point your brain will understand wait a second I thought her confusion about her lifetime of loving her mother and fearing her. at the same time because watching a person deteriorate, watching a person who you need to be strong, not be strong, feels terrifying, right? So there's two hugely conflicting things. The need and desperate love, a child feels toward their mother and at the same time this terror of loving her and what that could mean, what it would mean to lose her, what it means to watch her not be the strong mother, like that's so challenging. Now the brain sees that and it says, "Oh, no, danger. We can't solve for this. Let's lay down in bed. Don't think about it. Let's get obsessed with our health and have specialists and Dr. Google and how do I get the next supplement? Like that becomes your semblance of control. And when human beings have a perception of control, they feel safer. And that's what keeps people in chronic illness for years and years and years. And so that's why I believe that, you know, the education, the knowledge. Dr. Sarner used to say, "My prescription is knowledge. The knowledge of what's going on in your body at long last when you've been so confused is key to build upon and then you can do the work with self-compassion." That makes perfect sense to me. And like as you were speaking, one of the conflicting beliefs that I have had to grapple with in the years since my mother's loss are feeling angry towards this, you know, perfect loving wonderful mother. And then learning through research that that feeling of anger and abandonment is very common in bereaved children, no matter the circumstances of your relationship with the deceased parent. So yes, like cosine. And that's another reason why journals speak is so powerful because I've worked with many people over the years that let's say they're caring for their dying parent. And this is a parent who they have, let's even say in the best case scenario, a fantastic relationship with, they have loved, you know, obviously no human relationship is perfect, but like they have really felt love and care and respect. And they come to me, racked with chronic pain, and when we finally get down to it, they're like whisper to me, I kind of wish she would just die. I can't do this anymore. And like that kind of a conflict is very, very unspeakably hard for certain people to come to. But when they finally were able to just air it in your own journal, speak and really align with that very sweet tender inner child who's like, I just can't watch this happen for one more day and realize they're not a bad person because they were able to say that their pain has diminished like by like 80% in a day sometimes just coming to these, these, these touch points along the way of things that are, and it's not, it doesn't always happen like that. Sometimes it's just a gentle, iterative process that, you know, can be more of a, like a slope. It's both. But really like that kind of stuff is really profound. I want to take a moment to address something that you said about your daily life. So now that I've kind of loaded in, the sign, okay, here's where I get to be bossy and maybe a little tough, lovey, but you see, you have a very lovely smile. So I'm, I'm hoping you can, you can handle it. Um, okay. I always have to be careful that I am not saying that there is no use in things that people find use in. For example, I know people that say, this supplement I take is fantastic. And I say, great, if you love the way it makes you feel or you really think it expands your life, I have no problem with it. I have people who said, I love my physical therapist. I love my physical therapist because I go in and I, and they understand the concept of the lens of fear and the lens of love, like I teach often. And so they say, I know Nicole, but I go to the physical therapist and I go through the lens of love, meaning I'm partnering with someone. They're giving me exercises. I'm strengthening my core. Now, when does physical therapy hurt people? When do supplements hurt people? When people through the lens of fear are like, this better help me, this better work. Oh my goodness. If I don't, oh my god, I ran out of my supplement. I'm going to miss it today. Oh, I'm going to be sick for weeks or I'm going to the physical therapist. This better be the thing. This better do it. You know, I'm not going to be able to make that work trip. I'm going to get fired. This will make you in so much more pain. You have no idea because the nervous system is just going to go into higher and higher panic mode. And so the one thing I want to say to you about the supplements, about the hours of rest built into your day, and about the strategic way you look at your life and the determination of what you can and can't do. I'm going to say the following. I, in my experience, do not believe that that's why you can get through the day. You know, because you loaded it in and you said, I used to be really, really in extremists. Now I've found your work and I've gotten to the point where I do the following and it gets me through the day. And I actually feel quite the opposite. I think that the structure you've created in your life that gets you through the day is what is stopping you from moving forward in your healing. Oh, okay. I think it is a barrier. So this is where we get to the real time. Heel. So there's a book. And I mention it quite a bit on the podcast. So apologies to my listeners because I'm here from Marissa right now. So I have to say all the things. Even if you're like Nicole, you can talk about that last week. But there's a book called The Untethered Soul by Michael Singer. Have you heard of it? I have it on my bookshelf right here. Okay. Have you read it? I have. I have. It was, so I think I failed to mention this in 2019. We had a really devastating pregnancy loss after three years of trying to become parents. And I found it in that season, you know, that crazy 2020 year that we all lived through together. So yes, I haven't I haven't picked it up in a while, but I do have it. I have read it and to Zalder. I think he has another living untethered. Yes. Yes. Yes. He's just got the best energy. But the reason I'm bringing it up is it's really a perfect analogy for what I'm trying the point I'm trying to make. So he has one example he gives in the book that he says in this scenario, the person has a thorn. And the thorn, let's say is, you know, in like the let's just call it, I could be misquoting this. But this is the way I can see the bottom of your foot. You know, you got a thorn. There's a thorn in your body. And so what you do is you create a contraption and you build a box around that thorn so you can walk because you're you're you obviously have to walk. And now of course it becomes a little heavy to drag that box around so you can build wheels on the box. And so you can drag the contraption around the thorn in order for life not to bump up against you and hurt you. And what happens when we have these elaborate contraptions is inevitably they will weaken and they will then fail to work. So what do we do? We build another layer on, you know, we build a police system that pulls the wheels that has the box that covers the thorn. And here is what I will say to you my love. You are exactly where you need to be. You have a lot of pain. You have a lot to process. And that's okay. We all do. And in that you are moving in the right direction. Life is not a trek from the base to the summit of the mountain. Life is moving in concentric circles like a spiral up the mountain. And every time you pause and say, oh, I'm right back where I started. It is so essential for you to turn around and look down because you will say, no, no, no, I'm somewhere and I may be not where I want to be, but I look at that version of myself six weeks, six months, two years ago and say, I'm not her. No, I know more. I've learned I get it. I've had proof. My body has been my proof. I've had that day where I walked out and salted my driveway. And I came back in and look, I was able to sit and do this podcast with my head up straight like these are the beautiful moments. However, what stops us is the huge contraptions we have built around the thorn instead of the systematic compassionate understanding that we have to take them all off. And we have to prepare for whatever pulling out that thorn. And we all have hundreds and thousands of thorns. So it's not one. But each moment is an opportunity to say, how can I become more ready to actually leave that winter coat in the hundred degree day and let it fall onto the field and walk away. And there's so much to be said for how hard this is because even though it's hot wearing the winter coat on the hundred degree day, there's something in the coat you have felt that you have needed. And it could be freer and it could be more comfortable to take it off. But it's like true readiness is everything. Which is why I teach journal speak in the way that I teach it. Why it is systematic. Why it is not outcome dependent because little by slowly when you say, okay, okay. So before I tell you that I really want to get rid of many of those things that you do, I want you to tell me how this lands for you and tell me the truth. Does it make you lock up? Does it make you scared? Help me. It doesn't it doesn't make me lock up. It's so when you do just said outcome dependent, like I am a very outcomes oriented person. Like I love discipline, I love lists, I love strategy, I am a paid strategist, like that's one part of what I do for a living. Um, and so like that space is where I am most comfortable, you know, for a million reasons, many of which go back to that mom, who just one day got sick, um, you know, being controlling and having systems and processes in place around things so that I can get to wherever I want to go. Like it's, it's, it's just, it is very hard to undo that. I think, you know, partially because while I can recognize and actually like, it, it, it hasn't kept me safe. You know, I just went through a laundry list of unfortunate events and traumas and things from the last 20, 30 years. Um, but it has worked well professionally. And so one of the things that I have really had to work at is saying like, you know, you, you have to do things differently. Like you, you are not the person who you were January 1st of 2024. Like you are a different person. You believe in growth. You are committed to growth. You want to allow this, you know, very unpleasant experience to also be a learning experience. But figuring out how to let go of the long COVID, you know, like relapse fear, like I did too much. And now I do have to spend the day in bed and like, that just feels so bad. And I, I don't, I don't want to be afraid of that. But I don't know how to not be afraid of that. And maybe this gets back to the patient's face from the beginning, right? Um, but yeah, it is, it is landing like stuff that I need to hear. So I'm super grateful for it. And I just, I'm trying to figure out how to put it into practice. I guess it would probably be the language that very, very fair. I would. So let's, let's take this one, one thing at a time. The first thing I'll say is the best first way to put anything into practice is to change nothing except your perception of what you're doing. Okay. So take the same exact supplements lay down for the same number of hours, have the same plans in place. But no, there are two things I want you to do with first of all, wear it more loosely, lighten it up. Okay. La la la. Here I go. Take these supplements. Okay. Gotta take them because I still need to take them because even though nobody in the face of the earth has ever been cured of anything by supplement. I'm sorry. They haven't. You're not wrong. It could benefit you. Listen, I, like I said, please don't come at me like supplement world. It can benefit you. I'm sure. I'm sure. And the things I like in my life, I do. You know, like I have a thing where it used to be that I could just like go to a business meeting and they have a big thing of pastries and I could eat one. And then that would be it. And it has nothing to do with weight. And it has all to do with if I start my day with sugar and carbs, I feel like shit. Yeah. Okay. It's just I can't. The first thing I need to eat in the day has to have some level of protein. It doesn't even matter what is. Okay. That doesn't mean that I don't believe in mind bodywork. That doesn't mean it means that I have learned I see my kids. They eat a donut and go off on their own. Very way like it's not that it can't it's not that any human can't do it. I have learned myself. So if there are things for all of you guys listening, this is not just for Marissa, that you're like, I know it's not curative, but I like my so and so supplement. I can afford it. Okay, because that's another thing like people are breaking the bank on this thing is really a point of irritation for me just because it's so so harmful for people who don't have the money to get caught up in the fear driven world of supplements. Like, and if I don't have this, I won't be okay. But all that to say, when you do your routine, I want you to understand that none of this stuff is anything, but the fake safety. And like I said, it's not that it can't help you, but it certainly can't cure you. And I know that because I have done this work with at this point, hundreds of thousands of people around the world and so many long COVID patients in the past several years. And it takes sometimes letting all of that go because of the fear that is connected to it in order for them to finally release the winter coat on the hundred degree day. And, you know, I think that the best way to do it is to do nothing until you decide it is a really important thing for you to be aligned with your concept of safety. So it means change nothing until one day you say, kind of feel like that one, I don't know if I need or, you know, oh, here's enough and here's a good hack for the like, I'm scared to do too much or I'll have, you know, like a long COVID. What's it like, what there's a name for it, right? The post-exertional malaise, like, you know, you have like a limited like a relapse. Yeah, it's not pleasant. Okay. Here is the advice I'll give you on that. The human animal is the only animal that is capable of making what is happening between our two ears more real than what's happening right in front of us. The only animal. So when you pre-grieve catastrophize, future cast, what it might be, if I do this, this, and this, your nervous system does not know the difference between that and the problem right in front of you. So the problem begins. So when you say, if I do X, I'm going to be stuck with this post-exertional malaise or whatever it is, you already are starting. Your nervous system is ramping up and preparing for the malaise because you are telling it through your fear and your perception that it needs to start stealing itself for the predator that it's on its way. So here's the hack for that. You decide the best case scenario for your day and then you say, I am going to walk through my day mindfully one step at a time and I'm going to honor the way I feel. So it's not, oh my god, if I do this, this might happen. It is, my day would be best. Not, and it's no shame if this is not the way it goes, but my day would be best. If I got up in the morning, if I ran that one, Aaron, if I attended that meeting, if I picked my child up from school and if I was able to make dinner and go to bed, simple day, right? That would be a really successful day. Now let's say the old you would be like, yeah, but I mean, I really shouldn't do three things and if I do the third thing, what if that, and then what if that's going to affect my week? How about this? No, and like honey, it is like every one of us. So there is nothing but shared humanity in this scenario as all there is, but having said that, what if you were to say, that would be ideal. And if that happens, how will you? And if it doesn't, oh well, it's all, it's, it, however this goes, it's okay for me. I'm going to do what I need to do with full permission and self-compassion that if at any point during this day, I am getting a sign from my body that I need to listen to it and rest, I will. And there will be days that you will go through the whole thing and you will lay in bed that night and you will be tempted to be like, I got through it, but now tomorrow, I'm going to be like, and that's when you say, okay, so this is another thing that I love. I love the concept of I don't know. I've had to get comfortable with that. Yes, because if I don't know Marissa, if I don't know, the possibilities are infinite. If I don't know, then the answer to the question exists within everything in the world that I don't know. Instead of, I know this finite number of things that I could possibly know. So when you're laying in bed that night, your only job is to say, I'm tempted to pre-grieve and to decide that tomorrow might be a catastrophe. I'm curious. Maybe it will be. Maybe it won't. Let's find out. Like it's just a gentler way of going through your life. So I don't know. And then the other one, I can't remember if you mentioned this to someone on a podcast or if it was in the book. Or you said, can you just say, so what? You know, like, I'm going to do the thing. So what? You know, we'll see what happens. And so I am trying to replace fear with curiosity. And I think maybe I just need to be a little bit more patient. It's, you know what? And like, even that sentence, I'm going to try to push back on because I need to be a little bit more patient. To me, just has like a touch of shame. Like, you know, you, yeah, you're not patient enough. Like, how about even broader than that? How about, you know, my favorite line, my daughter's a senior. And so she's like preparing all like the yearbook quotes and like the things, you know, like when she's getting ready to graduate. So we were talking about it. And I said, so what's the quote? What are you going to do? And she said, I love that quote from Juneau. I don't know what kind of girl I am. And it's just a really like it's always kind of struck me too. In that scene where Elliott Page is like announcing pregnancy and the fathers as I thought you were the kind of girl who would know better. And like so softly Elliott says, I don't know what kind of girl I am. And it's like that energy. It's like an open, an open-pombed energy. It's I am not going to with fear, urgency and outcome dependence tell you what is. I'm going to say which takes so much vulnerability and so much lovely surrender with my, my palms open. Oh man, I don't know. I kind of wish I did but I don't. And since I know I don't, it hurts me worse to pretend that I do or to need things to go a certain way. That is hurting me worse. The only way people are enabled to choose the option of what did you say? What did I say? Like, oh well, oh, you know, like, you know, however this goes it's okay for me. The only reason we are empowered to choose that is because the alternative hurts worse. That, you know, if you keep doing what you're doing, you'll keep getting what you're getting. The old doctor Phil, how's that working for you? You know, it's like if it's not working, then you might be motivated to say, all right, well, this feels like really weird and like uncomfortable, but what if I don't know what kind of girl I am? What if I don't know the answer? What if as hard as I tried, I couldn't keep my mother alive? What if no matter how hard I think about this and research and write books and succeed and go to the best universities and have the best jobs somehow I feel lost in here. So what if the solution was within help me? The energy of I don't know help me to me. The most sacred prayer is one word help. Yes. I love it. I love it. It's just like I don't want to be in charge. I want to open myself and understand myself without the barrier of that fear energy that keeps me from learning new things and from being enlightened. Oh Nicole, you are you are such a gift and like I'm I am agreeing with everything you're saying and you know, you you used the term unlearning and that's you know, it's it is it is a process I guess and but I am committed to it. And so I am just so thankful that you know, as I sit in this space of you know, really not knowing exactly how to do this. You know, like there is no blueprint. There is no script and I think for someone like me and I think for most long COVID sufferers having this thing that is new that you know in the beginning people didn't even acknowledge was I think many people still don't even think it's a thing. And there's no you know, there's no clear timelines or protocols or anything associated with it. That is really hard for you know, controlling type A. Let's make a list, make a plan, get it done personality, but I am I am choosing to accept that I don't know and I am going to stay deeply committed to being open. I feel like that is probably the in some ways the hardest but also like the most important thing because being controlling in a situation like this like it really doesn't it really doesn't serve you. Not only does it not serve you I want to I want to say some stuff about one COVID which I will in a moment because I really want to make sure that this podcast as as I do my best for all my podcast to be a real container that someone really understands what's going on and what to do for themselves, but I want to say something about control. Human beings love control because innately we understand that we don't have it. Like I think there isn't a need understanding to humans because in addition to all of the primitive brain and all of the survival skills, we also have very advanced brains that allow us to think in reason and you know understand things far beyond our own personal scope and by doing that we are really terrified because we get we know what why I always say we don't have an exoskeleton we don't have a turtle shell to go into. We are soft chewy humans and it's it's a bit terrifying how vulnerable we are so we like to control what we can control and that is very fair and that's very human, but in the world of mind body science and in the world of nervous system regulation that leads to whole body healing and wellness, you have to understand that the only message you need to send to your nervous system is one of safety. It is literally the core concept that I want people to understand. When you perceive yourself to be safe you go from fight or flight to rest and repair your body regulates you can digest you can sleep you can thrive you have the energy you need. When you are in sustained fight or flight your body is constricted respiration heart rate elimination digestion everything is affected by the urgency that fight or flight commands because they have to keep you alive. I mean it's fair. So when you say I know that I need to like replace my fear with curiosity and know that I don't have control the first thing I want to say is honor yourself that your need for control is very human innate and it is evolutionary and it cut you come by it honestly so every time you're tempted to want it be like welcome to me here I am you know like this makes sense and then I want you to roll in with this sentence the only message I need to send to my nervous system is one of safety. So control what you can control I'm a big believer in that you say what you need to say draw your boundaries eat what feels good drink what feels good sleep what feels good pause when it feels good all the things that you can do but when the lack of control is coming from outside of you so either another person a situation that you don't have your hand in or your physical body that is sending these signals that you would prefer to stop instead of gripping tightly and saying if only I could control this know that the only message the nervous system receives when you want to change something when you want something to be other than it is is fear the need to be different and other than we are in any moment sends a message of fear because the nervous system is perceiving what's a miss what's a miss and it says oh I see what's a miss if only marissa didn't have this fatigue she could be happy and successful fear danger fear danger more symptoms so you slow down and you say acceptance does not equal agreement I do not like I do not like what's going on I do not co-sign it I do not agree with it and next question do I have control over this and that's an important question because like if something's going on with one of my kids and I need to have a difficult conversation with them I could send myself up into a nice migraine or I could say I actually do of control over the situation it's unpleasant I don't want to deal with it but I can decide to deal with that and that'll be my choice and on some days I'll pick the headache because I just don't tolerate it but at least I have answered the question now a lot of people come to me these days with questions of geopolitics with question of chaos and they say to me Nicole how do I live in a world where I feel unsafe all the time and I say exactly what I just said to you you pause you assess what can I do and then you look within your realm of a your possibilities your capabilities your world and you do what you can do some people feel better when they're volunteering some people feel better when they're you know protesting like whatever it is that makes a person feel but once you have made decisions either that you have no control or that you might be able to do something but that doesn't work for your life right now the only thing you need to do to get to that place of safety is to come into full alignment with yourself you are going to make a decision and you're going to say I see the decision I just chose it hurts worse to make the decision and then beat myself up for not doing it so here I am I've made the decision that even though I could go out and volunteer it does not fit into my life right now I'm not going to do it and that's my choice it's like so important that we are slow down and take a look at things we're doing to constantly be in battle with ourselves because that energy is very exhausting oh god yes you can put in full alignment so that's another thing just to kind of put in your part of it. it because it's really, really important in terms of mindset. But in terms of I would, like when you're saying like I know that I need to just say, "Oh well, best way to get to O'Well is I right now at this moment no longer want to be stuck in this loop of fatigue and symptoms. And if doing all this, you know, controlling and wishing and wanting outcome dependence, if all of that is where I'm at, it hurts worse to stay here. And if it hurts worse to stay here, I am going to try something different. So although acceptance does an equal agreement, I'm going to say I accept the situation as it is. And now I'm going to live within it and I'm going to check in with my body and see how it feels. It's just a gentler, looser mindset that makes space. It makes space to do things differently. Now I mean, 100%, I just, like this conversation, honestly, it could not be more well timed. Because you know, the fear that's been hanging over my head, I have a book coming out in April, this is my second book. You know what a book launch is like and how relentless, exhausting it can be. And I've just been, you know, trying to be very, I don't even know what the right word is. I've been struggling to not be afraid of it. And I don't, I don't want to be afraid. Like I worked really hard to, again, you know, like to put a book out into the world is so much work. And to do it when you're, you know, physically unwell, like it just, it was so hard. And so now I want to be able to enjoy it. And so my only regret about this conversation is that I haven't been taking notes. That's what it's a podcast. You're not only going to be able to listen to it, you know, Apple podcasts or whatever platform you're on will transcribe it for you. So you're going to be in good stead. You know, not, not to. But before we wrap, I do want to say something very specifically about long COVID because although you've had other, you know, quote unquote symptoms, the stomach stuff lifelong. I want to say something about long COVID. It's very important for me to say. I've been doing this work officially since like meaning like professionally since 2000. I've been doing this work for years now professionally. I was doing it before that with my own body. So really the long, the whole, you know, trajectory of it is more like 30 years. Having said that in my 26 years of clinical practice, every single symptom that is under the umbrella of long COVID has been. Has come through my practice and I have seen it completely resolved. This is because although long COVID is as real as the day is long and the symptoms are debilitating to the point where I've worked with people and many of them have come on the podcast that were completely bed bound. So this is absolutely nothing that people are being dramatic about. It's only called long COVID because it has been connected to COVID and COVID is clearly a catalyst for some of these symptoms to come up. So it's not that I'm taking away the realness. I just want people to know because I think it's comforting. This stuff is not new. Like in my world, crushing fatigue, brain fog, horrible migraines, chest pain that has no discernible cause because you don't have any damage to your heart. I've been suffering from trouble breathing, panic attacks, insomnia. Like I could go on and on and on. I've treated every single one of them successfully many times as the doctor Sarno, many fold before me and many of them in my own body. So all I can say is as real as it is, please be less everyone listening. Please be less afraid because if this were truly a brand new thing, I'm going to say something really awful and incendiary. Like let's say we have another pandemic and as a result, people skin falls off. I don't even know what to say. Your eyeballs fall out of your head. Something happens that is so crazy and you thought you were better and then one day you wake up and your eyes are on the floor. I'm being joky for reason because I don't freaking want to ever say anything that feels more real. But the point is if this were that, I would be right with you and I'd be like this is a freaking 10 out of 10 panic, holy shit. I have no idea what this is. This is terrifying. But what I need people to understand is it is only terrifying when you attach to it a desperation, a helplessness and a meaning that has been whether it's purposeful or not been attached to many of the pieces of media. I have seen come out about the like it's a disaster. There's no cure. It's for the rest of your life. People are taking their own lives. Like it's very serious. The messaging around it. So that's the first thing I want people to know is it's not new. It's just being packaged in a new way and called something. And so please take the opportunity to be less afraid. So that's the first thing I want people to hear from me. The second thing I want people to hear is as however this conversation landed with you. There is a recipe on the box of what I do. And if you have and this is a lot of today for Marissa was helping her understand the mindset of laying down her weapon of control and of what she thinks needs to protect her and however she's structuring her day. That's a big part of this conversation and what I know Marissa has already seen huge benefit from is consistency in your journal speak practice. You know anyone who's new to this work. Go to my website. Click on the how to journal speak button and download the instructions. So many resources to help you get started because basically what consistency and journal speak means is since the overflowing emotional reservoir is causing the sustained fight or flight in your nervous system. A systematic daily journal speak practice puts a ladle in the reservoir and brings it down so you are no longer being consistently triggered into a chronic fighter flight state. And you start seeing your symptoms decrease which Marissa has already seen. So in addition to all of this mindset. My prescription for you my dear is to just remember that journal speak does not stay true. It is about being curious and saying what if my favorite journal speak is what if and then I say the most horrible thing like like like what if this is what if this is this life is too hard and I I'm done I quit the podcast I quit everything I'm freaking done. You know what you know what this is like I'll do it my journal speak you know what I do I do quit I'm never doing this again. This is too hard I'm finished I'm done like you be that five year old you be that part of you you know that as you know if this noise I'm done and what I do and what I invite you all to do is go to these really bizarre places and say does this feel true to me. Because what I promise you happens in that space of total permission of total permission to say arms crossed I'm not doing this anymore I quit I'm finished I'm done being your mom I'm done being a therapist I'm done being your partner I'm freaking finished I'm going to sit on a beach by myself and to heat for the rest of my life like when you do that what I promise you inevitably happens is you get it all out and you're just really there and you go. But I like being your mom you know like it's this urgency to like keep yourself from feeling the thing you don't want to feel is removed and then you could say okay what do I really want and what would happen to me in that situation is I would say I know it feels like I want to quit here's why it feels like I want to quit because on days when this is hard I feel really alone. I feel like I want to quit and even though I'm surrounded at certainly now in my life between Lisa and my and my team like I am less alone than ever but it doesn't matter because it's not me who feels alone it's Nicole in seventh grade when we moved and I didn't have any friends like whoever it is in there that is feeling something they need a voice and that's where you get the most beautiful moments of epiphany and surrender where you just go all the way and then you say that's why I want to quit but if feeling alone is the problem and not really the fact that I'm not where I need to be why do I feel alone right and then you get underneath that I feel alone because this was the way I felt with this okay and then you can reflect but I'm a 53 year old woman is it really like that anymore and if it is and if there are plate it is like that when it's this this like it's so wonderful to just let that string pull you through to what you need to know and then the best part is at 20 minutes when your alarm goes off you erase the whole damn thing so it doesn't really matter it doesn't matter where you took it it was just inventing it was blowing your nose into a tissue throw it away it's it's it's what's next it's what and then you move it so that is my prescription for you oh I'm gonna I'm gonna keep out I like the what ifs I hadn't I hadn't gone there and it's also interesting their days where, and I try to do it first thing in the morning because, you know, I don't want to get away from the practice. I've been doing it daily since September. And so, like, I know it has changed my life and given me tremendous clarity. And then over of times, I'll like start writing about one thing and then I'll be like, "Oh, that's what I'm actually upset about." Okay, I'm going to, now I'm going to, my 20 minutes start over. Now that I've like figured out the thing and we need to get to the root of it, it works. Like, I want people to know that this works. This is not just, you know, Nicole saying these things. And if you're listening to the podcast and you're wondering, you know, like, can this really work for me? I'm also just going to take a minute to plug your book. Because I am, you know, again, like the type A, I like research, I'm very technical. Like, I wanted to really understand the science. And so I bought it. I started reading it. I then sent it to my girlfriend who's a clinical psychologist who focuses on grief and cancer. And she was like, "Oh, my God, yes, I love this. I'm going to be recommending it to my patients." Like, I've brought copies for other friends who were struggling with things because it works. And it can be so hard and so lonely when you are feeling unwell and sort of find something that helps you. I mean, it's just, it's a game-changer. So again, thank you. Well, thank you for saying that. It really matters as you know when you write a book. It's like your heart outside your body, you know, trying to have this thing out there. And the fact that it is being received by people means the world. So thank you for that. Absolutely. And I'm so glad to have gotten to know you a little bit. And it's amazing. And I'm really, really, I'm very thrilled for you. And I think that you are going to find more and more ease. And I would imagine that you at some point will turn around and look back and say, thank God for every moment of that suffering because I am free. And there is nothing like it. And you're on your way. And you're already doing it. And it's just very, it's well worth the journey and whatever it takes. Well, thank you. I am hopeful. So thank you. I appreciate that. Stay in touch with us. We love to check in with these real-time heels and see how everything is going. And for all of you guys out there, if anything here lit you up and you are curious and you need any guidance, everything you need is at knucklesacks.com. I will put in the show notes every way that you can access. Marissa's wonderful work and her book that is I'm sure on pre-order, right? Yes, yes, please pre-order waiting for dawn. Pre-order for damn book. Tell me the name of it. Waiting for dawn, living with uncertainty. Oh, I can't wait to read it. Okay. So Marissa's book, Waiting for Dawn, Living with Uncertainty is on pre-order right now. And I will tell you from a person who has dealt with publishing pre-order is very important. I will pre-order my coffee today. And let's keep in touch. All right. Wonderful. Thank you so much, Nicole. You're so welcome. And for everyone out there, if you're enjoying this podcast, please hop over to your favorite podcast platform, subscribe and leave us a review because it means the world to me to see how the podcast is landing with you and it helps people like Marissa find the podcast. And until next week, this has been Nicole Sachs with the Cure for Chronic Pain podcast and I will see you then. Bye-bye. Hi, I'm Tamsen Fidel, journalist and author of How to Menopause and Host of the Tamsen Show, a weekly podcast with your roadmap to midlife and beyond. We covered all. From dating to divorce, aging to ADHD, sleep to sex, brain health to body fat and even how perimenopause can affect your relationships and trust me, it can. Each week I sit down with doctors, experts and leaders in longevity for unfiltered conversations, packed with advice on everything from hormones to happiness. 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