This week on the Less Stressed Life, Dr. David Hanscom joins me for his 4th appearance to explain why anxiety isn’t psychological—it’s physiological—a survival response that we can learn to regulate, not control. We talk about how unprocessed emotions and repetitive thoughts get stored in the body as pain and how tools like expressive writing, calming the body, and softening the ego help break those loops.

You’ll walk away with a new way to think about anxiety, pain, and healing—one that focuses on awareness, compassion, and creating safety in your body so your mind can follow. It’s about rewiring your nervous system, not forcing it.

Dr. Hanscom’s past episodes:
• Ep 71: Roadmap out of Anxiety and Chronic Pain
• Ep 72: Anger & Anxiety in the Family
• Ep 325: Overwhelm & Pain

KEY TAKEAWAYS:
• Anxiety and anger are body states, not character flaws
• Calm the physiology first; thoughts will follow
• Expressive writing helps separate from looping thoughts
• Awareness and compassion are core to lasting change

Free resource: Try Dr. Hanscom’s Expressive Writing Exercise (PDF), a foundational tool from The DOC Journey to help calm the nervous system and release looping thoughts.

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ABOUT GUEST:
David Hanscom, MD is a former complex spine surgeon who left his 32-year Seattle practice to help people heal from chronic physical and emotional pain. After overcoming his own 15-year struggle with anxiety and pain, he developed the Dynamic Healing approach, which focuses on calming the body’s threat physiology and rewiring the nervous system for lasting relief.

He’s the author of Back in Control: A Surgeon’s Roadmap Out of Chronic Pain and the upcoming Calm Your Body, Heal Your Mind: Transcend Pain, Anxiety, Anger, and Repetitive Unwanted Thoughts (June 2026).

WHERE TO GUEST:
Websites: https://backincontrol.com/ and https://thedocjourney.com/
Instagram: https://www.instagram.com/drdavidhanscom/
Facebook: https://www.facebook.com/drdavidhanscom
YouTube: https://www.youtube.com/user/DrDavidHanscom

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Podcast Instagram: @lessstressedlife
YouTube: https://www.youtube.com/@lessstressedlife
Leave a review, submit a questions for the podcast or take one of my quizzes here: ****https://www.christabiegler.com/links

SPONSOR:
Thank you to our friends at Jigsaw Health for being such an incredible sponsor and partner. 😎 If you’re listening during November 2025, use code LESSSTRESSED15 at JigsawHealth.com for 15% off every order. If you’re listening after November 2025, use LESSSTRESSED10 for 10% off anytime.

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TRANSCRIPT:

[00:00:00] David Hanscom, MD, Orthopedic Surgeon : anxiety is fight or flight. You cannot control that reaction, but you learn to be aware of it and regulate it.

In other words, you can downregulate the reaction, so it's not as disruptive. We have zero control over anxiety. We have zero control over anger, but you can control how you react to them consciously.

[00:00:20] Christa Biegler, RD: I'm your host Christa Biegler, and I'm going to guess we have at least one thing in common that we're both in pursuit of a less stressed life. On the show, I'll be interviewing experts and sharing clinical pearls from my years of practice to support high performing health savvy women in pursuit of abundance and a less stressed life.

One of my beliefs is that we always have options for getting the results we want. So let's see what's out there together.

[00:01:08] Christa Biegler, RD: Alright. Today on the Less Stressed Life I have David Hanscom, who's a former complex spine surgeon who left his 32 year Seattle practice to help people solve chronic pain, both physical and emotional. After a 15 year personal battle with pain and anxiety, he discovered that anxiety is the pain and that healing happens when we calm the bodies throughout Response.

He's the author of Back In Control, A Surgeon's Roadmap Out of Chronic Pain and the upcoming Calm Your Body Heal Your Mind, which. Comes out this summer through his dynamic healing movement and his site back in control.com. He teaches practical ways to rewire the nervous system and reclaim health and.

I've had Dr. Hans come on a few times, but it's been a while. So back in 2019, he was on for episode 71 with a roadmap out of anxiety and chronic pain, and I thought that one was so good. He came right back for episode 72, anger and anxiety in the family, which I actually wanna go back to that one myself.

So that in 2019, and then in 2023, he was here for episode 3 25. Overwhelming pain. And so I was just telling him that I always think of him as an early, I just really enjoyed our conversations and I always thought he brought a really surgical approach to this concept of pain stored in the body, a topic I'm generally interested in.

I'm interested in emotion stored in the body, and I say it surgically because I remember him saying on a previous episode, he's the body doesn't know what to do. If you don't process the emotions, the body just stores it as pain, or the body doesn't know what to do with unprocessed emotions, so it just stores it as pain.

And I was like, that is a very surgical, very concise, direct, black and white way to say it. And so there's some things that have been impactful for me, and I've referred lots of people to him. So he's back now to talk about his most recent concepts in his newest book. So welcome back Dr. Hancock. 

[00:02:54] David Hanscom, MD, Orthopedic Surgeon : /Thank you.

No, I enjoyed the conversation. This is great. 

[00:02:57] Christa Biegler, RD: /Yeah. Okay, so I'm curious. You heard me, I cut up your bio made it shorter, but you have the original book, the Back In Control, the Roadmap out of Chronic Pain. And then I thought there was another book in between, but it's, this one is the next one.

And so I'm curious, why was there a need for this particular book? Like you had a concept and I'm curious, usually I feel like with a book, it's almost a legacy thing. It's I gotta get this in the hands of people and help them understand this concept. So tell me what kind of created that for you.

[00:03:28] David Hanscom, MD, Orthopedic Surgeon : / My first book was 2012 and the second edition was 2016. 

[00:03:32] Christa Biegler, RD: /Wow. 

[00:03:33] David Hanscom, MD, Orthopedic Surgeon : /And then the surgical book, do you really Need Spine surgery was 2019 and. I met a Dr. Steven Porges in 2020 of the Polyvagal Theory. Do you know Dr. Porges by chance? 

[00:03:46] Christa Biegler, RD: I don't know him personally, but yes. He's the kind of one of the fathers of polyvagal theory.

Yeah. 

[00:03:50] David Hanscom, MD, Orthopedic Surgeon : So he and I started a scientific Roundtable in 2020.

And his wife is Sue Carter, who's an oxytocin person. And it's incredible how much I've learned about the physiology of the body since I've met these two people. It's unbelievable. So we have a group that meets twice a month, minus this summer is just talking about scientific topics.

And what's happened since I talked to you last is just a dramatic increase in understanding about the body's chemistry and physiology. When I wrote my back of control, I did not understand that at all. So what I found out. The process is getting better as far as pulling people outta chronic physical pain, and it turns out that mental pain is also an inflammatory metabolic disorder.

As we talked about before, anxiety and anger are not psychological constructs. They're basically physiological states. So if somebody threatens you or you feel threatened or you feel unsafe, you feel anxious. And so that's a sensation generated by your body's fight or flight physiology. So it's just a sensation.

The reason why it's so critical that if you think of anxiety as a psychological construct, your unconscious brain process is about 1 billion in bits of information per second. Guess how much the conscious brain processes? 

[00:05:08] Christa Biegler, RD: About 5% of that 

[00:05:10] David Hanscom, MD, Orthopedic Surgeon : less, it's 20. 20 bits. So 20 bits not 20 million, 20 bits.

And so you have a billion versus 20. And so what happens when you have this massive thing called anxiety, which is just your survival response? We try to counteract that with cognitive constructs, and it's a complete mismatch. And so the more harder we fight our survival physiology, the stronger it becomes.

So what I found out I was watching. Hundreds of people go to pain-free. So mental pain dropped, anxiety dropped, physical pain, all sorts of symptoms dropped. And as I mentioned before, I had 17 different physical and mental symptoms myself. Anxiety, depression, headaches, migraines, back pain, neck pain, skin rashes, all sorts of stuff.

They're all gone. And so it turns out as you learn to regulate your body's chemistry. These other symptoms resolve. So the one I wanna talk about today is anxiety slash repetitive unwanted thoughts, because I noticed people would get better. But what drove me down the hole really badly were these repetitive, unwanted thoughts.

And my patients suffer a lot from these things, and I still notice that anxiety would drop, their pain would drop, but these thought patterns would persist. And for me personally, these unwanted thoughts were the worst part of my hope ordeal. They were miserable. So with my patients, it's the same thing.

So I found out over the last 18 months there's some additional things that have to come into the equation to solve these thought patterns and severe. Intrusive thoughts are considered untreatable by the mental health profession. They can be decreased, they can be managed. You can solve, you can drop them down quite a bit, but they're generally not considered solvable.

And the problem is, what's happened in medicine is that the, that your conscious brain reflects your unconscious physiology. And if you don't comment on the physiology, the driving force. You can't solve the thoughts. So it's that need. So that's I swore. I swore I would never write another book. It's hard to do.

You don't have much free time when you're writing a book. But I started learning how to solve these things and I had a young professional in Southern California who was 35 years old, who came to me for back pain. They needed some floaters in his eye. But it came out pretty quickly that he had severe problems with intrusive thoughts.

Extreme. He had it for 20 years. He was absolutely, I miserable, and I started talking to him through the principles that I put out there. Again, they're not my principles, they're just the science. Within three months, they were gone. He probably read a hundred self-help books. He was shocked to see these things go.

I was shocked and I talked to him. Even I talked to him yesterday after three years later. He's fine. So for me personally, what the worst part of my ordeal were two things. I had all sorts of physical symptoms, but it was the intrusive thoughts that were the worst part of the ordeal. Then he also become very socially isolated, which is another part of the problem.

So of all the symptoms I had, the thought patterns were the worst. 

[00:08:31] Christa Biegler, RD: I wonder if it took you a while to even become conscious of the thought patterns, because I find that physical symptoms very much tend to move us to action. And the reason I think sometimes the physical symptoms manifest in the first place is because the unconscious has gone unaddressed for a long time.

So I'm curious about that. And I actually wanna go back to the top before we go deeper into ruts or recurrent recurrent thoughts. Okay. Essentially, so if we talk about, oh you mentioned anxiety, right? And I'm curious if you have, so something I'm really interested in is this topic of generally unconscious stress and the fact that people run through life and they're like, this is just life.

This is baseline, but I'm in pain, or I have this symptoms or whatnot. And we don't necessarily see a relationship. And I'm curious about this with anxiety maybe because I don't necessarily. Resonate with saying I'm resonate with the word anxiety, but every once in a while I might say, yeah I can see that.

So I'm curious if you think that sometimes anxiety just presents in the body and people don't think that they have symptoms of anxiety, first of all. 

[00:09:35] David Hanscom, MD, Orthopedic Surgeon : So let me go back even farther in the dynamic healing model. So every living organism has to assess their environment. The threats stay alive, their stresses, adversity.

So you have to process those through your nervous system, which has all these sensory receptors, vision, touch, spell sound, et cetera. So you're taking all the sensory input, you're determining whether things are safe or dangerous. Your body sends out signals to your body that I call output, that you're either in safety physiology or in threat physiology or fight or flight.

So if your body determines your environment's unsafe, you have threat physiology. That sensation is anxiety. Every human being has anxiety because we would not be alive without. So anything that makes you uncomfortable or says danger, that is anxiety. So for a lot of people, I'm not gonna say most 'cause most people have anxiety that's actually bothersome.

And right now, in this day and age, it's become worse. That's a different topic. So your body has a sensation of I have to do something. So somebody is coming at you that's threatening you. Your body has a fight or flight response, right? That sensation is the anxiety, not psychological. More importantly is that if somebody, let's say you see a dangerous person walking across the street, or somebody starts to threaten you in any way, shape, or form, your body actually re reacts first.

It's a physiology first. Then the thoughts come one to 10 seconds later. 

So your body's unconsciously taking care of everything. So the dynamic healing model, you have your input or your stresses. You have your nervous system, that's collating everything. Then you have your body's chemistry. By the way, physiology means how the body functions.

It's either fight or flight or safety. Then sustained threat physiology that should create symptoms. 

So there's essentially every chronic symptom, mental and physical are from sustained threat physiology. And the reason for that is that we have to have threat physiology. To stay alive, you have to be alert.

And I have a word progression on anxiety is alert, nervous, afraid, angry, panic, and terrorized. But it's all the same chemical reaction. So again, that's a physiological state, not psychological. It's supposed to be incredibly unpleasant because the species of creatures who did not pay attention to those cues just didn't survive.

So if you can't solve the problem causing anxiety, you become angry. Which is a same chemical response, except now you have dopamine, you have excitatory neurotransmitters, your whole body gets inflamed, and when people are trapped by anything, physical pain, mental pain, circumstances, relationships, whatever it is, that is a very intense situation and you're on a low grade anger.

People pleasing, for instance, is a major source of anger. You're not getting your needs met. So the bottom line is that everybody has anxiety. Everybody has anger. You would not survive without those. They're survival states and you cannot treat those with talk therapy. So in medicine you have this sustained the physiology, create symptoms, and administer are, now we're treating only the symptoms.

We're not dealing the stresses, we're not helping people create coping skills. We're not addressing the physiology. We're treating only the symptoms. So unless you address the root cause, the anxiety, anger, and pain are gonna keep going. 

[00:13:15] Christa Biegler, RD: Yeah, I think that it's possible that part of the. Benefit of talk therapy might be to bring some things conscious, right?

Because if we're just operating through, and I say this as someone who is a little bit of a verbal processor and not someone who has had massive success with therapies, but sometimes talking through it like helps you realize, oh, I didn't realize that this, as you were just describing anxiety, some of the things I would've underlined it or highlighted to make it.

Even land with someone listening is, oh, okay. So Dr. Hanscom is saying, if you are a person who cannot sit still and wants to go move or do something else, or you're having trouble being at rest and you feel like you must go be productive, all of that is anxiety. That is like the manifestation of anxiety.

[00:13:57] David Hanscom, MD, Orthopedic Surgeon : Just crossing the street anxiety, not touching a hot stove, avoiding anxiety. So in other words, the guiding force for human life is safety. And you don't feel safe. You feel anxious. Now, it may not be something that's an intense, but see your behavior's automatically guided to avoid pain.

We call that de nociceptive system, so your anxiety's in play all the time. Now, it may not be troublesome, but for a lot of people it is troublesome and if I gave people the choice, I'm getting rid of their physical pain with surgery and they would have to live with their anxiety and or they could get rid of the anxiety and live with the physical pain.

Almost everybody chose to live with the physical pain. 

They could not tolerate the unrelenting anxiety. So again, I had a population that was obviously in pain and again, physical pain and mental pain is the same thing. Turns out anxiety, depression, OCD, bipolar and some forms of schizophrenia are all metabolic inflammatory disorders.

They're not psychological either, so we keep thinking anxiety is a psychological state, right? 

Most people, two things. First of all, people think stress is psychological, that I feel stressed out. It's just your challenges to staying life. That's stress. It's your response to the stress that causes the trouble.

So it's a chemical reaction to your circumstances that causes the sensation we call anxiety. And so again, just fight or flight survival reaction. And what I did that got me in deep trouble as a spine surgeon, I suppressed it. So I wasn't until I was 37 years old, I went honestly from no anxiety. I did not know what the word meant.

I could not feel anxiety. I was always busy doing all sorts of stuff, but I never felt anxious. 

So what happened to me in 1990, I was driving across the five 20 bridge in Seattle and I had a panic attack. Which is a dysregulated nervous system, which is extreme anxiety. So I went from no anxiety to a panic attack because repressed or suppressed emotions are a huge problem, much bigger than expressed emotions.

So that's what got me in trouble in the first place. At the same time, I had the panic attack. I already had 17 different physical and mental symptoms at the same time. 

But your body chemistry doesn't lie. Again, your body physiology is what keeps you alive. Out of 4 billion years of evolution, human language is only about two or 300,000 years old.

So we have this survival body that's gave us alive, and the cognitive part of the language part is very recent in the course of human history, or history in general. So going back to what you're talking about. So thoughts are input, unpleasant thoughts are input that your nervous system processes and it creates a physiological response that we call anxiety.

So emotions are what you feel. So emotions are that physical response. So thoughts or input emotions are what you feel or the physiology, and so it separates it out into the cause and effect mode. Does that make sense? 

[00:17:18] Christa Biegler, RD: It does make sense. It's a little hard. You know what? I feel like you have to reset how we think about emotions in general.

I think you almost have to unlearn. What you know about that to take in these things, and I would imagine that this. Becomes somewhat challenging for some of the people who come in to get help from you as well. Like they hit a desperation point, I would guess. Or they're inspired by some part of your story or someone's story or a testimonial, right?

That is I would like to relieve my pain without surgery, or maybe I don't even have an option to relieve my pain with surgery, so I'm gonna try this other thing. But I would imagine that there's some relearning that takes place, right? Because any concept of, this physiological state of emotions being manifested in the body.

It's just not how we generally talk about it in society. So it takes so much 

[00:18:10] David Hanscom, MD, Orthopedic Surgeon : money. That's a huge problem. And that's why I quit my surgical practice. Yeah. Because anxiety is the pain. 

[00:18:16] Christa Biegler, RD: Yeah. 

[00:18:16] David Hanscom, MD, Orthopedic Surgeon : Anxiety is your physiology. Your physiology, which keeps you alive. And you have this massive automatic survival machine that keeps us alive.

It's, I would use the word more education 'cause you cannot unlearn anxiety. There's a friend of mine, Bruce Lipton's pointed out really clearly that anxiety and anger are automatic hardwired survival reactions. We have no control over zero. Now we can regulate. Again, anxiety is fight or flight. You cannot control that reaction, but you learn to be aware of it and regulate it.

In other words, you can downregulate the reaction, so it's not as disruptive. We have zero control over anxiety. We have zero control over anger, but you can control how you react to 'em consciously. 

[00:19:04] Christa Biegler, RD: Consciously. Okay. So let's talk about recurrent intrusive thoughts. So you just shared part of your story and I think that's another reason I liked you is because, we have many guests on the show.

It's very common actually, where people change their entire lives. They pivot completely. And I think it's a big deal when someone goes to school for a million years and then pivots to do something completely different. Like a surgeon especially. And so I think I always appreciate these reinvention stories and it's it's gotta be something big that makes you reinvent yourself.

So we're, you're 37 years old, you've got these 17 symptoms. You also do not resonate with the idea that you have anxiety until you. Suddenly of this panic attack. And you're probably wondering what the hell that is in the first place when you're having it. Because I think I've seen that.

Like I've had that client story before. They're like, what is this? I think I'm dying, type thing.

And but then you say that the recurrent intrusive thoughts or the recurrent unproductive thoughts ended up being the actual bigger problem, which I'm guessing was the next layer of your healing journey, right?

It's oh, or maybe the initial, once you peeled back the layers, you found those. I'm curious when you became conscious that those were actually playing in the background. Because I think. Normally that kind of stuff is playing in the background for everyone. Can you give us some examples of what these recurrent, and I know it seems like it should be self-explanatory, but can you help the listener?

Be in the shoes of this and help them understand like, oh, okay, maybe we all have some recurrent unproductive thoughts. What are some examples of these, and how did you start to notice that they were there? Because I think that what this boils down to me is that we go. And we don't really stop and assess where we are.

And we're not really stopping to notice all the noise that's there already. We're just, it's just plain in the background. 

[00:20:49] David Hanscom, MD, Orthopedic Surgeon : I agree with that, except I think it's bigger than in the background. Yeah, I think over time it consumes people. So see part of the problem, I came from a very abusive background, which a lot of people do, which is very frustrating.

Then also things like bullying come into play later on in life is life is rough for everybody. So what happened with me, anxiety was my baseline. So was anger. So that was normal. So why would I think those sensations were abnormal? That's all I knew.

[00:21:19] Christa Biegler, RD: Yeah. 

[00:21:19] David Hanscom, MD, Orthopedic Surgeon : But looking backwards, so the research shows that 93% of children that are eight years old have obsessive thought patterns.

And it's mostly around their parents' safety, which makes sense because their parents aren't safe. They're not safe. So I'll say this multiple times throughout the podcast, is that safety is our goal. All of us want to feel safe. We don't feel safe, you feel anxious. So that's true for every living creature.

So you know, people in the animals in the wild take evasive action. The problem with humans, we have words that feel as unsafe as a physical danger. Because we actually become our thoughts. So as far as the thought patterns, I started noticing them. It's odd. Back in high school, this odd thought patterns came through.

Random thoughts like stepping out in front of a car, throwing a glass of water in somebody. Just weird thoughts. Never thought much about it. And so just to be clear, there's a whole range of thoughts. So it turns out that 90% of people have a self-critical voice. That's a repetitive thought pattern that's unwanted.

That's not very nice. And so about 70% of people have repetitive thought patterns that are disturbing and disruptive. So gonna be a little bit or a lot. But I had the full-blown obsessive compulsory disorder. And I talk about that very much, and people say I don't have OCD and you probably don't, so I'm gonna work backwards for a second.

There's a pattern. We have just occasional unwanted thoughts. It's not a big deal. Then you have thoughts that are repetitive and bothersome, but not a big deal. Then they can become disruptive where you're on a nice vacation and you can't stop thinking about work where people are thinking about you or feeling rejected or feeling unworthy.

And a huge factor as far as repetitive one to thoughts is simply, I'm not good enough. The self-critical voice doesn't really stop. And then the final part is that the thought patterns become really extreme. Intrusive. Disruptive is what I had. They're totally inappropriate, and a lot of people have the self-critical voice.

In fact, the research shows again, 90% of people have a self-critical voice. Those aren't very nice, and it turns out that a lot of times the more successful you are, the louder the voice gets. 

So for instance, in orthopedic surgery residents, they did a research study that shows 73% of orthopedic surgery residents had imposter syndrome.

I'm not good enough. 

So that doesn't make sense. They've gone to medical school, they've gone through residency. They've gotta compete for jobs. Jobs into a very high stress field. They're very competent. Why would they not think that they're good enough? 73%. So those are some examples. The repetitive thought patterns.

When I talk to my patients over and over again, they really suffer from these repetitive thought patterns much in fact, the research on Arizona shows that mental pain is actually less tolerated than physical pain. And they showed this in MRI scans in the lab that people would rather feel physical pain than mental pain.

And that's one of the reasons people do cutting. Are you familiar with cutting how people cut themselves? 

[00:24:29] Christa Biegler, RD: Yes. 

[00:24:31] David Hanscom, MD, Orthopedic Surgeon : Okay, that's, so you've externalized your pain. You have some control over it. So with mental pain, you have no control. With physical pain, there's an automatic withdrawal response. With mental pain, there's no withdrawal response because you cannot escape your thoughts.

The more you talk about these things, remember thoughts or input, your physiology is the output, the your thoughts reflect your physiology. So if you're under a lot of stress, what, for whatever reason, or you generate unpleasant thoughts, just racing repetitive thoughts, don't stop. 

In the metaphor, I like to use that of a hornet's nest, where the nest represents your brain and nervous system and the thoughts represent hornets.

And what happens? Somebody shakes the nest, the hornets are pretty unhappy. 

So what we're doing in medicine, we're fighting the hornets. Which makes them more angry, more frustrating. And that's why with trauma therapy, by the way, talk therapy by itself absolutely doesn't work because you're addressing the hornets.

The real answer is quit shaking the desk. So as you calm the physiology, the thoughts drop down, the thoughts drop down, the physiology drops down, and there's a couple other steps we'll talk about later. But the bottom line is, unless you calm down the physiology, which is the driving force, you cannot control the thoughts.

[00:25:54] Christa Biegler, RD: Let's talk about the steps to working through ruts, because when I read them, I don't automatically. Understand them. So I'm curious if you'll walk us through and how did you start to figure out the answers to ruts? When did that start to shift and change for you? 

[00:26:14] David Hanscom, MD, Orthopedic Surgeon : I had a woman who came to.

Some workshops that my wife and I put on back in the Omega Institute and they were phenomenal workshops, is around awareness, hope, forgiveness, and play. And people's pain would disappear really within three to five days. Now, it came back when they went home, but at least they had some training in their brain.

So I had one woman who came to tour workshops, had an incredible experience. Pain was gone. It was gone for a couple years, and then she started with these repetitive thought patterns. And no matter what I did with her, when I talked to her, she knew the tools. It got worse and worse, and there's nothing I could do.

I go, huh, this is a problem that I knew in my own experience that as I healed in general, that my thought patterns essentially disappeared. 

And so then I started realizing more and more people are talking about the repetitive thought patterns. And so I said, I gotta figure this out. And so then I told you about this young professional who after 35 years old, within three months, his thought patterns resolved.

So all these concepts over 30 years started to come together in a big way and started to come up with this final pathway. And I soon to be able to help people get through this better. I'm still a work in progress. I still wanna help people more clear about what's going on. But the first thing people say I don't have OCD.

You don't, you probably don't, but you probably have more unpleasant thought patterns than you would like. They could be very disruptive, especially the self-critical, right, self-critical voice that shouldn't have, perfectionism. All these things that we do to quote drive ourselves are really, become disruptive to our life and relationships.

I started looking back at my experience, talking to different people, watch what did and didn't work, and I realized there's a couple extra layers to solving these ruts compared to just the physical pain and anxiety. So I'll just briefly mention the four aspects of it. They're simultaneous. You don't go 1, 2, 3, 4, and a fixed.

So the reason why dynamic healing is what it is because your physiology in fight or flight is gonna generate symptoms. So some days your stresses are huge. Okay. And you're gonna have threat physiology no matter what. It's your body doing its job. Some days your nervous system is just tired. You're not sleeping well, not exercising, whatever.

So you're under-resourced. So it takes less stress to set off the threat physiology. So it's dynamic. So the skills you learn, the emphasis on the skills, not the pain. So the skill is learn how to process your sensory input. In a way that is less impacting on your nervous system and you learn how to calm down the physiology.

So the four parts are separating from your thoughts. Can't control 'em, but you can separate from 'em. Second thing is calm the physiology. The third thing is softening the ego. I actually like to use the term kill your ego, except you can't really do that. But ego is probably the biggest source of your ruts.

Then the fourth part where the healing actually occurs is neuroplasticity or creativity. So what you're doing, you're separating from your survival physiology. It's doing its job. You learn to embrace it. Then on the other hand, you learn how to nurture joy, good food, good wine, good friends. The healing occurs with creating and reconstructing a nervous system.

But if you're using those tools to outrun your pain. It's actually inflammatory, makes things worse. I wanna talk about talk therapy just for a second, because I wanna be really clear here. 

[00:29:56] Christa Biegler, RD: Sure. 

[00:29:56] David Hanscom, MD, Orthopedic Surgeon : You're not gonna talk to angry hornets, you're not gonna solve these thought patterns. And the more you talk about 'em, the more you reinforce 'em.

So talk therapy is helpful for support, feeling heard and also feeling safe. 

[00:30:11] Christa Biegler, RD: And 

[00:30:12] David Hanscom, MD, Orthopedic Surgeon : using tools to learn to feel safe. So talk therapy is great for education, developing a nice relationship with your therapist, but what doesn't work is talking and analyzing your trauma.

And you end up developing a trauma story, which becomes its own anchor.

So learning the tools. So talk therapy is helpful in its own context and a lot of somatic type therapists are. Much better at this than they were 15 years ago, but yet talk therapy by myself. I went through talk therapy for 13 solid years, and I'm not against it at all, except I was shooting it the wrong direction.

I thought if I just understood my troubles enough, I would heal. 

I really understood. Every millimeter in my life, I quote, processed it. The problem is if the healing actually occurs in neuroplasticity and constructing a new brain. If you're talking about your troubles, where's your attention 

[00:31:06] Christa Biegler, RD: on the trouble 

[00:31:07] David Hanscom, MD, Orthopedic Surgeon : on the troubles?

So you, so my repetitive thought patterns became way worse. The more I talked about 'em, the worse they became. And that's a pretty common story. 

[00:31:17] Christa Biegler, RD: Yeah. 

[00:31:18] David Hanscom, MD, Orthopedic Surgeon : So I guess we can talk about the principles and the solution at the same time. So the first thing is thought separation. You cannot control your thoughts, but you can separate from them.

And what I also didn't realize until I wrote this book is that, have you heard of a term called cognitive fusion? 

[00:31:35] Christa Biegler, RD: No. 

[00:31:37] David Hanscom, MD, Orthopedic Surgeon : So why don't we have repetitive positive thoughts? 

[00:31:42] Christa Biegler, RD: That's funny. As you've been talking about repetitive, unproductive, or negative thoughts, I started thinking about negativity bias, and of course, all of our internal chatter is automatically negative because it's wired towards safety.

I'm just thinking about it differently. 

[00:31:55] David Hanscom, MD, Orthopedic Surgeon : Yeah, definitely. You're thinking exactly right, because you wanna feel safe, so you're looking out for danger, right? So you have negativity bias. 

[00:32:03] Christa Biegler, RD: It's, 

[00:32:03] David Hanscom, MD, Orthopedic Surgeon : and so if you talk about it, you're actually reinforcing it. 

[00:32:07] Christa Biegler, RD: And I always tell people,

it's two marbles going down a pathway. It's like the easy path is the negative path. It's like where your brain wants to go all the time. And if you want to go down a slightly different path, if you wanna massage that thought into something different. And I'm just curious 'cause I'm using my own I'm.

As all humans are, I'm operating out of my own experiences and trying to understand your pillars or concepts, right? So separating thoughts in my brain is like awareness of the negative. I think that's the issue is we're not always aware that our thoughts are on a negative spiral until we're just spiraled and we are like, yeah, but you don't understand my situation is so unique and blah, blah, blah, blah, blah.

And I'm like, I find that. Rarely are things unique. The circumstances unique, but the core feelings underneath are the same as you're describing. It's like fear is the core feeling unworthiness. No one comes in and says they feel unworthy, but as you unwrap the circumstances, it's oh, that's the actual thing underneath of it, right?

Underneath the overwhelm or these, what I call frosting thoughts. And so when I think about separating from thoughts. This is how I think about, it's oh, I have to help this marble go down a different pathway, or I have to be aware of this one thought and choose different thoughts. Now, you may say that's not enough, and what I'm hearing from you generally is like it's a combination of awareness and separation, and then I'm guessing.

These other pieces of body work, et cetera, et cetera, et cetera. I'm just guessing this because you're friends with Steven Forges, right? So carry on, but you're separating from thoughts. I apologize, I got off on a tangent here. 

[00:33:39] David Hanscom, MD, Orthopedic Surgeon : No you're, no, you're very, that was very good. So you're dead on.

But I didn't understand until I wrote this book is that the reason why I don't have repetitive positive thoughts is we don't fight 'em.

 so when we fight them, we interact with them. That's called deep learning. And so what we do is you've heard the term, what you resist will persist.

[00:33:58] Christa Biegler, RD: Yeah. 

[00:33:58] David Hanscom, MD, Orthopedic Surgeon : So as you fight the thoughts, you've actually really reinforce those things.

So what happens is that you've heard the phrase that you're not your thoughts. Have you heard that phrase? 

[00:34:08] Christa Biegler, RD: I'm not sure 'cause I was just reading your book, so I pulled out several things. I'm not sure if I got it from you or somewhere else.

You are not your thoughts. 

[00:34:14] David Hanscom, MD, Orthopedic Surgeon : It's a saying in the Buddhist world that you are not your thoughts. In other words, you wanna separate from your thoughts. It turns out that you are your thoughts. So as we interact with these thoughts over and over again, they become embedded in our nervous system.

And then as we fight them and defend these things, we be developing a rigid identity. So you actually become your thoughts. So when you're separate from your thoughts, what you're doing is actually I separating who you are as a person from your survival physiology. The key issue is your survival physiology is here.

You embrace it, it's doing your job. So instead of finding the sensation of sensations of anxiety and anger, again, you said the keyword awareness, you separate from them. 

So the number one factor that's always been not the final solution, but mandatory, is what's called expressive writing, which I know we've talked about before.

You write down your thoughts, they're more emotional. They are, the better. The more crazy the thought patterns on paper, the better because it's the craziest thoughts that you tend to suppress. So your thoughts are on the table, you're here, and so what happens? You instantly tear them up for two reasons.

One is to write with absolute freedom, and the second is to not analyze 'em. 'cause all these issues come up, they're not issues. So if you want to analyze these issues, you're actually embedding the thought patterns even more. So it's just a separation exercise. I've seen Hardy, anybody heal without that exercise?

Really simple. Dr. Penny Baker's a friend of mine who wrote a. The original research in 1986, and it was actually Women with Sexual Trauma, is how this all started out with pelvic pain. And you have these secrets that are nasty. Nobody wants to talk about 'em even to their therapist, and you don't need a therapist.

You just need a piece of paper. 

[00:36:05] Christa Biegler, RD: Yeah, we've been talking about this a lot actually on the podcast. Not maybe a lot, but we've been talking, I've been talking about a lot with clients. I first heard about it from you in 2019. I remember you shared that you did expressive writing for the first time, and the next day you woke up and your pain was 50% better.

I was like, interesting. I've always liked writing, blah, blah, blah, blah, blah. But then later, somehow I ended up on the journal speak, Nicole Sachs, which came from, I don't even know where the John Sarno's book had a client who told me about John Sarno. And apparently maybe this is coming from someone else's research from a different time period.

And I think the reason I bring this up is because success leaves clues. And so when you find similar threads running through things, it's a really good sign. In general, overall I wanted to mention something about this identity thing and our thoughts becoming our identity. I say it like this and I, as a parent with middle schoolers, I feel like I, it's even more important now as all, all humans.

We all think our thoughts are facts. Unfortunately, none of them are. Most of 'em are just thoughts and not facts. No. And so 

[00:37:09] David Hanscom, MD, Orthopedic Surgeon : Can I stop here for a second? 

[00:37:10] Christa Biegler, RD: Yeah please. 

[00:37:10] David Hanscom, MD, Orthopedic Surgeon : So you're exactly right. Thoughts are nothing. There's nothing there. They're not gonna physically hurt you, but since when we fight them, they become embedded.

They're being a part of our identity. So somebody attacks your thoughts and concepts. You feel like you're being attacked by a tire, so your body perceives those thoughts the same as physical pain, but they, it doesn't have to.

But since we don't matter, so you know, you're exactly right with that.

[00:37:34] Christa Biegler, RD: All right, so we're talking about separating from thoughts, and you've given some examples, right? And using expressive writing, it's really just a separation exercise. Not sitting here analyzing, but ripping it up. And another way we think of it to try to really hone in on these ugly thought is like ugly journaling.

It's like ugly writing, right? Like the stuff you wouldn't wanna say to anyone. It's like letting this stuff out. And I would say that generally that is not comfortable to do the first time.

[00:37:57] David Hanscom, MD, Orthopedic Surgeon : And 

[00:37:57] Christa Biegler, RD: you may, 

[00:37:58] David Hanscom, MD, Orthopedic Surgeon : In fact, I tell people if you feel too uncomfortable, stop.

Because there's a small percent of people decompensate.

And so Dr. Pennebaker's research was on really incredibly emotionally laid in expression. And some people can decompensate. So I say look, to start with writing, so I don't, I call it expressive writing instead of the deep writing. We should call it negative writing, but literally it can be anything.

And the key, what's different about the process I recommend to people, I think Dr. Sax does also is just, you just keep doing it. I've done it for 25 years. I went a little bit of a hole a few weeks ago myself and I, went back to the expressive writing more diligently, and it's amazing how powerful it is.

It decreased inflammation, hypertension, depression, all sorts of things change just with the simple expressive writing, physical changes in your body. Yeah. 

[00:38:50] Christa Biegler, RD: Remove separate from this anger, anxiety, you put those in a pile earlier, like all of the symptoms. 'cause I was saying what if we don't acknowledge that?

Oh, you got a book there? 

[00:39:01] David Hanscom, MD, Orthopedic Surgeon : This is Dr. Penny Baker's book. 

[00:39:02] Christa Biegler, RD: Oh, I 

[00:39:02] David Hanscom, MD, Orthopedic Surgeon : didn't know. It's called opening up a writing down. So now it's a really short read, but he documents the positive benefits of expressive writing and it's unbelievable. Which disturbing to me, I'll just rant for a second, is that 2200 research papers on the benefits of expressive writing, both physically and mentally.

I never heard a word of it ever. Still don't. Medical students are never taught this, and these are really well documented research papers. This is not a subtle intervention. 

[00:39:30] Christa Biegler, RD: Yeah. Yeah. Thank you for talking about that. Okay, so that is a tool for step, it's not really steps, as you said it was. It's all simultaneous at the same time, right?

So you get to do all of these things. So would you mind you go to whichever one you wanna talk about next, but I'm really curious about softening your ego. And there's some specific things you say about ego is that defending your ego drives the thoughts in general, right?

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[00:41:41] David Hanscom, MD, Orthopedic Surgeon : So first of all, what's ego?

[00:41:43] Christa Biegler, RD: Yeah, exactly.

[00:41:43] David Hanscom, MD, Orthopedic Surgeon : My, my cat doesn't have an ego. Yeah, I don't think she does. She might, she's a little bit difficult, but in general, she doesn't have an ego. So the, your ego is a story that you create about yourself to feel better, and there's several reasons why we pursue it. One of 'em is we're.

Programmed by criticism by most everybody, parents, teachers, instructors, peers, and the self-critical voice becomes their own voice. And it's pretty universal. 90 5% of people have a self-critical voice, so it's programmed into us. Second thing is our survival physiology is unpleasant and scary. So anxiety feels incredibly vulnerable.

Anger feels incredibly destructive and scary. And the third reason we pursue Eagle, 'cause we're a competitive species like everybody else, and we compete on concepts as well as physical traits. So we developed this story about ourselves. This is a cognitive construct to deal with the lifetime of programming.

Also incredible survival, physiology, and we're competitive. So we develop these stories and at some point between just three and seven, were like an open. Book. All sorts of information comes in. Then we start creating these thoughts, become the concepts that become our identity. But your identity by definition is a form of mental rigidity.

This is who I am, this is who I stand for. This is what I believe in. And somebody attacks your belief systems. You get defensive, but it's like being attacked by a tiger. That's the problem. So defending this thing called ego is probably one of the main source of these repetitive and pleasant thoughts.

That's what's been edited in my paradigm compared to before, is that I've always calmed down physiology. We've talked about separating from the thoughts. We know the healing occurs from neuroplasticity, but you have this identity that you want to defend. By definition, it's say mental rigidity. If you look at the way humans treat each other, it's a huge problem.

Because we treat each other very badly based on just stories, different religion, different races in a classroom. We have all sorts of, hierarchal things that happen. I'm, this year this, they're all stories. So we are defending ourselves against our negativity around us. We also wanna look good to ourselves.

And so the problem is, again, this massive survival reaction with these cognitive construct to try to counteract it. There's no endpoint, and a lot of times the more successful people are the worse the self-critical voices. So it's not logical. 

[00:44:27] Christa Biegler, RD: When I think about this ego, I think about this is what I wrote.

It was like attachment to rigidity, which is the opposite of neuroplasticity. If you're really attached to a rigid story that you're attached to, it's there's no way you can start to change, 

[00:44:40] David Hanscom, MD, Orthopedic Surgeon : right? 

[00:44:40] Christa Biegler, RD: These pathways in your brain these highways that you're constantly driving down with your thoughts.

[00:44:45] David Hanscom, MD, Orthopedic Surgeon : So dissolving your ego. David Burns calls it disarming technique. He says, kill your ego in his books. I think that's the right idea, but defending your identity is a massive source of repetitive thoughts. I just, I know we're running out of time here, so I wanna give some basic overall concepts to think about.

So again, you gotta separate from your thoughts, which is essentially separating from your identity. Menstrual rigidity is actually covers every mental health diagnosis. It's a trans diagnostic trait. Common physiology is a whole separate topic 'cause you can't separate from your thoughts or. Soften your ego without calm the physiology.

'cause what happens when you're anxious and frustrated, your thinking brain, we call the prefrontal cortex of the brain actually doesn't work. Yes, the blood supply doesn't work there, so you cannot access your highest powers. You actually reason with it. So if you're using this cognitive trying to use cognitive construct to deal with the survival physiology, you must be talking to your toaster.

The lights aren't on, so you get a color. Physiology. We talked about the ego a little bit. The final phase is neuroplasticity, nurturing, creativity, joy, pleasure, good food and wine, good friends, but you can't do it to outrun your circuits because there're so powerful. So again, you learn to embrace the circuits.

You could learn to embrace joy. Separate skill sets. They both have to be in play all the time, every day. That's what it's called, dynamic. And some days are just bad days. That doesn't mean failure just means you had a bad day. So you get to process adversity more efficiently. You get to nurture joy more consistently as you change the structure of your brain.

You don't fight these thoughts anymore. Now, I'm not saying at all, but you said the one word that I think is a key word for the podcast today is the word awareness. Awareness creates a separation awareness. Actually counteracts anger. 'cause with awareness you have to have your highest thinking brain in play.

Anger blocks that. So anger blocks awareness, but awareness can also break the anger cycle. So again, that's a whole different topic on anger. That's a big one because talk about locked into a rigid thinking pattern. When you're angry, your brain isn't working. So with awareness, you separate you're from your thoughts, you become aware that you're angry.

You become aware when your ego's coming into play, and there's different kinds of awareness, but for today, just awareness is the key word. Then with awareness, you just open up to new data. So if you keep stirring the same pot, I mean there's a very limited amount you can do by doing ongoing personal work.

Could you stir in the same pot? The way you change is as you actually quit doing personal work, but you're learning tools to actually reprogram your brain. So with awareness is you open up and bring in new data, your brain changes. You wanna keep analyzing the old data, you're stirring the same pot and making things worse.

[00:47:54] Christa Biegler, RD: Yeah. 

[00:47:55] David Hanscom, MD, Orthopedic Surgeon : so I think the three words that are really critical is compassion. Awareness and persistence. 

[00:48:05] Christa Biegler, RD: Yeah, I agree with you and I think it's easier for me to grasp what you are sharing and the concepts that you're sharing because of, I'm thinking about it through my own lens when you talk about how when you're angry, et cetera, it shuts down things.

We have this coaching model we use in practice and some people. It's really nothing like therapy at all, but it allows people to say what they're thinking and name the feeling and realize what's happening and what always is happening when the feelings are anger or fear or whatnot is there is.

I'm like, all right, and then what happens? And the answer is always some kind of shut. Just stop or block. And it's every single time. And it's a beautiful gift to me to see, oh, we're all exactly the same. And so science has proven this, right? When we have that going on, it like shuts down our prefrontal cortex, right?

And yet we can know the science. But when you see it in your own circumstance played out, since we all think our circumstances are quite unique, the fact that. I fought with my husband this morning is so unique. It's no, it's actually like we have these same responses and so generally like that stop and awareness allows us to then separate those thoughts, right?

One of the pieces, right? And then I think it takes work and effort to soften this ego, right? How do I become a detached to it first? I must be aware that I even have it. And then calming that threat physiology, I assume that there's a lot of body work or somatics involved.

There are skills or tools, right? Or is there 

[00:49:32] David Hanscom, MD, Orthopedic Surgeon : I'll just give you a couple examples. So again the bottom line is you want safety physiologies as opposed to threat. So again, going back to the dynamic healing model, you have your input and stresses. You have your nervous system, and you have the physiology.

So as far as the nervous system, there's diet, sleep, and exercise are huge as far as increasing the resiliency of your nervous system. So again, those are whole separate topics, but all those lower inflammatory markers, that's where trauma therapy comes into play is increasing the resiliency, increasing the re resiliency of your nervous system.

'cause you're literally rebuilding your brain. So the physiology, there's things like breath work, rubbing your forehead, humming, taking a walk, being in nature. Calm physiology, sociality cause calm physiology. So you have the nervous system and the output on the input. There's two factors that are really critical.

The number one is anger. Everybody that heals, learns to be with anger, not to conquer it, not to solve it. I call it anger processing. Dr. Luskin iss, a friend of mine who wrote the book, forgive for Good, and we talk a lot about the word forgiveness, and it's the right idea, but it's the wrong word. This some things are unforgivable, period, especially ongoing abuse.

So we call it flipping the switch. Okay, this person's treating me badly. I don't like this person. Done. Just not gonna take that into my day today. My mother treated me badly. Fine. But why bring that into today? And when you look at Dr. Luka's book, it's actually what I call anger processing, where you change the channel, you quit giving up, should thinking.

He calls it the unenforceable rules. The bottom line is you're calming down the nervous system. 'cause remember, anger is a physiological state. So letting go is really a big one, but one that's very concrete and people have a hard time doing this is never discussing your pain. And people in pain talk about their pain all the time.

Mental or physical. So that means no complaining, no gossiping, no discussing your medical care. Come off the internet looking for solutions. Don't give un ask for advice. No criticism, just stop the negativity, gives us input. That comes out is through physiology and fires up the symptoms, and so you get a cycle going that you have to break.

So this is as important as expressive writing is. Just absolutely stop the negativity and people have a hard time with that. 

[00:52:10] Christa Biegler, RD: Yeah, understandable. I think it's because we're wired for negativity. 

[00:52:14] David Hanscom, MD, Orthopedic Surgeon : Yeah. Yeah. 

And 

[00:52:14] Christa Biegler, RD: so it's 

[00:52:14] David Hanscom, MD, Orthopedic Surgeon : a habit. 

[00:52:15] Christa Biegler, RD: And so when something that helps me is oh of course you struggle with it because you're a human.

Yeah. And we don't blame ourselves for being humans. But if you're aware of it, then. And you know how easy it is to go that pathway, right? And you know that it's not the pathway that helps with healing, then maybe we can choose something else. But of course it happens, right? Of course it happens. So it's a version of compassion, right?

It's oh, of course I can be compassionate that this has occurs in general. And if I have to continue to talk about it, is there anything here for me that I need to deal with? Is there any reason that I feel like I need to keep talking about it or could I just. Turn it off. Could I just choose something different?

[00:52:56] David Hanscom, MD, Orthopedic Surgeon : First of all, you're right, we're always gonna fail. We're all human. And I think you said it really clearly a couple times is that probably the home run for repetitive pleasant thoughts is gonna be compassion focused therapy instead of reassuring yourself that you're okay just having some compassion for yourself.

But I also say, and people think this all the time, if you think your suffering is special, that's a huge block. 

Because poor me, I'm again, with anger. It's the victim mode. Poor me. My suffering is worse than somebody else's. Poor me, I can't heal. So feeling like your suffering is unique is a huge problem.

As everybody gets to suffer just a matter of degree. 

[00:53:37] Christa Biegler, RD: Yeah. 

[00:53:38] David Hanscom, MD, Orthopedic Surgeon : So you start developing compassion for yourself, compassion for others. One little exercise I have my group do when I do my group question and answer period, is that if somebody irritates you, take a deep breath. If somebody insults you, and this is a David Burns technique, just agree with them.

If somebody insults you disagree with them. 'cause that's their opinion. You don't like this person who cares. So again, defend yourself is what fires up your brain. Pour me, I, I was insulted. They did this and this. You just let it go. But the other one, that's hard for people to do. Very hard. If somebody irritates you, take a deep breath.

You don't have to say it, but silently, I wish you well. I wish them well. And people have a very hard time doing that. Yeah. But it's a direct contrast to what we just talked about. Every reaction. It is a direct counter reaction to that reaction. 

[00:54:35] Christa Biegler, RD: Yeah I can understand why it would be hard 'cause it might feel accepting to someone, and all of these things. I think the takeaway to me in general is that there might be a phase where we are moved to desperation and we are willing to do a lot for our health and then we may move into a maintenance phase or we've had, we have these skills and we need to bring them out sometimes because a common thing I see with people.

That we're rewriting the script on is the concept that if I just do the work to heal once, I'll never have to do this again. And that's not accurate. Healing is ongoing, but it doesn't have to feel uphill. Maybe at the beginning it feels uphill. And I will say I have some other expressions, like everything is easier after you experience results because then you believe it right before that.

It's like your brain is almost it's like a challenge of creating evidence For what you wanna believe. 'Cause our brain wants to recruit all kinds of negative things. And so I just think in general, and you said you used the word skills early on and that's how I embrace this.

It's hey, everything is a skill. And it's like there's a lot of skills I didn't wanna know in my life. 

There's lot of things I don't wanna, I don't wanna know how to clean up the flood in my utility room this week, like the skill I gotta run the fans and dry everything out so nothing happens.

That's just a skill. I'm not gonna freeze and not do anything and go back upstairs and go to bed. It's oh, this is a bummer. And it's really a beautiful thing to not have a big nervous system response to it. 

[00:56:00] David Hanscom, MD, Orthopedic Surgeon : Yeah. The thing is, that's really interesting because the process I'm describing is not a project, it's actually not work.

[00:56:08] Christa Biegler, RD: Yeah. 

[00:56:09] David Hanscom, MD, Orthopedic Surgeon : Because remember the antidote, remember you want safety physiology. Instead of fight or plight. So the word is playful, spiritual journey, good food, good wine, good friends. So right from the beginning, a sense of gratitude and curiosity is healing. Yeah. Yeah. So again, it's not like you, the skills are important, but the quicker you take a light, playful approach to it, the better.

So the course I put together is like 10 to 20 minutes a day. That's it. If you rush through the course to get fixed, that's a problem. So if you go through the course slowly and practice the skills as you go along, they become automatic. 

[00:56:45] Christa Biegler, RD: Yeah. 

[00:56:45] David Hanscom, MD, Orthopedic Surgeon : So 

this isn't stuff you do the rest of your life. That's work.

It's dynamic. Pretty much every minute of the day, you're doing some part of the skillset, but essentially the automatic learned responses that we've had, you're programming in a new set of responses. In over three to six months, they become automatic and eventually you don't think about it much anymore.

So life becomes a lot easier if you just instinctively know how to process adversity and move forward with what you want. It's very automatic, so it's just not a lifetime of work. It's a lifetime of simply living your life differently. 

[00:57:19] Christa Biegler, RD: Yeah. Yeah. Making a shift, so that be, it becomes automatic. 

[00:57:23] David Hanscom, MD, Orthopedic Surgeon : Yeah.

[00:57:23] Christa Biegler, RD: And easy.

Cool. I love that you're leading with joy and gratitude. I think that's where we sometimes go wrong in healing is that it feels like a drudgery, and that was a big thing I said last year. What if we could just enjoy ourselves a little bit more along this pathway? Because what if we could just lighten it up a little bit, which is a wonderful thing because the opposite leads to fast burnout. Yeah. 

[00:57:47] David Hanscom, MD, Orthopedic Surgeon : Yeah. 

[00:57:47] Christa Biegler, RD: For all parties. 

[00:57:48] David Hanscom, MD, Orthopedic Surgeon : That reminds me the, our theme for the, our process going forward is wake the fun up. 

[00:57:54] Christa Biegler, RD: Thank, 

[00:57:55] David Hanscom, MD, Orthopedic Surgeon : Everybody knows how to complain. Complain.

So what do you want? What exactly do you want? 

[00:58:00] Christa Biegler, RD: Yeah. 

[00:58:00] David Hanscom, MD, Orthopedic Surgeon : So if you're complaining about what you don't want, again, that's who your brain develops. Anyway, but there's, that's a whole different discussion. But anyway, it's not that hard is what I'm saying. 

[00:58:11] Christa Biegler, RD: That's a mini topic for another day. Wake the fun up.

[00:58:14] David Hanscom, MD, Orthopedic Surgeon : Yep. 

[00:58:14] Christa Biegler, RD: All right. Thank you so much for coming on today and talking to us about ruts, which has been quite a labor of love overall. It has. From your personal experience to years of this book, really this book has been in creation for a few years, and you had said it took a couple rewrites to get to where you wanted to be, so it's a beautiful thing to.

Let your legacy live on. So thank you for sharing it with us today. 

[00:58:39] David Hanscom, MD, Orthopedic Surgeon : Yeah, no, thank you for having me. I appreciate it.