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Complex Chronic Illness, High Sensitivity, Undermethylation, Safety, Limbic System Retraining & the Vagus Nerve If you've been working very hard to heal and still feel stuck, I made this episode for you. I also made it for practitioners who wonder whether they're overwhelming some patients with too much information, too many protocols, and too many steps. I share my own story of perfectionism during my illness, who tends to be vulnerable to this pattern, how it affects the whole family, and the tools that help the body and mind feel safe enough to heal. Chapters
Full transcript linked below. Resources mentioned:
Until next time, Courtney Dr. Courtney Snyder MD is a holistic and functional psychiatrist for children and adults. Full Transcript...
Medical Disclaimer
This podcast and newsletter is for educational purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Please consult your own physician for any medical issues you may be having. Transcript 00:00 Introduction Welcome to the Holistic Psychiatry Podcast. I'm Dr. Courtney Snyder, a physician and holistic adult and child psychiatrist. In this episode, I'll be talking about perfectionism and how that can get in the way of the healing process. So if you're someone trying really hard to heal through perhaps complex chronic health issues and feel like you're stuck, then this episode is for you. Also, if you're a practitioner and feel like you might be overwhelming certain patients with too much information, too many protocols, and too many steps, this can be beneficial for you as well. I'll talk about my own story and how I struggled with perfectionism in my own healing process. I'll discuss what can make many of us more vulnerable to perfectionism, the risks and benefits of doing deep research to find our answers, and the impacts on a family system. I'll discuss how practitioners can be susceptible to perfectionism as well, and how we can ultimately start to experience safety, what tools can be helpful, how we can learn to trust the process, and learn to be embodied and not in opposition to our bodies as we're trying to heal. I'll end with what was a turning point in my own journey, and I'll provide resources that relate to this topic. 01:56 My Story My own struggle with complex health issues began in 2008 when I started to have increasing chronic fatigue, pain symptoms, and unusual neurologic symptoms that were coming and going. Eventually I would come to learn that I had mold toxicity, mast cell activation, and upper cervical instability that was causing many of my episodic neurologic symptoms. What I thought I might have during my journey was multiple sclerosis, and at one point I even thought I was dealing with ALS because of progressive weakness. Obviously that was very traumatic. In parallel, my daughter, who was three at the time, was starting to have developmental regression. Four out of five days, she was a different person. She was quite regressed. And then there'd be the days that she would be back. But losing her repeatedly was quite traumatic for me. So I was on a quest to find answers for both of us. A quest that involved a lot of time online, a lot of time researching. Now, granted, this was back around 2010, so the information was less readily available. When I did, however, start to find my answers, I became more perfectionistic, more vigilant about my environment, what I ate, and more controlling. And I really was on a quest to get back to my previous level of functioning. I'd always been quite active, I was athletic, I had good concentration, I enjoyed reading, and I really had lost many of those abilities in the throes of complex chronic illness. But I was on a pursuit and I was driven. And I was going to not only fix my body, I was going to fix and restore my daughter's as well. So again, I can speak to this personally from having been quite perfectionistic and quite stressed in the beginnings of trying to heal. So if this sounds familiar to you, you're in good company. Many people I see are highly driven when it comes to their health, highly perfectionistic, and begin to find that the very quest for healing is becoming a major stressor in and of itself and getting in the way of the healing process. 04:28 Who Is Vulnerable? Now, many people who are, I would argue, vulnerable to complex chronic illness already have a high degree of sensitivity. So they may, prior to becoming ill, be a highly sensitive person. They may be someone who's able to connect a lot of dots, is quite observant, is quite empathic, able to feel the energy and emotions of others, sometimes to a fault. I talk about this in a previous episode on three models to explain high sensitivity, but I would argue many of us likely came into the world with a degree of high sensitivity and an ability to deep dive into information. Now, add to that undermethylation. When I talk about undermethylation, I'm referring to a methyl-folate imbalance in which someone can have lower serotonin activity. They can be perfectionistic, they can be quite driven, they can be detail oriented, they can have a vulnerability to addiction or have addictive tendencies, and they can have obsessive-compulsive tendencies. They have difficulty breaking down histamine. The high folate issues, the high histamine issues, can affect a receptor in the brain that contributes to thoughts getting stuck — ruminations. So many people who are dealing with complex health issues are undermethylated and dealing with a high histamine state that can be worsening those very symptoms. Add to this other early traumas, whether they be attachment disruption, traumatic events in one's life, or other toxic hits which could be traumatic to the nervous system, and all of these things can add up to both a high vigilance and a high threat response, impacting not only the limbic system, that threat part of our brain, but also the autonomic nervous system. 06:46 The Risks and Benefits of Research So this sense of threat and not feeling safe can drive someone into a more stressful approach to their healing process. Their way of managing fear and threat is to be more controlling, more perfectionistic. And as you can imagine, this is actually the antithesis of safety, and of trust and trusting the process. So it can create more stress, reinforcing those pathways around danger and around threat instead of healing. Now keep in mind there are benefits to being a deep diver, to being disciplined, to honing in on the details. For many of us, that is how we found our answers. That is how we found the people who ultimately were able to diagnose and treat us. But it's also what ultimately can keep many people from moving forward in their healing. Many people unknowingly, while they're controlling their eating, controlling their exposures, doing excessive research online, are reinforcing those pathways around threat. The more they're experiencing this notion of "I'm not safe unless I'm controlling everything," the more they'll reinforce those pathways. And there are alternatives to that. The hope is always that when someone finds an effective treatment provider, they won't feel a need to excessively control things, that they'll trust that they have a plan, that someone is guiding them through the process of identifying the root causes, so they can feel that they can start to let go of some of that control. Spending time online researching, holding our breath, being in a tight posture, getting high EMF exposure is not conducive to healing. Aside from the limbic effects, it simply puts our autonomic nervous system in a state of threat. While people are doing these things, they're often not tuned into the basics of sleep, movement, connecting with other people, and being out in nature. These areas are what can put our physiology more into a state of calm, along with some other really important tools that I'll talk about. When we are embodied in our body, connected to our body, experiencing our mind and body as one, we are not in a place of dominating our body, fixing our body, micromanaging our body. Now granted, many people find that they'll excessively control what they're eating because they feel horrible when, for example, they eat carbs or when they get gluten or dairy or whatever. So there can be benefits to some of this discipline. But it needs to be contained so that it's not at the forefront of someone's mind 24/7. Many people are also on a quest, aside from fixing their body, to get their mind and body back to where it was before they became sick. And as I'll get to, that's not a realistic goal. Not that people have to stay sick, but because this is quite a transformative process. The goal shouldn't be to get back to where we were. The goal should be to actually be more in a place of thriving than we even were before we were ill. 10:51 The Impact on Family I can't state enough how much someone having complex chronic illness and being in that chronic state of threat can impact not only them on a day-in, day-out basis, but those that care about them. Partners and spouses can be traumatized by this experience. Some can be bending over backwards, trying to help the person feel safe, help lower exposures, help support what can be complicated dietary interventions, and it can be quite isolating for families. Children who are in high stress, or hearing a lot of messages around the dangers within an environment or within what people are putting in their body, can start to develop similar limbic-type symptoms of fear, lack of trust, and lack of safety. Many parents and children, however, are dealing with complex health issues in parallel, as was the case with my daughter and me. So it's not as if the parent is causing those symptoms in the child. Oftentimes there are shared vulnerabilities, shared physiologic vulnerabilities, where both people can be dealing with oxidative stress, inflammation, and symptoms of chronic illness, likely manifested differently. So there can be within a household a lot of talk about symptoms, a lot of talk about food, a lot of talk about the environment, whether it's mold, EMF, or chemicals in the home, that can keep everyone, including the children, tuned into these areas of threat and keep reinforcing pathways telling the nervous system that they're not safe. So again, this comes out of a survival instinct, both for our own health and for our children if we have a child with health issues. However, we need to recognize that this very healthy survival instinct can start to work against us, can start to work against the healing process for ourselves and for our children, and can create high stress for the whole family. So much of the healing that I'll be discussing, everyone can benefit from. 13:27 Practitioners Can Be Perfectionistic Too Practitioners, as I mentioned earlier, can unintentionally be contributing to this threat. Again, there's an internal threat on board, whether that's mold, Lyme, one of the co-infections, or long COVID. And while the practitioner is treating that, they could, through excessive supplements, excessive dietary interventions, and excessive protocols, be contributing to that threat response. Now, practitioners — physicians, nurse practitioners — we are human too, and susceptible to doing too much in a desire to help someone. And I think for all of us, when we're working with someone, we really need to be mindful and tuned in to where they are at and what they need. Very often more is not better. We may need to focus on safety, with tools that I'll talk about, instead of over-functioning, doing too much, putting too much on someone's plate that will just keep them in that limbic state — thinking about all the steps, all the avoidance, all the things they need in order to heal — and unintentionally worsening that sense of threat. 14:57 Healing Requires Safety The primary, overriding goal is that the body and mind need to feel safe. There's a lot that can be done in that direction, and people can start to really feel safe even if they still have a toxin on board. That doesn't mean not to ultimately address that toxin or that biotoxin or that trauma. But it means that starting to retrain the limbic system and starting to use vagal nerve interventions to retrain the body to a place of safety can already be removing the threat that comes with chronic illness. In the last episode, Dr. Neil Nathan talks about this trifecta of mast cell activation, which is inflammation; the limbic system, that part of our brain that senses threat; and the autonomic nervous system, that part of our nervous system that puts us into fight-or-flight or shutdown. These three systems work together. Many people struggling with complex health issues who are highly sensitive may need to have these systems addressed and calmed down, moving to a place where they feel much safer, so that they can start to really tolerate and benefit from the treatment of things like mold toxicity, Lyme or its co-infections like Bartonella or Babesia, and/or long COVID. Limbic system dysfunction can look like hypervigilance, health anxiety, being obsessively tuned into sensations in one's body, things in the environment, and what one puts in their body. If you find your thoughts repeatedly landing in these areas and ruminating in these areas, that would suggest limbic system dysfunction. It could also suggest undermethylation layering on top of it and amplifying it. And again, that hypervigilance may have been the very thing that helped you find your answer, helped you find the person that can treat you. So we don't want to label it, and we don't want to dismiss it. We want to recognize that it has served its purpose, but now we need to start to give it some rest. 17:24 What Helps? So what helps us feel safe? Limbic system retraining can be very helpful. I have a newsletter on this topic that I'll link in the description. The originals were DNRS and the Gupta Program. Primal Trust is another, and there are some others out there that are available. Primal Trust is one that also integrates some vagal nerve interventions. Either way, whether it's integrated or not, we do recommend people do some vagal nerve interventions. I have a newsletter that I'll also link related to the vagus nerve, and how accessing the vagus nerve can put us in a state of rest and digest and allow our body and our physiology to start healing. So both of those systems work together, and both of those need to be addressed. Neither has to be all or none. Retraining our limbic system can take a little bit more time — for the vagus nerve it may be about 10 minutes a day, while limbic system retraining could be up to an hour. We tell people to do what you can. Just like exercising a muscle, if you're not doing it regularly, those neurologic pathways around safety won't be getting reinforced. So it's something that, done regularly, can be beneficial. And many people, I would say, are able to address their nervous system and start to address, for example, mold toxicity in parallel. It's only those who are extremely sensitive, who can't tolerate putting anything into their body, who may need to take a good eight weeks to do some nervous system training — limbic system retraining and vagal nerve interventions — to be able to tolerate treatment and move forward. Everybody's different. If someone has a history of trauma, ultimately working on that would be important, whether that's using EMDR, brainspotting, or somatic therapies, and working with someone knowledgeable in treating trauma. When I'm working with someone and making treatment recommendations, that could be addressing some of the Walsh nutrient imbalances and addressing, let's say, mold toxicity, and they will often be making dietary changes to lower the amount of carbs that they're getting. I recommend that people do the best they can to put these thoughts around treatment into a box so that it's not permeating their entire day. If they're doing any research, I tell them to limit the time on that — to put it in a box. And recognize that yes, you need the treatment, you need to tend to your health, but you don't want it to take over your life. You don't want your thoughts to be there all day long. 20:41 For the Practitioner For practitioners, fitting with what I've just described, I would recommend considering limbic system retraining and vagal nerve interventions early in treatment, addressing the threats. Even if somebody's nervous system is doing better, if they still have mold toxicity, I would still recommend that. And I would recommend having conversations with patients around this balance of: yes, there are details to these types of treatment, but you don't want to lose the big picture of your life and your healing. Practitioners may, for some people, provide one treatment protocol and then layer in another, but really pull back on putting in too much all at once, especially for someone who seems to be easily overwhelmed or excessively detail oriented. It's only going to reinforce some of those tendencies. Instead, you might help them focus on bigger-picture types of healing: getting out in nature, being around trusting people, gentle movement. 21:53 My Own Turning Point So lastly, to circle back to my own journey: I certainly benefited from those very tools that I've referenced, but another key turning point for me was letting go. I got to the point in my own healing process where I realized that the stress of healing was getting to be worse than not healing. And I just sat with the idea of: what if I didn't get back to where I was before, and never got back to being able to have more energy? What if the neurologic symptoms just kept coming and going? And I let go of this idea that I would fix my body, that I would get back to who I used to be. And it was in that moment that things softened — that I was more accepting of my body, more accepting of the present moment, more trusting that I was okay exactly where I was in that moment. And I do think that release was really when I started to heal. So wherever you are in this process, honor the gift of your sensitivity, of your ability to find answers and connect dots, but recognize that ultimately you want to achieve a sense of safety, a sense of trust, and a sense of embodiment — being at one with your body and not in opposition with it. Look at your life and consider: what areas do you find highly stressful, and what changes can you make, in time, to address those stressors? Many people on the other side of this process find that they're making decisions they never would have made. They're finding that they are more at peace. Your body isn't asking to be perfect. It's not asking to be what it was five years ago. It's asking to be safe. So be gentle with yourself. Treat yourself the way you would treat someone that you care about. Think about the inner child that we all carry within us. You might even put a picture of your inner child out, and tend to that inner child not by trying to fix them, but by helping them feel safe — letting them know life is uncertain, we don't have to control everything or fix everything, and we can just be present with ourselves. Many of us have become healthier than we ever were before becoming sick, and many of us are truly grateful for having gone through this process. 24:57 Resources So I will share information on high sensitivity, on limbic system retraining, on vagal nerve interventions, and the recent episode with Neil Nathan, where we talk about mold, Lyme, co-infections, complex chronic illness, and this intersection with brain-related symptoms and this issue around safety. If you have questions or comments, I always welcome and appreciate any engagement. If you'd like to share this information and help get it out into the world, I'd love for you to do that as well. Thank you for listening. If you'd like to receive these episodes and newsletters in your mailbox, please consider subscribing at CourtneySnyderMD.com, where I have information on my treatment practice, but also my non-patient consultations and the mentoring services that I provide. Until next time, Courtney Courtney Snyder, MD
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Courtney Snyder, MDFor anyone experiencing brain symptoms. This blog (and newsletter) is your guide to demystifying root causes and learning about surprising paths to healing. From a holistic - functional adult and child psychiatrist dedicated to helping people heal and thrive. Categories
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