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Anxiety can seep into our lives like an uninvited guest, disrupting our relationships, altering our moods, and even impacting our physical health. The struggle to recognize and address the roots of this pervasive issue often leaves us feeling overwhelmed and helpless. What if we could reframe our understanding of anxiety, seeing it not as a problem to be suppressed, but as a messenger of deeper, underlying issues? Could this shift in perspective transform not only our personal well-being but also our interpersonal connections?

In this episode, we dive deep into the nuances of anxiety, exploring its complex relationship with our bodies, minds, and interactions with others. We discuss practical strategies for setting personal limits to prevent burnout, share insights from groundbreaking research on anxiety and trauma, and introduce step-by-step algorithms that empower you to uncover and heal root causes. You'll discover how integrating biological and psychological knowledge can lead to a more holistic approach to mental health, paving the way for healthier, more fulfilling relationships. Tune in to learn how you can turn your symptoms into powerful access points for healing and personal growth.

Nicole Cain, ND, MA, is a pioneer in integrative approaches for mental and emotional wellness. With a degree in clinical psychology, training in EMDR, and being licensed as a naturopathic physician in the state of Arizona, her approach to mental health is multidisciplinary: medical, psychological, and holistic.

In this episode

08:03 Can anxiety be healed or just managed?

12:34 How medications like SSRIs and Benzodiazepines can impact relationships.

21:45 How trauma triggers persistent protective responses.

25:06 High-functioning individuals often mask internal struggles.

32:17 How understanding anxiety as data can transform healing and relationships.

36:48 How emotional adaptations from trauma protect us but can also cause issues. 40:08 Identifying root causes rather than just treating symptoms.

46:20 Expert guidance for calming the nervous system and optimizing health recovery.

55:49 Reflecting growth in relationships: Navigating subjective feedback and personal reactions.

Your Check List of Actions to Take

• Understand personal limits: Reflect on your energy levels and identify signs of burnout to establish personal boundaries in relationships.
• Initiate boundary conversations: Approach discussions about personal boundaries with openness and courage, acknowledging the discomfort but prioritizing mutual understanding.
• Use self-reflection quizzes: Utilize tools like those in Dr. Nicole Kane's book “Panic Proof” to assess your emotional well-being and identify areas needing attention.
• Engage in diaphragmatic breathing: Practice diaphragmatic breathing exercises to help regulate your nervous system and reduce stress.
• Investigate symptoms holistically: Treat symptoms as data by exploring potential environmental, psychological, and nutritional factors that might be contributing to health issues.
• Seek professional guidance: Collaborate with healthcare providers to identify root causes of symptoms and develop comprehensive treatment plans.
• Monitor environmental factors: Be vigilant about living conditions and potential toxic exposures that may impact health, similar to Dr. Higgins' discovery of a toxic mold environment.
• Empower and collaborate with partners: Communicate observations with your partner respectfully and encourage them to take an active role in their healing, making sure to respect your own boundaries.

Mentioned

Panic Proof: The New Holistic Solution to End Your Anxiety Forever (*Amazon Affiliate link) (book)

Relationship Map To Happy, Lasting Love

ERP 423: How to Transcend Trauma (And the Effects Experience in Relationship) — An Interview with Dr. Frank Anderson

Connect with Dr. Nicole Cain

Websites: drnicolecain.com

Facebook: facebook.com/DrNicoleCain

YouTube: youtube.com/channel/UCe-hcFYhi5QMmXcR_kNippQ

Instagram: instagram.com/drnicolecain

Podcast: podcasts.apple.com/us/podcast/holistic-inner-balance-natural-mental-health-podcast/id1506869161 | drnicolecain.com/podcast

Pinterest: pinterest.com/drnicolecain

Connect with Dr. Jessica Higgins

Facebook: facebook.com/EmpoweredRelationship 

Instagram: instagram.com/drjessicahiggins 

Podcast: drjessicahiggins.com/podcasts/

Pinterest: pinterest.com/EmpowerRelation 

LinkedIn: linkedin.com/in/drjessicahiggins 

Twitter: @DrJessHiggins 

Website: drjessicahiggins.com  

Email: [email protected]

About this Episode

Nicole, thank you for joining us today.

Oh my gosh. I am so, so happy to be here, Jessica. I love your work. I love the opportunity to get to hang out with you and your audience today.

Yes, likewise. I appreciate your enthusiasm and just how much you are passionate about really supporting people negotiating very difficult experiences, as it relates to anxiety and just relational dynamics. Where would you like to start? I typically like to ask guests a little bit about themselves or their perspective, or even how they got interested in their particular topic. Where would you like to start here, for people that are getting to know you or just reacquainting here?

I always like to start with the question of, can we actually heal anxiety? Is that even a conversation worth having? So that's how I got into all of this, is trying to prove to myself that anxiety was something that could be healed. Because, if you think about it in terms of just biological sciences, if you fall, scrape your knee, if you shut your finger in the door, any number of injuries, the body will heal that, even without you paying any attention to it. Yet, we have this dominant conversation about how anxiety is different. Anxiety is a part of our biology, therefore it's something to be managed. 

This is such an important question in terms of relationships. Because anxiety can feel really isolating and really lonely, and it can be so difficult for our loved ones, in addition to us who suffer with anxiety symptoms. So I feel like a great place to start is, well, what is anxiety? Can I heal it? Or is this something I'm stuck with for the rest of my life as my partner? Is this what I signed up for is to deal with by proxy: anxiety all the time? So I always love to start there.

Well, tell us. Tell us where you're coming from with your perspective, in regards to those questions.

I think of anxiety as your body, your mind, your nervous system, your soul, your gut microbiome. The totality of who we are as a person is anxiety. Symptoms of anxiety across the whole spectrum, whether it's just a little bit of frustration—I'm going to snap at you if you interrupt me, or I'm doing something, I can't handle more. All the way from that end of the spectrum, all the way up to just sheer crisis, panic attacks, agitation attacks. 

This is really substantiated with trauma-informed neuroscience, and we're seeing this, that the brain and the body and all of those other adaptive systems have incredible ability to change. We used to think, I don't know if you learned this when you were in your graduate programs, but back when I was in my original, I studied psychobiology in college, and we were like: Yeah, the brain stops doing most of its development in your 20s, so you're stuck after that. 

I love neuroplasticity and all the things.

Yeah, you studied that too. So what was the dominant paradigm when you were back in school? Because you have a lot of graduate training in psychology.

I do. I also personally come from a school of thought that is looking at positive psychology, and I don't know that it was actually called that. So I think I had a lot of origins, just in my life and influences that supported that. So I was always tracking for it, even in the attachment research. That was my doctorate qualifying paper. Just even the question of, are we doomed to stay in our attachment style if we have an insecure attachment style or tendency or system? I love all the research that really supports that no, we can actually earn a secure attachment. So I don't know that I had a similar experience, that I felt this weight of a closed door that we just stopped. I think perhaps there was information presented, but I also was tracking for what else complements that, or what other ways of thinking or research or science can look at other further development. I just never had that exact experience.

I love what you're saying, though. You're kind of drawing from the evolution of attachment. Then, do we get stuck in these particular attachment patterns, or is that something that we can grow out of, evolve out of, learn out of, re-pattern out of? Then, kind of mixing that with a positive psychology paradigm. There's a lot of hope that's instilled in that, and I love that. That's exactly the direction I want to see us going in as a mental health field, working with people. So I think that's brilliant.

Well, and just thank you. It sounds like you have studied neuroscience, and I appreciate just even your acknowledging the microbiome and the gut and the whole system, the holistic functioning system of a human body and being. That the anxiety is more or less, it sounds like, a symptom, is an indicator, an alert, an alarm, that can be very good information for us to turn towards. Yet, it is a diagnosis. It is a thing that we might say, I have anxiety. 

Talk to us a little bit about how you hold that. Because for me, I have always held the DSM and whatever version we're at now, I don't know. But that it is a tool for professionals to speak to one another and to categorize, so that we have a sense of how we can utilize the research and really help people deal with the symptoms that they're experiencing, and perhaps a diagnosis. I think sometimes it is important to have that. People feel like: Oh my gosh, there's an experience, there's a name, there's something around this that I can learn about. So that has value. And it's not necessarily a closed system or stop, and that we're not learning more. So tell me how you hold, because you're really drawing a clear distinction here.

Yeah, I love this. This is so great. I have so many thoughts about this. I want to emphasize the value in understanding what our symptoms are trying to tell us, and having language is so valuable. Because, as a doctor, as a person, as a healer, as just a woman walking down the street, having information empowers us to make actionable changes that can help us to get where we want to go. So for a science example, if somebody comes into my office, and they have constipation, dry skin, they have shadows under their eyes, they're missing the outer edges of their eyebrows, they're super tired. I can recognize those symptoms, and there are different diagnoses that can come to mind, one of which would be hypothyroidism, or under activity of the thyroid. The benefit in endocrinology with thyroid is that we have a test that we can run. It's a simple blood test to confirm that, and then we have researched treatments that work really well, generally, for people that come in with those symptoms, they get better. 

With anxiety, we haven't done as good of a job getting that specific and nuanced about it, in the Diagnostic Statistical Manual you brought up. We have generalized anxiety disorder, and then we have panic disorder, and then we have anxiety that could be due to medical conditions. But when somebody comes in with autonomic arousal and all its many different ways, the treatments are fairly limited to: we'll give you a prescription medication, oftentimes an antidepressant, like an SSRI. Then in relationships, when your partner is on an SSRI, they may have less of a libido, less of a sex drive, so that can impact relationships. Or a benzodiazepine, which can be very habit-forming, it could be very dangerous, very difficult to get off of. A lot of side effects, and so it's not a perfect solution. Both of these can be palliative to some degree for people. 

So I find that a lot of couples come in and they're like, well, I have anxiety. Then the other person is like: I'm anxious because they're anxious, what do we do about it? 

So I've actually identified, if we take all of the main ways anxiety presents, that there are approximately nine systems that we can categorize them into, which can then empower people. Number one is running the proper testing that can get to the root cause. Then, number two is implementing treatments that can treat that root cause. 

I'd love to give a concrete example, if that would be all right. So let's say that somebody comes in, they come into the doctor's office, and they have itchy eyes, runny nose, even their lungs feel like they're itching, and they have a lot of tissues in their purse, and they've been having just terrible insomnia and anxiety. So with the paradigm, understanding that anxiety is just a composite of symptoms, we go deeper. We can look and say that, ah, histamine can cause allergy symptoms. But we also know that histamine can be as stimulating to the nervous system as adrenaline. So then we could say, instead of giving someone an antidepressant and a Benadryl, what if we go deeper and we figure out what is the source of this histamine, assuming histamine is something that we could do testing for. We could figure out what the source of that histamine is. It could be that you're consuming a lot of high-histamine foods. It could be that you have a genetic detoxing issue, so you're not detoxing histamine out properly. But it gives us a lot more tools, and then it's really validating. So in a relationship, it's like: Okay, we're going to go and we're going to have margaritas tonight. That's a high-histamine thing, I know that that can cause insomnia and you get allergies. So let's collaborate together to make sure you also bring your DAO and your molybdenum and your Benadryl if you need it. We can work together, and it's just like an honoring experience for both people. So that's just one of the many examples.

Yes. Do you find, when you're speaking about getting to the underlying or core, are there times where you're working with patients that you're ruling out some of the physiological, and that they're still presenting anxiety symptoms?

I love this question. And what we want to look at is the domino effect of adaptations. So somebody may come in, and maybe they had a horrible flu, and they got prescribed all sorts of things, maybe herbal antibiotics and prescription antibiotics and antivirals and anti-inflammatories. So we have this inflammatory process on the system that now your whole body has to adapt to. Think about it like wearing a winter coat, when you live in northern Michigan. It's cold, you put on that coat, and that coat keeps you nice and safe and protected. 

So if you get a horrible virus, and then we take all these medications. Sometimes viruses, we just give them antibiotics, just to be safe, which that's like a whole other podcast. But when you take all the things, now we have all this systemic inflammation. So now, as a result of inflammation, your body is putting on this coat. So now your body is going to produce stress hormone cortisol, because cortisol suppresses inflammation. But now that inflammation is suppressed, the bacteria that live in your gut that are mobilized as a part of inflammation to protect you from pathogens and invaders, they become less effective because the cortisol suppressing them. So now you have opportunistic critters that live in the gut that you're exposed to, now they have more opportunity to take over. So then you get a population growth of that. So then they start creating more inflammation. So then that sends a signal to the brain, we have microglia in the brain. These are immune system cells, inflammatory cells in the brain. They say: Oh my gosh, we're inflamed, we're in danger! Tells the amygdala, that emotional part of the brain: Hey, we're in danger, send out the signal. Amygdala is like: I got you, we're going to stimulate more cortisol. So then we have this domino effect. 

So circling back to your original question, is there may have been an original root cause, and we want to figure out what that is by getting a really good history. But now we have all of this sequela, and we have all of this fallout that's happening to the periphery. 

It doesn't have to be overwhelming and incredibly complicated. I've kind of outlined all of that out with step-by-step algorithms, so that you can bring that to your doctor and be like: Okay, this is what we've got, what do we do next?

Well, I really appreciate what you're describing and how the system is responding in this very comprehensive way, and how we may get confused by what is presented, or what's presenting in us as a symptom or a response. Also, when we look at the history or really understanding, I also would add that if one grew up in a stressful or maybe even an environment where there was violence or abuse or different traumas, or just incredibly stressful or an emotionally dis-attuned environment, that this also affects the endocrine system and the nervous system. The nervous system is responding in stress, and that we could have a cascade of effects, as you're describing, from a psychological impact as well. Would you agree?

Absolutely, that's part of the whole adaptive process. I love the way that you said that, because putting on that coat will protect us from the cold. So if the cold, in this metaphor, is growing up in a really stressful or scary or dangerous environment, having a coat is really protective. You need it. Then that coat, if the nervous system, the body, the mind, doesn't continue to then adapt, then we'll somatically re-experience is what the research talks about. 

So then as we individuate, and we become adults, and we create our own lives, and we go into partnership with somebody else who has their own big winter coats on, now we're all sweating. We're like: Oh, we live in California now, we're no longer Northern Michigan, and these coats are hot, and we have symptoms. 

So then the paradigm that I'm so passionate about, is the coats aren't the problem. The coats, they saved your life. They got you to where you are today. The problem is the stickiness that's preventing you. Maybe your zipper is stuck. It's like, I can't get my coat off. So that's where we have an opportunity, but then also honoring and thanking the coats for their hard work, and then reverse-engineering all of that nervous system patterning and those adaptive programming that have taken place in the immune system and the hormones and the gut and all of that, so that you can truly actually heal. That is totally possible. Going back to that original goal, we see we can heal. The mind, the body, it can heal.

And what a different orientation to think of the coat as the problem. Or even for one who's wearing a coat, to even recognize that they're wearing a coat, that is a thing that we might even not be fully aware of. Some people who are very ambitious and goal-oriented and have a lot of fuel to live in modern life, and have very full, rich different aspects of their life, they might utilize that high energy or even anxiety to be very high-functioning. Yet, what their internal state is experiencing, and often, health is an indicator that will alert people too. That wearing a coat in California, this isn't optimal. Just even the awareness that I'm wearing a coat, and the orientation of it's not the coat that is the problem. It's an indicator of, this is a coping strategy. Can I recognize how it was adaptive? Can I really honor it and value it? And can I also open up to more ways of experiencing what it feels like to live without a coat? Or how to, I don't know what the metaphor would be, put on sunscreen?

Yes, or switch to a different coat. Maybe it's like San Francisco and you want something like a light jacket, but not a military-grade Spiewack feathered down coat. It's like reprogramming, and we can do that with neuroplasticity, and the body is so adaptive. Our gut bacteria, they can change with every meal in order to help us adapt. Because it takes generations for genetic adaptation or maladaptation to take place. But the gut microbiome, that can change very, very quickly. So we have the power, with every bite that we take, or what we drink or what we put into our bodies, to make those adaptations, to change those coats out, or at least begin that domino effect of changing that out really quickly.

I have a question that's emerging in me as I'm listening, that I appreciate the health and wellness model that you're providing. And I heard you say earlier, the natural propensity for healing when we scrape our knee, that we heal, or that our nervous system, that window of tolerance. Or where we might be able to be in the ventral, if I'm using polyvagal language, around when we can be creative, when we can be social, when we can be in our more loving state. That that is possible, and that is available. For someone listening and even myself, sometimes when I really am looking at all the choices, it can feel overwhelming at times to look at all the different systems, and the choices that I make and how that impacts my health, including the gut and the microbiome. So I'm curious, how do you see those two things, that it's so rich and so dynamic, so comprehensive, and also the natural propensity for healing and wellness?

Yeah, a concrete example is, I'll give you the story with me and my partner. He wouldn't mind at all that I'm sharing this story, because we joke about it a lot actually. So he's a therapist, and we met in counseling school, actually. So you can only imagine the conversations that we have behind closed doors. Like, you're projecting. Well, that was transference. All these funny things that we say. So he's done a lot of work, and he's done a lot of personal development, doing counseling, EMDR, Internal Family Systems kind of work, and gut healing work. He's done Reiki, all these different things. It's so fun. 

So then, because he trusts me and we have that level of intimacy, I get to take part in that healing process and understand: This is what's coming up for me, this is where it might be coming from, these are the needs that I have right now. Then we get to kind of co-create that. So not that long ago, it was probably, I don't know, six to eight months ago, he had been on this inflammatory bender, if you will. He was having a lot of fun, summer in Michigan, he's eating ice cream and having a cocktail here and there. Sometimes I would come out into the kitchen, and I'm ready for bed in my jammies, and he's in front of the freezer just snacking. He's just having the greatest time, like fun boy summer. And he's also doing all of the things, he's running his business and exercising. So he's expending quite a lot of energy, and the fuel that he's bringing into his body is inflammatory, by and large. 

So then one day, we were having a conversation, and I saw him grip his fists, and he got really agitated, which is really uncommon. He's the most lackadaisical person. And his body language, he fisted his hands, he rawred, he got really tense, and he was just like, ah! So then he stormed off, and he came back. And while he was gone, I was like: Oh, we talked about this, that body language. I was like, I bet he had a hijack. So then he came in 20 to 30 minutes later, and he's like: Nicole, I'm so sorry. I think my 12-year-old coat, that program that came in—that program that's stuck with me in some ways, working through it—but I got hijacked by that, and I'm sorry that I behaved like a 12-year-old boy. I understood, because we kind of do that for each other. I was like, okay, so you're not just a man jerk. 

But the behavior is a symptom of stress, these programs that he's working on, of not taking care of his body the way that he could have. Then that level of insight, because of his self work, gave us information about what we could do to help him get back on track, for me to have communicated a little better so that I didn't add fuel to the fire. So that's kind of a concrete example.

Thank you. So you're saying there's a lot here, and also, as I asked the question around, it could feel overwhelming to look at all these different layers. Also, there is this tendency for health and wellness. Am I hearing you, that both exist in some ways? If I'm understanding what you're saying in your concrete example, that while all of those things are happening simultaneously in the system's inter-workings or inner workings, that there is an access point that can create change. Is that where the ease of healing happens?

You worded that so beautifully, that was amazing! Finding that access point, is having that ability to look at our symptoms, to look at our behaviors, to look at our thoughts, our emotions, our sensations, as data. Then finding that access point to say: Ah, that's where this coat came from, or this is maybe the period of time where that coat came from, or these are the factors that contributed to my body needing to activate that protective mechanism that we developed. So that I had to put on that coat, and in his case, have an anger outburst with the clenching of the fists. That's an adaptation that he developed a long time ago, and it's there to protect him. It was information about, there's something going on in the current environment that we can work on and we can heal. Plus, we have these old programmed patterns that may be coming out in other ways, and we can heal that. And we could do it collaboratively, because it makes sense to both of us, because we've gone through it together.

Well, thank you. I am very intrigued. I can say, I can give examples for what leaning into that access point and having change occur, what that feels like relationally, what that feels like psychologically. Also, I imagine you could speak to the physiological systems, how are they impacted by this access point and potential change of how we're experiencing stress and trigger and inflammation and all the things?

Yeah, this is where I'm thinking about your and my conversation before we started recording, about Internal Family Systems. There's this research that came out a long time ago about multiple personality disorder, and we're trying to understand the neuroscience behind that, where somebody with true Dissociative Identity Disorder (DID), which used to be called Multiple Personality Disorder, where somebody can go into a particular state. In that state, their handwriting may change, their blood metabolism may change. Some people in a particular state may have glucose intolerance and they may be left-handed. They may write in a certain way, different language, they may have a different voice. Then fairly instantaneously, that can switch into a different state, where now their glucose metabolism is normal, and they write with the other hand, and they speak in a different way. 

So these are really extreme versions of parts that we can have. We can look at this on a whole dissociative spectrum, where that's one extreme of that spectrum. Then on the other extreme of the spectrum is, we all dissociate. Like, if you've ever driven to the grocery store and you get there and you're like, I don't really remember that drive, kind of zoned out a little bit there for a second. Or you go into flow, and you're doing something fun, and you're like, I just lost track of time. It was so great! I was having so much fun. So we dissociate, and it's really neat, because we've looked at the brain areas that are associated with that. It's called the default mode network, which is where we just go into autopilot. It's the conserving energy part activation of the brain. Then the default mode network shuts off, and then we see turning on of the executive control network. That's your executive team. This is where you make decisions, you change lanes, you think about things critically. 

So when we're thinking about that dissociative spectrum, I think about parts work on that spectrum. We have different ways that we've adapted to stress, overwhelm, trauma. That adaptation, in Internal Family Systems, they really look at it in a psychological perspective. So maybe I grew up in a really stressful environment, and if I could fawn and appease the person in charge, and try to mitigate stress and protect myself that way. So now we have this psychological adaptation. But I think the way that we could uniquely add to that conversation is to say, psychologically, we've adapted to fawn. Then, what are the complementary biological, emotional, blood chemical, what are those other adaptations? So that later in life, when I'm going to a job interview, and I know that people-pleasing will help me do a good job, because I learned that, I adapted in that way. It's not inherently problematic to people-please, until it becomes problematic. But we can look at all of those other complementary adaptations and find if those are beneficial for us or not. 

So I write about this girl, Esme, in my book, and how her emotional adaptations occurred when she was really little. There's a big triggering event, and there's a lot of things that were happening for her. But there's one really big triggering event where she got kicked in the stomach by her father when he was in a fit of rage. So her body, in the theory—we can't do a case-control double blind study on her—the theory is, which was validated by her outcome, by her experience, is that her mind, her body, her emotions, her behaviors, everything coordinated to put on this coat to protect her. But some of those hormonal adaptations predisposed her to having hormonal issues that got better when doing trauma work. We see this in EMDR, that people can come in with autoimmune type symptoms, digestive irritable bowel syndrome, that show up biologically, but get better when we do the trauma processing. So that was a long monologue there, to a brilliant question.

Well, it's really important, because you're describing, through various examples, that we can start to see how the impact of that access point can create change. You gave more extreme version. You also gave another version, an example that maybe people might be able to understand. It sounds like people will get your book and learn more. Even as you were talking, I was thinking, just even the simple 20-minute recommendation to calm the nervous system, perhaps to be able to do some deep breathing, diaphragmatic breathing, to activate the parasympathetic, kind of rest and digest. That there's so much happening neurochemically in that, and that's just 20 minutes when we look at being able to have more access points, to have more awareness, to be able to have more clarity around what's happening and how to be more attuned to the inner state, physiologically and psychologically. That has such a ripple effect. Perhaps, what we're talking about is, there can be indicators, if we're measuring psychological, or with the experience of emotion or thoughts or tendencies and behaviors, and then we can also measure medical physiological. They're likely going to be reflective of one another.

Absolutely. To add to what you're saying, because I think that you're pulling out a really important piece of nuance, is that the dominant medical model is almost like, this symptom comes up, I'm going to give you something for this symptom, and then that symptom comes up, and you're going to take something else for that symptom. So what I feel like you're really wisely circling, and I'm not sure this is like where you were going, but what came up for me as you were saying this, is that oftentimes, if we are able to identify the root cause of our symptoms, whether that is an adaptation to a trauma, whether that's an emotional trauma or physical trauma, maybe somebody had an injury, whatever that is. So if we can identify those obstacles to cure, and we can give the body what it needs, whether that be rest or shifting, like retraining the body out of shift into a parasympathetic state. 

So that we don't have to go through and be like: Oh my gosh, Dr. Cain was talking about the three detox pathways of histamine, and I heard this brilliant Dr. Jessica podcast, and I don't know what to do first. Sometimes it can be really just as basic as that 20 minutes of recalibrating the nervous system, because in that state of restoration and repair and relaxation, the body knows what to do. We've just got to get out of its way sometimes.

Thank you, it's so important. I want to echo. I don't want to lose what you had said a moment ago about when we're doing our trauma work. Because hopefully, some can identify quickly, the root cause. Sometimes it's complex. There's many different injuries or issues or inflammation, it's not just one to identify. But I will say for myself and what I have seen and heard from colleagues and just see with clients, that the more trauma work. I know you were talking about Internal Family Systems. So I interviewed Frank Anderson, and he was talking about how youthful he looks. He's like, it's not the face cream, I do my trauma work. It's visible on him, his system. I think with ADHD, when we can do trauma work, that we see that those symptoms improve. I mean, on every level. 

Even my husband and I were in North Carolina, and we were visiting with a friend from my doctorate program, and she was talking about having had a lot of inflammation. My husband was like, how did you heal that? She's like, I did my trauma work. 

Just an aside, I know I'm focusing heavily on the psychology here. My husband and I, in 2022, were living in a highly toxic mold environment, and didn't know it, and it was affecting. We don't drink, and I am very active, was playing beach volleyball, yoga, hiking, all the things. My doctor was like, your liver enzymes are high, this is liver damage. This isn't even indicating that you might have it, you do have it. I was like, I don't know. It took me several times, we did three rounds of testing, and months in between, by the way. By the third round, she finally was needling me. Like, are you sure you're not exposed to mold? But those three iterations, months in between, I was on all these deep dives. I'm eating too many nuts, I'm eating too many almond crackers. I was on all these different routes of like, I'm taking this Herber. I thought I was ingesting something, but it was actually in my environment. I hear so many people, probably because I've been through it now that I pay attention more, that are contending with exposure to toxic mold. But it is important to not just identify it as like: Oh, this is happening and now I have this. That there's perhaps an origin, to your point.

Yes, there's a root cause, there's something going on. I really respect and admire that you kept digging. Because you could have just been like, I don't know, I'm going to take some milk thistle for liver enzymes.

Which I was, but yeah.

Yeah, smart, by the way. Milk thistle, selenium, and Alpha Lipoic acids, it's like the liver trifecta of happiness. Just a little tip there for liver lovers. And I really admire that you were curious about your symptoms, instead of just trying to be like, what pill can I take to make it go away? So you're like, okay, is it diet? I'm going to do this experimentation. Sometimes it can be a process of trial and error to figure out what the root cause or root causes are. I really also appreciate that you're looking at it from, is there a psychological? Is there a trauma piece? Is it an internal? Is it a nutrition piece? And you're also looking at your environment. So is there something that could be going around in my house? 

With mold, as a total aside, have you seen those big whiskey barrels? It's like a wooden barrel. We use the metaphor of it just fills more and more and more, so it's like our toxic burden builds. So somebody can have had mold exposure in a kindergarten classroom, and then 40 years later, their body is exposed to all sorts of things between point A and Point Z there. Then they hit their threshold, and then they get symptoms, and it could still be part of mold from back in the day. So doing that timeline, and understanding your history, and being curious about what could have been going on, emotionally, biologically, psychologically, relationally, environmentally, that could be impacting how I'm feeling today, and how can we reverse-engineer that?

Wow, and we likely could benefit from some assistance and guidance around this. Because sometimes, to have this territory that's completely unknown, and we're fumbling about, trying to get our bearings. To have someone that is educated and trained on all these levels can help, to your point, try to identify root causes, or maybe a cause. Also, you're saying, the tremendous value of the system's ability to heal and rejuvenate, when we can calm our nervous system, that that is highly beneficial. Also maybe both, that at times, if we're getting that indicator and the data that something's happening here, that we could investigate and explore that, in the hopes of having more optimal health, or being able to get back into more recovery if we're compromised.

Yes, exactly. I have a question for you. When you were going through that experience and your liver enzymes were elevated, if you could share, did you experience any other canaries to let you know, like, maybe I should get my liver enzymes checked, like something's a little off? Or was it just an endocrine test?

So I get just probably yearly testing, just to routine. On an aside-aside, when we moved in, we were only there for nine months, by the way. But my friend was like, but you were there for nine months! It was extremely, extremely toxic. So I smelled something funky, and I was asking, should we get testing? The property manager was like, no, it's probably just something in the garbage disposal, do different treatments. I did the salt and ice. I did the citrus. I did the baking soda and vinegar. I did all kinds of stuff, and it helped a little bit. Fast-forward, in the spring, my mother was visiting, and my husband has allergies typically. But what's fascinating, you have two bodies in the same environment who experienced vastly different symptoms. I was having periodic rashes on my skin. Eventually, the white of my eyes was yellowing. I actually had a ton of liver spots. My nails. I went and got the ultrasound. That was my experience. 

My husband was having memory issues. Like, I was really worried that this potentially was early onset of Alzheimer's. I was like, what is happening? Simple things. Then he had incredible inflammation of the nose and the throat, and he was snoring like you wouldn't believe. So then I wasn't getting sleep. It was just a whole domino effect. So your question was like, was I getting routine testing, or did I have this hunch that something was up? I had a hunch, but to my earlier comment, I didn't ever cross-check. I was very like, I'm doing something. What is it that I'm doing? I didn't then connect the two.

This is so important to acknowledge, how our bodies can provide really unique data. So you had these objective symptoms that convey that there could be something going on with the immune system. So you have the skin rash, you're getting a little jaundiced in your eyes, liver spots. So now the question is, what is the basic tier-one testing that we can do to just rule out physiological causes of that? So then you got elevated liver enzymes. So now you have a significant finding in just your basic insurance-covered tier one. So then we could say, well, now we're looking, there's a reason that my livers elevating enzymes. So you in your wisdom, you got curious, and then you did a little bit deeper digging. Through that digging, through looking at your symptoms as indicators, as opposed to, like: I have a rash, give me a steroid cream and some eye drops. You followed it down to the root, and that's game-changing for you. You could actually improve your health as opposed to suppressing it.

And get out of a highly toxic environment. I mean, it is horrifying to think we would have stayed, and that happens for people. Sorry to interject.

I love that. I'm just filled with so much passion. It's just like, honor our bodies, honor our symptoms, love our bodies, love our symptoms, our partners. We're in this life with someone with their own fluffy coat on, and so love and honor that, and use that as an opportunity to collaboratively take power. Know that your body wants to heal, and it's producing symptoms across all of these domains we've been talking about to tell us that there's something out of bounds, we want you to pay attention so we can collaboratively figure that out. Your story and your husband's story with the mold is such a perfect example of how the same thing can show up differently in different people. So it's really about listening to your body.

So interesting, thank you for acknowledging that. I want to say, it wasn't easy, in the sense of, I think many humans, when it's so subtle, or seems subtle, it's easy. My husband was like, I'm just stressed, or all the Googling and what comes up, maybe did I swim in the ocean? In Santa Barbara, they have that channel, and there's cruise ships. I mean, they're not supposed to dump, but it's possible. So anyway, all the different things. So it's easy to make excuses for it, but to stay awake enough to follow the breadcrumbs. So I know we haven't talked a ton about relationship, and you just mentioned how we could potentially have compassion for the brilliance of our body giving us indication and data. And also, can we hold that compassionate stance towards our significant other when they're presenting in a certain way, and to get curious about that. It's difficult to do. Because we often, on the receiving end, will take things personally, or you're doing it because whatever story we make up or perceive that to be. What do you recommend to really try to hold enough space or hold enough curiosity, even a part of us, that can approach relationship or approach a significant other from that paradigm, if you will?

Yeah. I feel like there's a lot of language in personal empowerment, personal responsibility, and seeing the greatness in your partner. And so when something is coming up for me, my partner will come to me and say: I know that you're working on really doing a lot of deep healing, and I'm noticing some data, and I'm wondering if I could share that with you. So then he's asking me for permission, he's noticing. He sees the greatness in me, and so he's presenting it. Like, I know that you're doing a lot of great work, and I'm wondering if I could share and help. So you can notice that in your partner, ask permission to share that with them. But then ultimately, the responsibility is for your partner to do their own work. Sometimes in our healing journeys, it's going to feel like you're walking through the dark circle of hell. You're in the bottom of the Grand Canyon, and you're just walking together, and it feels like it's never going to get better. 

I think it's also really important to also identify your personal limits. So as a caretaker, if my partner is dealing with really severe intractable anxiety and panic, maybe they have a health condition going on, or maybe they're in EMDR, and it's just like, shit is hitting the fan, if you will! You're holding space for them, but it's like, you're not knowing how much longer can I walk through this fiery pit while they're struggling. That impatience or that urgency or that despair or that frustration is your data. So then I encourage you, if you're feeling like you're suffering, and you know they're doing the work, they're not just phoning it in and giving up, and they're doing their work, and you're committed to being with them and collaborating with them. Take your symptoms, whatever they are, however they're showing up, as your opportunity to be accountable to your healing. So holding the both at the same time. 

Thank you. I often talk about what gets activated in relationship as an opportunity for growth, and that our relationship or our partner can hold a mirror to ourselves, and we can also, if they're willing and we solicit. Do you want to hear? Can I hold a mirror about what I'm experiencing? Maybe it's distorted because it's informed by my stuff, but that's where it gets tricky. We think we're giving objective feedback, but sometimes it's actually more about us. Easier said than done, and if we're coming from that real intention place. I can hear some people potentially saying, well, what if my partner is not committed to their work, or what if they're not invested in growth? I would imagine that still, the same principles apply. You can hold space, and also then look at what's coming up for me, and then the challenges around that, and there's choices to be made. But what would you say? 

Yeah, I would really honor yourself. Because we are ultimately responsible for meeting our own needs, and I think that there's so much pressure that can come from externalization of getting our needs met. Like, your job is to make me feel not lonely, that your job is to comfort me when I'm sad. Brene Brown talks about this in relationships, that sometimes, like: Hey, babe, I can show up and I can give 2% today. Then your partner may be like: That's okay, boo, I got 90. I can't fill all of it, but I got 90. Sometimes it can be a little bit more 50-50, but it's rarely 50-50 in relationships. But we also have to figure out, like, at what point do I hit my own personal limit and I don't have those resources anymore? To be really clear about that with yourself, to protect yourself, because you don't also want to burn out. And that's a hard conversation.

That is a hard conversation. It often feels like we're in the unknown, we don't know how we're going to lean in or how we're going to find each other and connect. I can realize that we could spend hours and hours, and I know our time is winding down. So tell us about your book, and what would you like people to know about your protocol? You have nine different systems. Is that right? Or is it nine steps? Tell me.

Yeah, you got it. There are nine systems. There are nine main types of anxiety, and these are backed by research in looking at how all the different ways our body could produce information. I know I just sort of threw a whole lot of complicated science and biology and trauma and stuff at your audience today, and it's all detailed out in so much beauty. I have the most amazing editorial team, they just made it all beautiful. There's images, there's self-reflection quizzes, there's real case composites. It's called Panic Proof, so it's for anybody who wants to improve emotional well-being with trauma informed and holistic strategies. I have a bunch of free goodies on my Instagram, so people could find me @DrNicoleCain on Instagram there. 

Oh, wonderful. I'll make sure to have the links to both your book and your Instagram handle and all the goodies there. It just sounds like you really helped people have such a guide and a resource, to be empowered, to be on the path of more health and wellness, and especially as it relates to anxiety. I'm so, so grateful of just the wealth of wisdom and integration of the biology and the psychology and the gift you're offering people to feel equipped.

Thank you, it's really an honor. It was a book that I needed when I was at the bottom of the Grand Canyon of anxiety, and I'm so honored to be able to share it with people. It's really a gift.

Wow! I almost get a sense, even as you're saying this, that it's helping people feel liberated, or to feel freedom to exist and be themselves. Yes, the anxiety might not be eliminated completely. There might be a propensity or tendency, or maybe not, depending on what's the journey. And to be able to be oneself. So many people who are debilitated often feel like: Ah, it takes over, I'm not who I am, or being at the bottom of the Grand Canyon. So thank you for breathing life and helping people have that.

Thank you so much. It's really been a joy to be here. I'm really grateful for you, and I love the work that you're doing. It's so important. So thank you for that, too.

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