Episode 21: Partners in Pain (Part III) - Compassion Plus Boundaries

Episode 25: Waking Up

Episode 25: Waking Up Dr. Zev Nevo explores awareness and alertness as the key to “waking up” in the context of pain and healing, arguing that awareness is the most important thing because nothing has experiential value without it. He explains that pain requires alertness and can diminish with distraction, and that suffering reflects both sensation and our interpretation of threat, shaped by limbic sensitivity, past experiences, and cumulative stress/trauma. The nervous system’s survival responses (fight, flight, cry for help, freeze, shut down) are framed as protective rather than adversarial, and a flashlight metaphor illustrates how attention can narrow reality to pain. Nevo emphasizes reconnecting to self-worth and values—what one is fighting for—so alertness has meaning, warning against identity becoming centered on pain, and offering the formula: aware plus alert equals awake. 00:00 The Big Question 01:32 Why Awareness Matters 03:05 Pain Needs Alertness 04:36 Meaning Makes Suffering 10:02 Flashlight Metaphor 11:49 What Are You Fighting For 12:59 Self Worth And Belonging 14:44 Stuck In Survival Mode 17:41 Aware Plus Alert Awake 20:22 Practice And Hope 24:44 Reflection Questions 26:12 Closing Encouragement Send us Fan Mail [https://www.buzzsprout.com/2139004/fan_mail/new] This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms. About Dr. Nevo [https://nessmed.com/about/] Read what patients are saying... [https://www.google.com/search?client=firefox-b-1-d&q=zev+nevo#lrd=0x80c2975ae1882c27:0x70200e19a96dcf2a,1,,,,] LINKS: * Body and Mind Pain Center [https://bodymindpain.com/] * Mind Body Rehabilitation * Substack

Episode 24: High Definition Pain

Episode 24: High Definition Pain Highly Sensitive Nervous Systems and Chronic Pain: Sensory Processing Sensitivity, Allostatic Load, and What Actually Helps Dr. Zev Nevo explains how highly sensitive persons (HSPs)—a neurobiological trait affecting about 20–33% of people—may experience chronic pain differently due to heightened sensory processing and insula activity, leading to vivid pain descriptions often misread as catastrophizing. He describes “bidirectional sensitization,” where sensory sensitivity amplifies pain and chronic pain further sensitizes the nervous system, shaped by central sensitization, autonomic dysregulation, and allostatic load. The episode introduces the validated 27-item Highly Sensitive Person Scale (HSPS) and outlines six sensitivity patterns (introverted, extroverted, empathic, sensory, intuitive, creative). It addresses misconceptions and offers strategies: patience, titrated “microdosed” exposure, interoceptive reframing to reduce hypervigilance, addressing allostatic load, pivoting to regulation during stress, and using objective data like HRV. Guidance is included for self-advocacy, provider practice, and cultural, gender, and lifespan factors. 00:00 Vivid Pain Dismissal 01:43 HSP Pain Link 03:24 Two Patients Contrast 06:40 Bidirectional Sensitization 09:03 Allostatic Load Bucket 12:42 HSPS Assessment Tool 16:59 Interoception Trap 21:42 Six Sensitivity Faces 28:49 HSP Pain Myths 33:27 Six Core Strategies 37:19 Balanced Sensation Tracking 37:45 Reduce Allostatic Load 39:21 Pivot Toward Neutral 40:34 Objective Data Trust 42:15 Self Advocacy Scripts 47:09 Patient Recovery Story 49:57 HSP Pain Neuroscience 54:39 Provider Clinical Framework 01:00:30 Culture Gender Lifespan 01:04:35 Final Healing Roadmap 01:08:39 Closing Thanks Share REFERENCES & RESOURCES: Sensory Processing Sensitivity & High Sensitivity Morese R, Palermo S, Defedele M, et al. Sensory processing sensitivity and social pain: a hypothesis and theory. Front Hum Neurosci. 2023;17:1122849. doi:10.3389/fnhum.2023.1122849 [PMC] Lionetti F, Aron A, Aron EN, et al. Dandelions, tulips and orchids: evidence for the existence of low-sensitive, medium-sensitive and high-sensitive individuals. Transl Psychiatry. 2018;8(1):24. doi:10.1038/s41398-017-0090-6 Hochreuter J, Wehrli S, Locher C, et al. Painfully sensitive: how sensory processing sensitivity affects healthy adolescents' perception of pain. J Pain Res. 2025;18:719-733. doi:10.2147/JPR.S473575 [PubMed] Aron EN, Aron A, Jagiellowicz J. Sensory processing sensitivity: a review in the light of the evolution of biological responsivity. Pers Soc Psychol Rev. 2012;16(3):262-282. doi:10.1177/1088868311434213 [PubMed] Allostatic Load & Stress Ruiz-Robledillo N, Costa-López B, Moreno O, et al. Sensory processing sensitivity as a predictor of health-related quality of Send us Fan Mail [https://www.buzzsprout.com/2139004/fan_mail/new] This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms. About Dr. Nevo [https://nessmed.com/about/] Read what patients are saying... [https://www.google.com/search?client=firefox-b-1-d&q=zev+nevo#lrd=0x80c2975ae1882c27:0x70200e19a96dcf2a,1,,,,] LINKS: * Body and Mind Pain Center [https://bodymindpain.com/] * Mind Body Rehabilitation * Substack

Episode 23: The Parts That Hurt

Episode 23: The Parts That Hurt - When Protection Becomes Pain Episode Description Ever feel like you're at war with yourself when dealing with chronic pain? One part of you wants to push through while another screams "stop!" In this episode, Dr. Zev Nevo explores Internal Family Systems (IFS) and how understanding the different "parts" of yourself can transform your pain experience. Learn why these internal conflicts keep your nervous system in threat mode—and what you can do about it. 00:00 Introduction to Chronic Pain and Internal Conflict 01:21 Understanding Internal Family Systems (IFS) 01:39 Real-Life Examples of Internal Conflict 05:03 The Neuroscience Behind Pain and Internal Conflict 16:31 Practical Steps to Work with Your Parts 31:29 Common Questions and Answers 34:27 Final Thoughts and Encouragement What You'll Learn * Why you have conflicting voices about your pain (and why that's completely normal) * How Internal Family Systems helps you understand your internal "family" of parts * The neuroscience behind why internal conflict amplifies pain signals * Four practical techniques to work with your parts starting today * How accessing "Self" can shift your nervous system from threat to safety * Real patient stories of transformation through parts work Key Concepts Covered Internal Family Systems (IFS) * Protector parts: The voices trying to keep you safe * Exiled parts: Emotional pain that needs to be seen and healed * The Critic: The harsh voice that's actually trying to motivate you * Self: The calm, compassionate center underneath all the parts The Neuroscience Connection * Fear avoidance model of chronic pain * How threat detection amplifies pain (amygdala & anterior cingulate cortex) * Polyvagal theory and nervous system states * Heart rate variability and pain regulation * The bio-psychosocial model of pain Four Practices You Can Start Today 1. Parts Mapping - Notice and name which parts show up during pain 2. Get Curious - Interview your parts to understand their positive intentions 3. Thank & Reassure - Acknowledge parts for trying to help, then update them 4. Unblend - Create distance when a part takes over completely Research Discussed * Yoni Ashar's 2022 JAMA Psychiatry study on Pain Reprocessing Therapy * Tracy et al. (2016) on heart rate variability and chronic pain * Lumley et al. (2017) on Emotional Awareness and Expression Therapy * Dr. Stephen Porges' polyvagal theory Send us Fan Mail [https://www.buzzsprout.com/2139004/fan_mail/new] This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms. About Dr. Nevo [https://nessmed.com/about/] Read what patients are saying... [https://www.google.com/search?client=firefox-b-1-d&q=zev+nevo#lrd=0x80c2975ae1882c27:0x70200e19a96dcf2a,1,,,,] LINKS: * Body and Mind Pain Center [https://bodymindpain.com/] * Mind Body Rehabilitation * Substack

Episode 22: Pain-Full Gratitude (Thanksgiving Special Edition)

Expanding Gratitude Amidst Chronic Pain: Transforming Your Mind-Body Connection In this Thanksgiving special episode, we explore the complex relationship between gratitude and chronic pain. We examine the neuroscience behind gratitude practices, Polyvagal Theory, the Window of Tolerance, how gratitude affects pain perception and emotional regulation, co-regulation in relationships, and practical ways to cultivate authentic gratitude while living with persistent pain—without falling into toxic positivity. Includes a guided 2-minute gratitude practice. Episode Length: 41 minutes KEY CONCEPTS DISCUSSED * Gratitude as nervous system regulation, not positive thinking * Emotional complexity: holding pain and gratitude simultaneously * The neuroscience of gratitude (medial prefrontal cortex, reward circuitry, anterior cingulate cortex, default mode network) * Polyvagal Theory and the three states of the autonomic nervous system (ventral vagal, sympathetic, dorsal vagal) * Window of Tolerance and expanding capacity for distress * Broaden-and-Build Theory of positive emotions * Pain acceptance vs. resignation * Co-regulation in relationships and interpersonal neurobiology * Micro-gratitude practices for chronic pain * Self-compassionate gratitude * Managing pain flares and grief * Seasonal challenges during holidays * Seven actionable steps for practicing gratitude with chronic pain KEY RESEARCH REFERENCES * Gratitude & Outcomes: Davis et al. (2016) - Meta-analysis; Emmons & McCullough (2003) - Well-being; Ng & Wong (2013) - Chronic pain; Sirois & Wood (2017) - Depression; Wood et al. (2009) - Sleep. * Neurobiology: Fox et al. (2015) - Neural correlates; Kral et al. (2018) - Amygdala reactivity; Huffman et al. (2016) - Inflammation biomarkers; Jackowska et al. (2016) - Vagal tone & sleep; Kok et al. (2013) - Vagal tone; Porges (2011) - Polyvagal Theory; Siegel (1999) - Window of Tolerance. * Regulation & Resilience: Fredrickson et al. (2008) - Broaden-and-Build Theory; Kashdan & Rottenberg (2010) - Psychological flexibility. * Relationships & Pain: Algoe et al. (2008, 2016) - Relationships; Cano et al. (2004) - Relationship quality & pain; Gordon et al. (2011) - Couples; Martire et al. (2002) - Caregiver burden. * Coping Strategies: Kratz et al. (2007) - Pain acceptance; McCracken & Vowles (2014) - ACT for chronic pain; Sturgeon & Zautra (2016) - Coping; Vowles et al. (2007) - Pain flares & self-compassion; Harris et al. (2003) - Grief & pain; Seligman et al. (2005) - Brief practices. Full citations list located in episode transcript. Send us Fan Mail [https://www.buzzsprout.com/2139004/fan_mail/new] This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms. About Dr. Nevo [https://nessmed.com/about/] Read what patients are saying... [https://www.google.com/search?client=firefox-b-1-d&q=zev+nevo#lrd=0x80c2975ae1882c27:0x70200e19a96dcf2a,1,,,,] LINKS: * Body and Mind Pain Center [https://bodymindpain.com/] * Mind Body Rehabilitation * Substack

Episode 21: Partners in Pain (Part III) - Compassion Plus Boundaries

Compassion with Boundaries: Sustainable Support in Caregiving In the final episode of the 'Partners in Pain' series, Dr. Zev Nevo explores the transformative concept of 'compassion with boundaries' as essential for sustainable caregiving. This episode highlights the role of empathy, the necessity of boundaries, and the impact of co-regulation in relationships affected by chronic pain. Dr. Nevo revisits the key points from earlier episodes, emphasizing the importance of self-care, concrete support actions, and maintaining partnership and intimacy despite the challenges of chronic pain. Practical strategies for both caregivers and chronic pain sufferers are outlined to foster connection, communication, and mutual support. 00:00 Introduction: Compassion and Boundaries 00:35 Recap of Previous Episodes 01:36 The Framework for Sustainable Support 02:28 Understanding Compassion and Boundaries 03:10 The Science Behind Boundaries 05:47 Practical Strategies for Caregivers 07:19 Empathy Misses and Effective Communication 18:49 Self-Compassion and Setting Boundaries 25:14 Support for Caregivers 30:46 Guilt and Honest Communication 31:44 Cultural Influences on Emotional Expression 32:10 The Cage of Traditional Masculinity 33:59 Boundaries and Sustainable Caregiving 36:15 Power Dynamics in Relationships 41:00 Talking to Children About Pain 46:02 Concrete Practices for Pain Management 50:18 The Power of Connection and Empathy 52:12 Final Thoughts and Takeaways Send us Fan Mail [https://www.buzzsprout.com/2139004/fan_mail/new] This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms. About Dr. Nevo [https://nessmed.com/about/] Read what patients are saying... [https://www.google.com/search?client=firefox-b-1-d&q=zev+nevo#lrd=0x80c2975ae1882c27:0x70200e19a96dcf2a,1,,,,] LINKS: * Body and Mind Pain Center [https://bodymindpain.com/] * Mind Body Rehabilitation * Substack