Dr. Russ Kennedy:
Hello and welcome to another edition of the Anxiety Rx podcast. I’m your host, Dr. Russell Kennedy, a medical doctor and clinical neuroscientist who struggled with severe anxiety for almost 30 years.
Today, I’m joined by Nicole Sachs, LCSW. She’s a licensed clinical social worker and the author of a newly published book, which is a major release with a top publisher. We’re going to talk about that today. Nicole, welcome to the show! Tell us a little about what you do and why you do it.
Nicole Sachs, LCSW:
Thank you! I’m thrilled to be here. It’s always exciting to speak with another professional who has used their personal journey to help others—because we have that in common.
Would you like me to start by sharing my story?
Dr. Russ Kennedy:
Yeah, give us a little rundown—a snapshot of your journey. I usually ask people why they do this kind of work.
For me, it was because my father was bipolar and schizophrenic, and I developed an anxiety disorder as a result. I had to find my own way out of that struggle. Your background, I believe, is more centered around chronic pain. So, how did it all start for you, Nicole?
Nicole Sachs, LCSW:
Well, when I was 19, I was a freshman in college, and I had what we call in my field an acute pain incident—basically, what people describe as "throwing their back out."
My lower back seized up completely. The pain was searing, and I couldn’t stand up. I couldn’t even get myself to the bathroom. My parents had to come to my college, pick me up, and bring me home.
As any good parents would, they made sure I got all the tests—X-rays, MRIs, orthopedic consultations. It was absolutely the right thing to do. And they did find something significant: I was diagnosed with degenerative spondylolisthesis.
I don’t remember all the exact medical classifications—people often ask, "Are you S1? S2? L4? L5?"—but honestly, it’s been so long since my diagnosis mattered to me that I don’t focus on those details anymore.
What I do know is that every time an orthopedic surgeon sees my scans, they go pale. I almost feel bad for them because they think they have to deliver a grim prognosis. And that wasn’t just back then—this has happened multiple times over the years.
At the time, the diagnosis made complete sense. I was in severe back pain, and this condition showed up on my scans. It seemed obvious that one was causing the other.
Dr. Russ Kennedy:
Yep. Makes sense.
Nicole Sachs, LCSW:
Right? I was in excruciating pain, and they found a structural issue in my spine. No one could be blamed for assuming the two were connected.
The orthopedic surgeon sat down with my mom and me and said, "Here’s the situation." You have to remember—this was 1990. So put yourself in that mindset.
At that time, the only treatment they had for my condition was spinal fusion surgery. He explained that it was a serious operation and that it would permanently limit my mobility for the rest of my life. The doctors told me, "We don’t recommend surgery for an otherwise healthy 19-year-old, but you will need to follow a very specific way of living. If you do, you might make it to 40 without needing surgery. You’re in a very precarious situation."
So, that became my reality—strict rules for how I had to live my life. No more exercise. No more sports. Travel was only an option if I carefully weighed the risks. I had to be extremely cautious with anything physical. I was also told never to lift more than 20 pounds and to always sleep in very specific positions. They weren’t kidding—my instructions were clear: I could only sleep in the fetal position or on my back with my legs elevated at least three feet.
Dr. Russ Kennedy:
That’s not living.
Nicole Sachs, LCSW:
Right? And they made it clear that if I slept on my stomach or without my legs elevated, I would be causing irreparable harm to my back. The word degenerate was used over and over again, which, at 19 years old, is a pretty terrifying thing to hear.
But the real kicker—the thing I’ll never forget—was when the doctor said, "The likelihood of you carrying a biological child is slim to none."
He explained that eight or nine months of pregnancy—carrying weight in the front—could destabilize my spine. He told me, "Maybe you’ll be able to have one child, but you’d likely spend seven months on bed rest."
So there I was, a freshman in college, being told that my body was essentially broken. And at that age, I think I coped the only way I knew how—through denial and emotional repression. I didn’t even freak out. I just thought, "Okay… well, this wasn’t what I was expecting."
Dr. Russ Kennedy:
Sure.
Nicole Sachs, LCSW:
With enough steroids, muscle relaxers, and pain medications, I transitioned from acute pain to chronic pain. That meant I was always in pain, but I could function.
They sent me back to school with a handicapped placard for my car so I could drive to class, which, quite frankly, was a celebration for my friends. My college was built on a very steep hill, so having a parking pass was definitely helpful to people.
Dr. Russ Kennedy:
Yeah, I bet you were popular around Christmas.
Nicole Sachs, LCSW:
In total, I lived with a very fear-driven narrative about my body and my future—which makes complete sense, given everything I had been told.
As life went on, I pursued psychology as an undergrad, earning my bachelor’s degree, and then went on to graduate school for my master’s in social work. I had always wanted to be a therapist.
While I was in grad school, I was introduced to the work of Dr. John Sarno. Have you heard of him? For those who haven’t, the foundation of Dr. Sarno’s work is that we live in a mind-body system. He taught that yes, your pain is real. It’s not "all in your head." You’re not making it up. You’re not being overly sensitive or hysterical. That’s really important to say up front because anytime you mention the mind-body connection or suggest that pain can be alleviated through emotional work, people can feel triggered—and I completely understand that.
For 20 years, I’ve worked with people who initially pushed back against this idea, and I always tell them: I welcome the debate. Challenge me. Because I will hold space for you with compassion, and I understand why this is a difficult concept to accept. But I also want to set people free from their pain.
At the time, Dr. Sarno had a bestselling book called Healing Back Pain, so I ordered it. And, you know, when you’re 24 and in grad school, you may not read an entire book cover to cover, but I read enough to understand something profound:
Sometimes, when we have too much rage or overwhelming emotions that make us feel unsafe, the body takes on that burden for us—it carries the pain.
That was enough for me to realize there was more to my pain than I had been told by the traditional Western medical model. And just that awareness opened me up to a much broader life. I started releasing my rigid definitions of myself. I began doing more, expanding my world, and as I did that, my pain started to lessen.
I went on to have two children. I exercised until the day they were born, and I was completely symptom-free.
You might think that’s where the story ends—a huge victory. But I always tell my story honestly because recovery is not a straight line. There’s no such thing as a "check the box, you’re all better, everything’s fine now" kind of healing. I never want people to live under that misconception.
When my son was 10 months old and my daughter was two, I had them very close together—which, to be honest, was not part of the plan. I got pregnant when my daughter was 13 months old, and suddenly, I was juggling two babies in cribs, both in diapers. It was a lot.
One day, I was lifting my son’s little walker to put it on the ground when I felt it—a hot, searing pain, like a knife dragging through my back.
Dr. Russ Kennedy:
Hmm, that is close together.
Nicole Sachs, LCSW:
Yeah, and then suddenly, I felt this electric shock of pain in my lower back. So, what do you think happened?
Dr. Russ Kennedy:
Same place—lower back?
Nicole Sachs, LCSW:
Yep.
Dr. Russ Kennedy:
Well, you had a spinal ulcer there originally, so it’s always going to be a point of weakness. That’s the thing about backs—I would see this as a physician all the time.
We’d be doing X-rays for something like a kidney stone, and we’d see a person’s spine looking completely wrecked on the scan. But if I asked, "Do you have back pain?" they’d say, "No, not really."
On the other hand, I’d see people with excruciating back pain whose X-rays looked completely pristine. That disconnect has always fascinated me.
I have a theory that when we experience overwhelming emotions as children—especially if we don’t have caregivers there to help us process them—that pain gets suppressed or repressed and pushed into the unconscious mind.
Since the body is a representation of the unconscious mind, that unresolved emotional pain often shows up in the body as physical pain.
There’s a basic law of physics: energy cannot be created or destroyed—only transferred or transformed. And that’s exactly what happens with emotional trauma. That word trauma is thrown around a lot these days, but at its core, trauma is unresolved pain. When it doesn’t get processed, it manifests as physical symptoms.
As a general practitioner, I saw this all the time. But instead of addressing the root cause, we’d just prescribe anti-inflammatories, muscle relaxers, or painkillers because, in medical school, we aren’t trained in the mind-body connection at all. In fact, it kind of scares us.
Back in 1997, when the Kaiser Permanente study on Adverse Childhood Experiences (ACE) came out, there was a huge focus in med schools for about a decade on the link between childhood trauma and chronic pain.
And then, for some reason, the conversation just disappeared. Now, half of the medical students graduating today never even hear about the ACE study.
Nicole Sachs, LCSW:
Right.
Dr. Russ Kennedy:
Your sound cut out there for a second.
Nicole Sachs, LCSW:
Yes! But what you just said is exactly in alignment with what I’m about to share. It’s like we planned this—but I promise we didn’t!
We just met five minutes ago, and I didn’t even know you were Canadian until now.
Dr. Russ Kennedy:
There you go!
Nicole Sachs, LCSW:
After that injury, I became completely overwhelmed with shame and terror. I started spiraling into thoughts like:
"Look what I’ve done to myself. I was told not to have kids, not to stress my back. Now I’ve ruined my life—and my family’s life."
That shame was all-consuming. And it set me off on a year of terrible chronic pain.
All the mind-body work I had learned? Gone. Dr. Sarno’s teachings? They didn’t matter anymore. I was in so much pain, juggling motherhood, and completely drowning.
During that year, I tried everything—physical therapy three times a week, electric stim treatments on my back, opioid pain medications, muscle relaxers, steroid packs… I did it all.
Dr. Russ Kennedy:
Yeah, the whole package.
Nicole Sachs, LCSW:
Exactly. I was crying myself to sleep every night.
Dr. Russ Kennedy:
When you're in that much pain, you do whatever you have to do to survive. Pain puts you in a state where you feel helpless—like a child again. You need someone to take care of you because it’s just so overwhelming.
For some people, medication is the only thing keeping them alive. And while medication has its place, it’s easy to get stuck there. Unless you have a deep reserve of inner strength, which you clearly do, Nicole, many people never find a way out.
Nicole Sachs, LCSW:
Exactly. That’s why I wrote my book—to help people understand that there is a way out.
But before I found my way, I hit rock bottom.
One day, I was at a deli with my kids. My back started locking up. My children—one and three years old—were running around like maniacs.
I somehow managed to get them out to the parking lot, but by the time we reached the car, my back completely seized up.
I couldn’t lift them into their car seats.
I couldn’t let go of their little wrists—because if I did, they could run into traffic.
So I just stood there, frozen in pain, holding onto them for dear life, and sobbing.
Eventually, I got them home and put them to bed. And in that moment, standing in my house, looking out the window at the stars, I surrendered.
I had no spiritual practice at the time, but I remember thinking:
"I don’t know what’s happening. I don’t know if Dr. Sarno was right about all this mind-body stuff. I don’t know if the doctors are supposed to fix me. But I do know one thing—mess with me all you want, but don’t mess with my kids."
That was my breaking point.
I needed to be more curious.
I needed to find another way.
So I went into New York City and met with Dr. Sarno himself—back when he was still practicing at NYU.
And that conversation changed my life.
He explained something that I had never fully understood before:
We live in a mind-body system.
When unresolved trauma, repressed emotions, and unprocessed pain start bubbling up, threatening to reach our conscious mind, the nervous system perceives this as a danger to our survival.
And when that happens, the body goes into protection mode.
What is pain? Pain is protection.
Pain is an alarm system telling us: "Look here! Something needs to be fixed. If you don’t fix this, you could die."
Think about early humans—if you got a deep cut and ignored it, you could develop an infection and die. Pain was nature’s way of keeping us alive.
But in today’s world, we aren’t dealing with wild animals or open wounds.
Our predators are things like:
• Our childhood wounds
• Our self-doubt
• Our toxic relationships
• Our unprocessed grief
And the nervous system doesn’t know how to handle those threats.
So instead, it does the only thing it knows how to do—it creates physical symptoms to keep us "safe."
Pain becomes a way of avoiding deeper emotional suffering.
If my back goes out, I can’t very well be expected to:
• Worry about my self-worth
• Deal with childhood wounds
• Face the judgments of my family
It becomes a twisted kind of safety—I call it "safe in the unsafest way."
Because while you don’t want to be bedridden with migraines or back pain, your nervous system believes you’re safer there than facing the real, unresolved emotional pain underneath it all.
That’s why my work is built around three essential pillars:
1. Believe
2. Do the work
3. Practice patience and kindness with yourself
And under Believe, the key is understanding the brain science behind pain and trauma.
Nicole Sachs, LCSW:
Understanding what’s actually happening in our bodies—the mechanisms that drive chronic inflammation, muscle constriction, spasms, neuropathy, anxiety, OCD, and panic disorders—is key to healing.
When we can identify the origins of these conditions, we gain the ability to safely process and release what’s been overflowing in our emotional reservoir. This work helps regulate the fight-or-flight response, but just as importantly, it teaches us how to hold ourselves with self-compassion—which is far more powerful than most people realize.
The three pillars I teach—Believe, Do the Work, and Practice Patience and Kindness with Yourself—are all outlined in my book and podcast, which I’ve been sharing since 2018.
I’ve interviewed hundreds of people from all over the world, across different backgrounds and with various chronic conditions, who are now completely free of their pain and anxiety after doing this work.
So, how does my story end?
I did the work.
I had another child. I exercised until the day she was born.
Today, I’m 52 years old. My MRI looks exactly the same as it did when I was 19.
But I have no pain. I haven’t had chronic back pain in over 20 years.
I can run five miles on the beach, travel the world, and do anything I want.
I live as an example because I want to inspire every person listening: You have more power than you realize to affect your physical and emotional health.
Dr. Russ Kennedy:
I think that’s absolutely true. Especially for people who experienced childhood wounding—because that kind of early trauma shifts the entire nervous system into protection mode.
If we receive love, attachment, and care as children—if someone helps us repair our wounds—we develop the kind of nervous system we were meant to have.
But if we experience unrepaired wounds, we start layering coping mechanisms on top of them. These protective layers become deeply ingrained, but they’re also incredibly energy-inefficient.
Chris Palmer wrote a book called Brain Energy, which explores how the brain’s energy system impacts emotional dysregulation. I think there’s truth to that, though I believe childhood trauma plays an even bigger role than he acknowledges.
Essentially, we develop a nervous system wired for protection.
Nicole Sachs, LCSW:
Exactly.
Dr. Russ Kennedy:
But protection is cumbersome—it takes a huge toll on the brain.
In contrast, love and connection are how we’re naturally meant to absorb information and navigate the world.
Since 80% of our brain development happens before the age of five, the blueprint we form in those early years determines whether we grow up believing life is about protection or about growth and connection.
And whichever belief takes root becomes a self-fulfilling prophecy.
Muscle spasms, contractions, tension—these are all symptoms of a nervous system stuck in protection mode.
How big of a role do you think resistance plays in chronic pain?
Nicole Sachs, LCSW:
Oh my God, it’s huge.
I often say that resistance to embracing the mind-body connection and doing this work is just another form of chronic pain.
Resistance is the same thing as a headache.
It’s the same thing as an IBS flare.
It’s the same thing as a back spasm or fibromyalgia.
Why? Because the brain and nervous system perceive our repressed emotional world as a bigger threat than physical pain.
Pain, oddly enough, can feel like a safe space—because it forces us to slow down, ease our demands, and ask for help. And in a society that pushes us to keep going no matter what, slowing down is something we resist.
So if you’re listening to this and thinking, "Good for you, Nicole, but this would never work for me. My pain is different. My pain is real."
I hear you.
I know your pain is real. I’ve been there. I was in so much pain I had to be helped to the bathroom.
But the real question is: What is causing the pain signals to fire?
If you allow yourself to be just a little curious about that, you can open the door to a completely new way of healing.
That’s why I dedicated my book to these three pillars:
1. Believe – Understand the brain science, the research, and the mind-body connection.
2. Do the Work – Step-by-step instructions for safely excavating the emotional reservoir.
3. Practice Patience & Kindness with Yourself – Inner child work, self-compassion, and the right mindset for healing.
At the beginning of the book, I focus heavily on resistance—because I know my job is to protect people from themselves.
Our nervous system speaks to us in our own voice, and because of that, it’s easy to believe what it tells us:
"Shh, stop this. You’re too tired. You have more important things to do. This will never work for you."
Skepticism often sounds rational, logical, even intelligent—but it’s really just fear disguised as certainty.
So I always encourage people:
Give yourself the gift of curiosity.
So much magic lives in the phrase, "I don’t know."
That simple openness to possibility can change everything.
Even though my MRI looks exactly the same, my life is completely different.
Dr. Russ Kennedy:
Right. Curiosity and resistance are opposites.
Curiosity pulls us out of fear and brings us back into the present moment. It helps us shift away from the pain of our past and the worry of our future.
But many of us grow up completely intolerant of uncertainty—because as children, uncertainty was unbearable.
So we cling to anything familiar, even if it hurts. And for many people, physical pain becomes the thing they cling to, because it feels safer than confronting what’s beneath it.
And I get it.
For people who have survived physical, emotional, or sexual abuse, going back and processing those wounds can feel impossible without support.
But in so many cases, that unresolved trauma is the root cause of what we experience as chronic pain.
The insula, a key part of the brain responsible for interoception (how we sense our internal state), picks up on these stored traumas. It then signals the amygdala, saying: "We are in danger."
And that alarm keeps ringing—constantly.
When your body feels alarmed, your mind follows.
You start thinking exactly how your body feels.
If your body is in a state of constant distress, your mind will only focus on what’s alarming.
That’s why pain can feel all-consuming—it hijacks our ability to see anything positive.
So, can we start shifting?
Can we say:
"Yes, I have pain. Yes, I have emotional wounds. But can I be gentle with myself?"
Can I come alongside myself, as developmental psychologist Gordon Neufeld says?
Because so much of our suffering comes from being at war with ourselves.
And I think that’s exactly what your book is helping people address.
Nicole Sachs, LCSW:
Thank you. 100%. Everything you’re saying is so important because when you slow down and really take in these ideas, you realize you’re hearing absolute truth—scientifically, neurologically, and in real human experience.
Over and over again, I see this truth playing out in people’s lives. And what’s rare is that I can confidently say:
"This will help you—if you let it."
It’s simple, but it’s not easy.
This is work.
There’s something I often tell people that might sound negative at first, but it actually brings a tremendous sense of relief:
Life is a choice between what hurts and what hurts worse.
There is no third option.
If you take someone who has suffered **horrific childhood abuse—sexual, physical, emotional—**they may say:
"I can’t go there. I can’t face that. It’s too much."
And I completely understand that. I will hold that truth with deep love and compassion.
But here’s the choice:
• On one side, you have your chronic anxiety, panic disorder, OCD, back pain, irritable bowel syndrome, fibromyalgia—whatever is manifesting in your body.
• On the other side, you have the difficult emotional work of sitting with those painful experiences in a safe and structured way.
Life is a choice between what hurts and what hurts worse.
We either face the pain that feels impossible to process, or we continue living in a way that feels impossible to endure.
But when you realize you actually have a choice, and when you understand that facing these emotions can set you free in ways you never imagined, the path forward starts to open up.
Of course, no one should go into this work alone—you need the right roadmap, the right tools, and the right support.
Dr. Russ Kennedy:
Yeah.
Nicole Sachs, LCSW:
That’s why I’ve poured everything into this book, my podcast, and all the other resources I offer.
Because not only do you have a choice—it’s not as awful as you think.
Sitting beside yourself, turning toward those wounded parts of you, is actually a beautiful and heart-opening process.
And once you begin releasing the pain and start living without the weight of these chronic symptoms, you become willing to go there more and more—because the transformation is extraordinary.
That’s why I always challenge people when they say, "I can’t."
You can choose "I can’t."
But just know that it is a choice.
Dr. Russ Kennedy:
Yeah. I’ve always believed that anxiety is fundamentally a separation of the adult self from the child self—and a separation of the mind from the body.
We start living in this neck-up world, stuck in the left hemisphere of our brain, disconnected from our body’s wisdom.
I’m reading Martha Beck’s latest book right now, and she uses this metaphor about the left hemisphere being a hall of mirrors.
It’s so easy to get lost in that hall—because the mind has a tactical advantage over us.
It just keeps reflecting the same fears and worries over and over again, like an endless loop of doomscrolling.
And the only way out?
Close your eyes and feel your way to the right hemisphere—because feeling is where we heal.
The body is a much better tool for healing the mind than the mind is for healing the body.
But Western medicine teaches the opposite.
Nicole Sachs, LCSW:
I know.
Dr. Russ Kennedy:
We’ve been taught to use positive thinking, affirmations, and mindset shifts—which are fine, but they don’t work unless your body feels safe.
That’s why I practice somatic experiencing—because if you don’t create safety in the body, none of these cognitive techniques will actually take root.
They won’t ground into your nervous system where real change happens.
But when you do create that felt sense of safety, you start realizing:
"This actually works. I have some agency here. I’m not just a victim of my pain."
And that’s critical—because a victim mindset is incredibly common in both emotional and physical pain.
Nicole Sachs, LCSW:
Absolutely.
When I was in private practice, I would listen to people’s stories—stories that were incredibly valid and painful—and I would say:
"If you were an innocent, fluffy white sheep walking through a pasture and a wolf attacked you, that would be one thing."
But for most of us, at least in later life, we do have a role in our own story.
Even if that role was simply:
• "I let someone mistreat me because I didn’t know how to stand up for myself."
• "I ignored my own needs for too long."
• "I stayed in an unhealthy situation because I was afraid."
That doesn’t mean you should feel shame—but acknowledging your role gives you power.
Because if you had a part in it, that means you have the ability to change it.
That realization alone can be incredibly freeing.
And I love the idea of sitting beside yourself—offering yourself compassion instead of judgment.
That’s where real healing happens.
Dr. Russ Kennedy:
Yeah, from a neuroscience perspective, worry—and even chronic pain—fuels itself with dopamine.
When we feel pain, it creates this illusion that we’re getting to the root of something—even when we’re just spinning in cycles.
Worry, in particular, makes the uncertain feel more certain.
And for people who grew up with a lot of uncertainty, that can be incredibly addictive.
Nicole Sachs, LCSW:
Yes! It’s like, "I’m alive. I feel something."
Dr. Russ Kennedy:
Exactly.
That worry triggers a dopamine hit through the brain’s reward system.
So even though worry makes us feel terrible, it gives us just enough of a chemical reward to make us feel like we’re doing something productive.
Even if we’re just spiraling deeper into fear.
Nicole Sachs, LCSW:
Yes! You have to come on my podcast. My community needs to hear this.
Worry feels like a celebration to the brain.
And when we don’t recognize that, we get trapped in it—over and over again.
Dr. Russ Kennedy:
Yeah, it does.
Nicole Sachs, LCSW:
You know, my son is 20 now—a sophomore in college. He’s always been an anxious kid. That’s just his nature.
Anyone who has more than one child knows that both nature and nurture are real. You could raise three kids in the same household, and they could all turn out to be completely different people. So there’s no denying that we are born with certain predispositions.
My son? He’s just wired for anxiety.
Dr. Russ Kennedy:
Totally.
Nicole Sachs, LCSW:
He tells me all the time how he feels, how his mind works. And I always say to him:
"Feelings aren’t facts. Please stop believing everything you think."
There’s so much brain science behind what feels "safe" to think and feel.
And he’s even admitted that sometimes, when I ask how he is, he hesitates to say "great."
Because in his mind, if he says "great," then I’ll expect him to always be great. Or maybe he worries that there’s some deeper truth underneath—that "great" isn’t the whole story.
And I tell him:
"It’s okay. You’re allowed to feel great. It’s not unsafe to feel great."
That concept is so important for people to understand.
Dr. Russ Kennedy:
Yeah. Some people even tell me, "Dr. Kennedy, I get worried when I’m not worrying."
Because worry is familiar—and unfortunately, humans often equate familiarity with security.
Whatever was familiar in your childhood, you unconsciously recreate in adulthood.
Freud called this the repetition compulsion—we unconsciously seek out the same patterns over and over again.
It’s why we keep choosing the same types of people, the same toxic relationships, the same emotional cycles. It’s like we’re searching for a do-over—another shot at fixing what went wrong.
Nicole Sachs, LCSW:
Exactly!
Dr. Russ Kennedy:
And on a neurological level, worry is chemically reinforced.
When you worry, your brain releases dopamine—a reward chemical—because it makes the uncertain feel more certain.
So even though worry feels terrible, the brain rewards it, making it an addictive cycle.
And beyond dopamine, the more you scare yourself, the more your brain releases endorphins—natural painkillers.
Nicole Sachs, LCSW:
Don’t worry—you had me at "endorphins." You don’t need to say "periaqueductal gray" for us to believe you.
Dr. Russ Kennedy:
Haha, fair enough!
But seriously, when fear triggers the brainstem, we release endorphins—and when you pair dopamine with endorphins, it’s no wonder that worry and chronic negative thinking become so addictive.
One of the fundamental truths of neuroscience is:
Whatever you focus on, you perceive more of.
If you focus on worry, you will experience more worry.
If you focus on feeling safe, you will start to perceive more safety in your body.
You can have pain, but if you approach it with curiosity instead of fear, you reduce suffering.
It’s that classic Buddhist teaching:
There is pain, and there is suffering.
Pain is unavoidable. But suffering—the mental loop of catastrophizing and resisting—is something we add on top of the pain. And that is avoidable.
Nicole Sachs, LCSW:
Yes!
And I have to say, everything you’re saying is pinging in my brain like a pinball machine—I agree with all of it.
But I also want to drive home one really important point.
Because I know we don’t have much more time together today, and I’ve loved this conversation. And I’m absolutely going to drag you onto my podcast so my community can hear this too.
Here’s the thing:
So many people are fantastic at identifying the problem.
They can say:
"This is my trauma."
"This is my chronic pain."
"This is the issue."
But very few people actually live in the solution.
And that’s why I’m so excited—because just last night, I received the first copy of my new book in my hands.
And when I step outside my knowledge and put myself in the shoes of someone suffering, I imagine what they might be thinking while listening to us right now:
"Okay, Dr. Kennedy, I hear you. But how?"
"How do I sit with my pain?"
"How do I stop worrying when my brain is literally addicted to it?"
And that is exactly what I have dedicated the last three years of my life to answering.
I have worked to bring a simple, elegant solution to people—so they don’t just understand the problem, but actually learn how to heal.
• How to lower the emotional reservoir
• How to regulate the nervous system
• How to sit with worry without being dragged around by it
So that when those anxious thoughts arise, you can say:
"I hear you, but I don’t need to listen to you."
You can sit beside the worry instead of being controlled by it.
That’s why I am so excited for people to get their hands on this book—because I want them to start living in the solution.
I love that there are so many brilliant people out there identifying the problem.
We need to identify the problem—because if we don’t know what we’re dealing with, we can’t heal it.
But we also need actionable steps to break free from it.
And that’s what excites me the most.
Because I have worked with thousands of people, and the despair I have witnessed is staggering.
But the transformations I have witnessed are equally extraordinary.
Every time someone reclaims their life from pain and anxiety, it brings me to tears.
So if you are listening to this, and you are struggling, I want you to know:
Everything we’re talking about today is real—it is happening inside your body—and there are solutions.
Dr. Russ Kennedy:
Yeah, and when we gain some agency—when we realize we have power over our own healing—it’s a game changer.
The thing about chronic pain, both emotional and physical, is that it can turn us into victims—if we’re not aware of it.
And that victim mentality is powerful, especially because of the brain’s negativity bias.
We are wired to focus on threats, to scan for danger. It’s so easy to assume the worst, to anticipate suffering.
Nicole Sachs, LCSW:
Yes!
Because we’re literally built for it.
If we didn’t focus on potential threats, we wouldn’t have survived as a species. Our nervous systems are designed to remember and respond to whatever has caused us fear or harm in the past.
That’s why we have to be awake.
That’s something I say all the time—if you can live awake, if you can develop the tools to stay conscious of these patterns, then you get to choose what hurts and what hurts worse.
You’re no longer being led around on a leash by worry, fear, or victimhood.
And when people truly understand that, it’s a revelation.
Dr. Russ Kennedy:
Yeah.
And you’re not a child anymore.
That’s something I work with people on all the time. Because when you were a child—being neglected, bullied, abandoned, or whatever it was—you didn’t have power.
And then the brain stays stuck in that story.
It’s like the story of the elephant—when a baby elephant is chained to a post, it learns that it can’t break free. And even when it grows into a massive, powerful adult, it doesn’t even try to break the chain.
Because it’s been conditioned to believe that escape is impossible.
Nicole Sachs, LCSW:
Right.
Dr. Russ Kennedy:
But we’re not children anymore.
We can come alongside our inner child and show them:
"You are seen, you are heard, you are safe."
I have an acronym, SHOULD—it stands for Seen, Heard, Open to, Understood, Loved, and Defended.
That’s what we should have received as kids.
And if we didn’t, then it’s our job now to give it to ourselves.
Because when we fight against our own resistance—when we fight against our emotions—it just aggravates emotional and physical pain.
Nicole Sachs, LCSW:
Exactly.
Dr. Russ Kennedy:
So every day, I ask myself:
"What SHOULD I give my younger self today?"
• See them – What’s coming up for me right now?
• Hear them – What does my body need me to listen to?
• Open to them – Can I sit with these feelings instead of avoiding them?
And I know this might sound "woo-woo" coming from a medical doctor and neuroscientist, but honestly?
This is the only thing that worked for me.
After 40 years of crippling anxiety, the only thing that actually helped was facing the pain directly.
Nicole Sachs, LCSW:
Yes.
Dr. Russ Kennedy:
I use this analogy with cold plunges.
When you first step into ice-cold water, your body screams at you:
"Get out! Get out! This is unbearable!"
But if you stay, something interesting happens.
For the first five seconds, it’s horribly painful.
Then, for the next five seconds, it’s not so bad.
Then, it’s horrible again.
Then, not so bad.
It comes in waves—but if you stay long enough, your body adapts.
As a child, you were stuck in the pain—you couldn’t escape.
But now?
Now you have a choice.
Now you can decide to stay with the discomfort, to move through it, and eventually, to come out on the other side.
And when you do that, you start to realize:
"This isn’t all of me. This isn’t my whole identity. I am more than this pain."
Nicole Sachs, LCSW:
Exactly.
Dr. Russ Kennedy:
We have so much more agency than we’ve been led to believe.
And whether that’s because of trauma or just chronic pain itself, we often feel like we have no control.
But we do.
We can either be led around by our pain, or we can recognize that, in many ways, we are creating our own suffering.
And I think that’s exactly what your book is helping people with—learning how to break free from the suffering.
Nicole Sachs, LCSW:
Yes.
And not just breaking free from suffering—but breaking free from pain itself.
Let me be clear—I’m not speaking lightly when I say this:
You do not need to live in chronic pain.
Now, there is no cure for being human.
We are here to feel big.
We are here to have our hearts broken, to experience grief, to feel joy, to celebrate, and to move through everything in between.
That’s the whole point of being alive.
Sorry, not sorry.
But chronic pain?
Chronic pain is an epidemic of nervous system dysregulation.
It’s a confused dance between the nervous system, the brain, and the body—and it can be undone.
I do not believe that anyone—if they are willing to pause, to be curious, to observe themselves without judgment—needs to live in chronic suffering.
Whether it’s anxiety, emotional pain, or physical pain, there is a way out.
Because once you realize that symptoms like:
• Inflammation
• Neuropathy
• Constriction
• Muscle spasms
…are actually being sent as a form of protection—you can start to unwind the pattern.
When you sit with the parts of you that no longer need to be protected—because you’re big now, you’re not a child anymore—the transformation becomes physical.
And that, to me, is something worth celebrating.
Dr. Russ Kennedy:
Absolutely.
Nicole Sachs, LCSW:
I cannot tell you how much I’m enjoying this conversation—because I rarely meet people who truly, hardcore get it.
This is the real stuff.
Dr. Russ Kennedy:
Yeah.
And if you put someone in a functional MRI scanner, you’ll see that physical pain and emotional pain light up almost identical areas in the brain.
Pain is an interpretation of sensory input.
And when we shift our perspective—when we start moving out of that left-hemisphere, survival-driven thinking and into the right hemisphere’s space of curiosity—we change the way we experience pain.
That’s why nature feels so healing.
That’s why looking at the ocean, at the mountains, at something vast and open, gives us peace.
Because it pulls us out of the rigid left hemisphere and into the expansive, creative, feeling-based right hemisphere.
And when we spend more time there, we start to heal.
Nicole Sachs, LCSW:
I often say that pain is information—it’s strong stimulation, but it is not inherently bad.
Pain is trying to communicate with us.
When we can actually hear its messages, rather than just label it as "bad" and resist it, something incredible happens—it can transmute.
Dr. Russ Kennedy:
Yeah, and I know we need to wrap up soon, but I always tell people with anxiety this mantra:
Sensation without explanation.
Because most people with anxiety can physically locate a source of alarm in their body. It feels like pain, but the key is learning to stay with the sensation—without immediately jumping into that left-hemisphere, overanalyzing, fear-driven loop.
Can you just be with the feeling?
Of course, sometimes you need a therapist or guidance for this. But healing isn’t about figuring it out with logic—it’s about experiencing it differently.
Your MRI? It was what it was. You could’ve gone to 100 orthopedic surgeons, and they all would have said the same thing.
But your outcome was completely different from what they would have predicted.
Nicole Sachs, LCSW:
Yes, exactly.
And that’s what people need to realize—if you can just widen your lens, even a little bit, you can start seeing new possibilities.
Most of us walk around with tight, fear-driven perspectives, and that’s understandable—that’s how we’re wired.
But when we engage in conversations like this, it can open our minds, and from there, we can start accessing the tools to make real changes.
So—amen, brother. I agree.
Dr. Russ Kennedy:
So… what’s the best part of the book?
Nicole Sachs, LCSW:
Oh, wow.
Dr. Russ Kennedy:
I know, it’s like asking you to pick a favorite child. But if you had to choose, what’s the most powerful part of the book?
Nicole Sachs, LCSW:
You know what? No one’s asked me this yet, but immediately, something comes to mind.
There are 14 chapters in the book, and at the end of each chapter, there’s a real person’s story.
These are unedited, raw, personal accounts from people who have gone through this work.
I had so many submissions, and I carefully chose the ones I felt would resonate the most. I barely edited them because I wanted their authentic voices to come through.
In these stories, you’ll hear their despair, their struggles, their moments of awakening—because, as I always say, recovery is not a straight line.
And then, by the end, you’ll sit with them in their gratitude.
Because here’s what almost no one believes at the beginning of their healing journey:
"One day, I will be grateful for this pain."
And yet, by the end, so many of them say:
"Yes, it was hard. But it cracked open the shell of who I thought I was. And because of that, I found a life of depth, connection, and presence that I never would have had otherwise."
That’s my favorite part—the human stories.
One of those stories is from my daughter, who’s now 17. She wrote her chapter when she was 15 or 16.
She has a diagnosis called accessory navicular bone in her foot, which she was told would cause lifelong pain.
And of course, the moment she got the diagnosis at age 11, she started experiencing excruciating pain.
It was so bad, her foot swelled up like a golf ball.
She’s a classical ballerina—she dances 25 hours a week, and she’s completely dedicated to it.
The idea that she’d be in chronic pain felt devastating.
Dr. Russ Kennedy:
Yeah, I can imagine.
Nicole Sachs, LCSW:
But we decided to look at it through a mind-body lens—even though it was clearly physical. I mean, it was red, swollen—it was undeniably real.
And in her own, beautiful, adolescent voice, she shares in the book how hard it was to accept that this pain wasn’t just about her body.
She resisted the process. She rolled her eyes, she gave me the finger behind closed doors—but she did the work.
And in time, her pain disappeared completely.
Now, she dances pain-free—25 hours a week.
That’s just one story.
The final story in the book is my own personal story.
And all the stories in between? They will inspire you.
Because they remind us that we are not alone, even when we think we are.
We are in this together, and that realization alone can be life-changing.
Dr. Russ Kennedy:
Yeah, I think chronic pain is, in a way, consciousness trying to experience itself.
This might get a little philosophical, but I truly believe that pain expands us.
A fire can’t burn itself.
A knife can’t cut itself.
Consciousness expands through pain and joy.
Pain either crushes us, or it transforms us into someone who helps others.
Nicole Sachs, LCSW:
Yes!
Pain expands us. It does both.
Dr. Russ Kennedy:
Right. Some people are, unfortunately, crushed by it.
But for others, pain leads to growth, and that growth expands our collective understanding of healing.
It shows us: This is possible. This can be done.
So, Nicole—where can people find you?
Nicole Sachs, LCSW:
The easiest way is my website: NicoleSachs.com.
Or you can just Google my name, and everything will come up.
On my website, you’ll find a dedicated book page, where you can preorder the book.
And if you order before February 6th, you get some exclusive preorder bonuses, including:
• A free PDF download of all my journal prompts
• Access to my live event at the end of February called Mind Your Body Con, where I’ll be hosting a global book club—going through the book chapter by chapter, totally free for everyone who preorders
If you’re a practitioner interested in bringing this work into your practice, we also have a CEU-certified training.
Dr. Sarno’s daughter, Christina Sarno, who is a practitioner in NYC, helped me write a professional training program with 18.75 CEUs available.
So whether you’re coming at this from a personal or professional standpoint, all the resources are there.
And of course, my podcast is The Cure for Chronic Pain, available wherever you listen to podcasts.
And Dr. Kennedy—you are coming on as a guest ASAP because this is the conversation we need to be having.
Dr. Russ Kennedy:
Absolutely.
Dr. Russ Kennedy:
And when does your book actually come out? Is it the 6th?
Nicole Sachs, LCSW:
February 4th is the day it drops. The reason I mentioned the 6th is that I think the pre-order count still lasts a couple of days after the drop. Oh, and one last thing—if you have anyone local to New York City, during the week of the book launch, on February 5th, I’ll be in conversation at the 92nd Street Y with Christina Sarno. It’s going to be a fantastic event, a live podcast taping, and a book signing. I’m not sure if tickets are still available, though.
Dr. Russ Kennedy:
Okay.
Dr. Russ Kennedy:
Got it.
Nicole Sachs, LCSW:
You can go to my website and click on the book tour tab under the "Book" section to find tickets for that. There are so many exciting things going on because I’m just so fired up to share this with people.
Dr. Russ Kennedy:
Yes, absolutely. That’s amazing, Nicole. And thank you for coming on. As I said, emotional and physical pain—especially their chronic nature—are very similar, and the healing process for both is quite alike too. I really appreciate you being here, and I’m looking forward to jumping over to your podcast.
Nicole Sachs, LCSW:
Thank you so much for having me. This was a great conversation.
Dr. Russ Kennedy:
It really was. Thanks so much, Nicole.
