Summary
Overview
Pain psychologist and neuroscientist Dr. Rachel Zoffness joins the show to revolutionize how we understand pain. She explains that pain is constructed in the brain, not just in the body part that hurts, and demonstrates this through fascinating examples like phantom limb pain and the tale of two construction workers. The conversation reveals that chronic pain is biopsychosocial—influenced by biological, psychological, and social factors—and that there's always hope for treatment through addressing multiple ingredients in a person's 'pain recipe.' Zoffness shares powerful patient stories, including a teen who was bedridden for four years and returned to life, and discusses how factors like loneliness, stress, sleep, and nutrition all impact pain levels.
Rachel's Background and Journey to Pain Science
Rachel introduces herself as a self-described 'library mouse' who became fascinated by pain neuroscience during her undergraduate years at Brown. She explains how pain lived at the intersection of everything she found interesting—neuroscience, psychology, human biology, and teaching. Despite being naturally introverted with performance anxiety, she found her calling in helping chronic pain patients and pushed through her fears by doing 42 podcasts during the pandemic to overcome public speaking anxiety.
- Rachel describes herself as a shy 'library mouse' who was fascinated by the neuroscience of pain from her first class
- She couldn't decide between research, clinical work, or teaching, so chose brain and behavior at Brown which combined everything
- Pain scared her, which partly drew her to study it—pain is designed to be aversive to save your life
- She overcame performance anxiety by pitching herself to 42 podcasts during the pandemic
" Pain is designed to be averse of it. It's designed to save your life. If it doesn't grab your attention and get you to stop doing the thing you're doing, there's a chance you could hurt yourself slash die. So that's pain's job. "
Overcoming Performance Anxiety Through Exposure
Rachel shares her own journey with performance anxiety and how she used exposure therapy—the treatment for anxiety—to overcome it. Despite being naturally shy and introverted, she forced herself to give talks and eventually cold-pitched podcast hosts, doing 42 podcasts during the pandemic. This preparation led to opportunities like appearing on Ezra Klein's show, and ultimately gave her the confidence to write her book and continue sharing pain science publicly.
- Rachel had performance anxiety and public speaking anxiety despite wanting to spread pain science
- The treatment for anxiety is exposure therapy—if you never do it, you never get through it
- During the pandemic when talks were canceled, she started planning virtual talks and cold-pitching podcasts
- She did 42 podcasts, which led to Ezra Klein inviting her on his show
- By that point she felt secure in what she wanted to say and kept her patients in mind when talking
" The treatment is exposure therapy right like if you never do it you never get through it so I had all these talks planned and then everything got canceled. I was like, okay, what do I do now? So I started planning virtual talks and I started cold pitching podcast hosts. "
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