How your thoughts and emotions help create an environment conducive to healing in my opinion …..

As physiotherapist I am very interested in helping individuals create an environment conducive to healing and I personally do this in many ways including things that are outside the traditional physiotherapy parameters. However traditional physiotherapy helps individuals do this by assisting mainly the physical body, by ensuring muscle length tension around joints is balanced, strength of muscles is appropriate and that joints have the optimum range of motion. But often we forget that your mind has a lot to do with how quickly you get better and has a significant contribution in creating an environment conducive to healing.

There has been a strong understanding of the mind body connection in many ancient healing modalities but western allopathic medicine also knows this to be true and a double blinded placebo study shows how strong this connection is.

Randomized double blinded placebo control (RDBPC) studies is where individuals are randomly assigned to interventions. One group will be assigned to the ‘control group’ and given a placebo and the other will be given the intervention the group are researching. Placebo is when an individual is given a treatment that appears to look just like the actual treatment, this can be in the form of a pill, injection, liquid or procedure.

1 in 3 people who receive a placebo will have 2 things happen; they either have positive changes in their symptoms i.e they improve without the “real” treatment intervention OR they have a negative change and they get side effects, this effect is called Nocebo.

So what determines which way you will go?……………………………………………………….


It is your thoughts, feelings, beliefs and a big one …. your EXPECTATIONS which can change your body chemistry and allow a change either for better or worse.

An outrageous example of this is a study that looked at chemotherapy drugs for gastric cancer. Fielding et al., (1983) studied 411 individuals which were grouped into three categories; group A where given a placebo injection of normal saline, group B where given a cocktail of chemotherapy drugs and group C where given another mix of chemotherapy drugs. As you would expect group B and C had the largest group of people to get alopecia (loss of hair) but this isn’t the interesting part! GROUP A who were simply given a saline injection also had individuals who experienced hair loss, in fact 30.8% of them!!!


It was their BELIEF that chemotherapy drugs cause hair loss that created a physical change in their body chemistry resulting in a tangible physical result!!! It is a perfect example on how your thoughts and emotions can cause a physical change that will either help you heal or get worse!

Researcher and psychotherapist Kelly Turner , Ph.D, researched thousands of cases of spontaneous cancer remission only to find that these cases were not so spontaneous at all and that there were many factors that were contributing to these remissions. One of these factors was that these individuals understood the idea that thoughts and emotions have a direct effect on the body and this effect could be negative and illness producing or positive and health producing.

In her research she found that individuals understood that thoughts such as fear, worry, anxiety, anger, resentment, grief, sadness and depression had a negative impact on their health and healing. While non worry, calmness, relaxation, forgiveness, happiness, joy and love had an overwhelming positive effect on their health and recovery.

The healing journey can be a long road that can at times feel never ending, have you ever asked yourself what are the over riding thoughts and emotions that flow through your mind? What is your level of expectation that you will improve? Do you have faith that a particular outcome will occur?

Even though thoughts and feelings are difficult to change in an instant, it is important to at least acknowledge what your current thoughts and feelings are ……


Fielding, J. W. L., Fagg, S. L., Jones, B. G., Ellis, D., Hockey, M. S., Minawa, A., … Wrigley, P. F. M. (1983). An interim report of a prospective, randomized, controlled study of adjuvant chemotherapy in operable gastric cancer: British stomach cancer group. World Journal of Surgery, 7(3), 390–399. doi:10.1007/bf01658089

Turner, K (2014). Radical remission surviving cancer against all odds. NY. HarperCollins Publishing.

Words that harm and words that heal in my opinion ….

Pain is one complex topic! If you suffer from chronic pain you would know that there is no simple solution and hopefully through your journey you might have noticed that there are some things that can really increase and decrease your symptoms outside of the pathophysiology (see my stress and healing blog post and the sleep/pain cycle blog post).

In particular, communication plays a major role. That is, communication from your health care provider and communication to yourself. O’sullivan & Lin (2014) reported that negative beliefs are predictors of pain intensity, disability levels and chronicity. They report that negative emotions and beliefs can play a role in sensitising spinal structures via the central Nervous System. In other words thinking negatively about your situation can make things hurt more!

In the health care setting most of our beliefs of our physical issues come from health care providers who have given us advice and education around our issues. Have you ever stopped and thought about how your health care professional communicates with you? Is your health professional using words that generate fear, anxiety, despair and hopelessness?

Now don’t get me wrong; I am certain that your therapist has no calculated intention of instilling fear… but sometimes without thinking, analogies and phrases can come out of our mouths that inevitably create anxieties about the whole situation.

Let’s do an experiment, have a think about how you feel when you read these words:

“Your back is damaged”

“You have a back of a 70 year old”

“Your back is weak”

“You have to be careful” (Really, what could happen if I don’t?”)

“This will be here for the rest of your life” (Great! I am doomed, stuck with issues forever”)

“Your back wears out as you get older”

“Let pain guide you” (You mean pain is always bad and should be avoided?”)

For myself they produce fear and leave me with a feeling of hopelessness. When there is a feeling of hopelessness it is hard to feel motivated to do anything… from exercise, to daily self care and inevitably it can be difficult in becoming an active participant on your healing journey.

Now once you have seen your therapist and you get home and friends and family ask you “how’s your back going, what did they say?”. You naturally reflect back the beliefs and the communicated messages your therapist gave you. Resulting in an affirmation of the negative emotions and beliefs.

This leads me to my next question, have you taken the time to consider the words you are telling yourself? Words infused with optimism are healing! O’Sullivan and Lin (2014) reported that people who have positive beliefs are less disabled. Why? Because positive beliefs bolster your strengths and increase self reliance which means you may have better coping strategies and are more likely to exercise and move in a more natural way throughout your day.

Now have a think about what these words illicit in you:

“Back pain does not mean damage, it means it is sensitised”

“The brain acts as an amplifier, the more you worry and think about your pain the worse if gets”

“Your back is one of the strongest structures in the human body. It is very rare to do permanent damage to your back”

“Your scan changes are normal, like grey hair is”

“Movements may be painful at first but like an ankle sprain they will get better as you get active”

The language you use can lift your spirits, so next time your symptoms are high watch out for words that intensify any negative emotions and potentially destroy hope and remember words infused with optimism are healing!

O’Sullivan, P & Lin, P. (2014). Acute Low back pain beyond drug therapies. Pain Management today, 1(1):813.

Main, C. J., Foster, N., & Buchbinder, R. (2010). How important are back pain beliefs and expectations for satisfactory recovery from back pain? Best Practice & Research Clinical Rheumatology, 24(2), 205–217. doi:10.1016/j.berh.2009.12.012