I recently listened to a moving podcast from Like Mind, Like Body: "Healing When Pain is Both Structural & Neuroplastic" (terms defined below) and I was deeply moved by something the guest speaker and chronic pain coach, Lara Birk, shared about why she shifted away from helping her clients cultivate safety to instead self-trust.

Lara has a rare physical condition herself. She I first became “a patient” over 30 years ago at the age of 16. Since then, she's had 17 surgeries and been on crutches for a total of 15 years.

For her, self-trust is about cultivating the capacity to be there with and for yourself, no matter what is happening. It is the pathway to more inner safety, agency, peace, and aliveness.

In nervous system healing and brain retraining work, we often talk about cultivating more safety but "safety" can be loaded, triggering, or not accessible.

And when the world at large doesn't feel safe, or if you have a disease, disorder, condition or syndrome that is driving your pain or symptoms, that can bring up: Who or how am I to feel safe?

If you've been engaged in the realm of mind-body chronic symptom or pain/brain retraining work for a while, and if you're feeling stuck, discouraged, gaslit, or like the model hasn't fit or worked, this one's especially for you.

Quick terminology recap:

• Structural pain is defined as unpleasant sensation due to actual or potential tissue damage.
  
• Neuroplastic/nociplastic pain is defined as chronic, learned sensation, generated by the brain misinterpreting safe signals as danger, and resulting in real physical sensations without ongoing tissue damage. It occurs when neural pathways become "stuck" in a pain/anxiety loop, often triggered by stress, trauma, or emotional factors.

(These types can be combined, as in Lara's case.)

In the podcast, Lara talks about why she recently changed the "S" in her Sage Practice acronym from "Safety" to "Self-Trust".

Adapted for readability from the transcript, Lara Birk's words:

""I felt like I wasn't resonating in any way with the word safety... safety can be a privilege that's not there for everybody. At some point in anybody's life, it may not be there. We also live in a world that we can't fail safe. There are things outside of our control that make safety hard. It can be too high a bar for people, or even triggering.

It can be triggering if you're trying to convince yourself "I'm safe, I'm safe, I'm safe, I'm okay, there's nothing wrong."

It can feel like [or in some cases actually be] gaslighting ourselves.

It can feel suffocating, trying to convince ourselves we are safe, and then can add into the idea of "I'm failing" when we don't.

First of all, people with structural issues can't say that off the bat. But also it's just hard, and unrealistic, for a lot of people to convince themselves of that.

If you've never felt safety in your body ever—from your lived circumstances, from how you relate to the world, from how the world relates to you, from your medical history, etc—then how the heck are you supposed to conjure it up in this very moment?

It puts such an enormous pressure on the person.

If you do have a strictly neuroplastic symptom, a lot of your success in treatment rides on the confidence of "there's nothing wrong with my body".

It can be harder to conjure up a feeling of safety the next time you experience a flare up, a passing illness, something more serious or tenuous....and the fear that can come with that.

This idea of self-trust is more expansive and inclusive: Self-trust means that whatever happens, I'm here, I've got me.

Self-trust for me has been critical because it's how I built that inner safety that honestly is more robust, more durable, and more accessible than any outer conditions can ever be.""

--> Listen to the podcast here (Like Mind, Like Body: "Healing When Pain is Both Structural & Neuroplastic" — including Lara Birk's incredible personal story, how she regained agency in the face of so much she could not control, and why you don’t have to wait until you’re “better” to start enjoying life again)

--> Check out her amazing and comprehensive list of free chronic pain resources here.

So what does cultivating self-trust look like in everyday life? In bodywork?

In everyday life it can look like:

- Pausing to remember yourself: take a breath, look away from your screen

- Noticing you have a body

- Noticing how your body feels and if it needs anything

- Remembering that the urgency might be self-created: trusting you’ll get done what needs to be done

- Calming yourself down when you’re awake in the middle of the night. You might be more tired, and not 100%, but you are still capable of showing up for the things you need to show up for.

- Touching a part that’s hurting, saying hello (not trying to fix or change, just acknowledging)

- Telling your anxious/protective parts that you see them

- Noticing tension in our posture and softening

- Mindfulness meditation practice of coming present

In bodywork it can look like:

- Noticing how you actually feel (vs how you think you should feel)

- Asking for what you need

- Asking for what you want

- Allowing yourself to move, adjust, stretch

- Feeling sensations in your body

ANY time we tune in, notice our thoughts, emotions or body sensations, and acknowledge, attend or respond, we build self-trust.

We send the message to ourselves that we are here for ourself, we are seen, we care.

These practices might seem small, but they are the foundation of conscious choice, agency, and inner safety with oneself. It is the foundation of inner healing and transformation.