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Episode 34 - How Back Pain Can Affect Your Relationship (and What to Do About It)

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Episode Summary
We’re talking about healthy relationships on this episode of Back Doc Talk.
 
What does that have to do with back and spine health? A lot.
 
With power couple and relationship coaches Jocelyn and Aaron Freeman at the helm, this episode examines how back and spine issues can affect your relationship and vice versa.
 
Physical pain influences how we feel and how we interact with others, and developing a conscious awareness about how that affects our loved ones is critical.
 
Aaron dissects the difference between pain and suffering, while Jocelyn explains the importance of setting expectations.
 
A sudden injury can change your life considerably, and dealing with the pain can feel like a burden to a partner. One way to address this is by more clearly defining roles and responsibilities when a family member is dealing with pain. This helps ensure there’s a discussion around expectations and to avoid leaving family members disappointed.
 
Helping a partner who is managing pain is a balancing act — one that can be strengthened by better understanding how your partner communicates. No one is a mind reader!
 
Tune in to this episode to discover how you can improve communication about back pain and prevent spine issues and injuries from wreaking havoc on your relationship.

Featured Guests
Name: Aaron and Jocelyn Freeman
What they do: Aaron and Jocelyn are a power couple in the relationship world, helping couples navigate the highs and lows of married life. Through their sold-out events all over Arizona, their book, and coaching classes, Aaron and Jocelyn are in the business of healthy relationships. They are the founders of the Empowered Couples University, which helps couples harness important communication skills and invest in their relationship.
Company: Meet the Freemans
Words of wisdom: “[T]he place to really start to make a differentiation here, between the impact on the person that has the ailment, and is actually in physical pain versus the spouse. It is the difference...between pain being of the body and suffering being of the mind.”
Connect: LinkedIn | Facebook | Podcast

Anchor Points
Top takeaways from this Back Talk Doc episode
 
Open communication is your greatest tool. To prevent pain from creating havoc on your relationship, open and honest communication is essential for couples. This applies directly to how spouses and partners deal with their loved ones being in pain. How to navigate that is critically important, not only for suffering but for support.
 
Understanding you and your partner’s personality type is crucial. Whether you are a reserved or assertive communicator will affect how you handle a challenge — like pain in your relationship. Knowing whether you need to ask more questions (or fewer!) can be critical in navigating pain management and care of a loved one. Jocelyn and Aaron developed a quiz to determine your personality type. Take it at mycouplesquiz.com.
 
‘Depositing’ thanks and ‘withdrawing’ energy. Using a bank account as a metaphor to describe the transfer of energy and emotions between couples is a useful way to think about pain and stress. When you’re the one in pain, “depositing” gratitude into your partner’s bank account can greatly help your recovery process. On the other hand. “withdrawing” too much of their energy can cause resentment. Balancing this and understanding you’re not a burden is a hard lesson to learn, but an important one.
​
Episode Insights
[00:00] Mobile-based solutions for clinical practice: Check out our sponsor, QxMD, mobile solutions for driving evidence-based medicine in clinical practice.
[01:34] Introducing the Freemans: Dr. Lakhia introduces relationship coaches Aaron and Jocelyn Freeman, authors of “The New Power Couple” and “The Argument Hangover: Empowering Couples to Fight Smarter and Overcome Communication Pitfalls.”
[04:51] Breaking L1 to L4 and her relationship: Jocelyn speaks to how hurting her back had an emotional impact on her previous relationship because she pushed herself too far.
[07:29] Navigating back pain and interpersonal issues: Aaron and Jocelyn detail how to mitigate and develop a conscious awareness of how pain can affect relationships.
[9:58] Pain in the face of powerlessness: Being in pain can give people a sense of powerlessness that can leak over into relationships. Jocelyn talks about her personal experience.
[13:21] Checking on expectations in a relationship: Introducing the theme of their newest book, “The Argument Hangover,” the Freemans talk about managing expectations in a relationship, especially when there is a sudden and dramatic change like a back injury.
[17:23] Do the work: Dr. Lakhia challenges listeners to write down everything they need to do to help with their pain, from exercises to knowing who in your family is doing what. Make it concise and clear.
[18:00] Pain journaling can help expectations: While pain journaling is nothing new, Dr. Lakhia and his guests discuss how it can be used to help set and meet expectations when it comes to pain.
[22:08] Knowing your communication type: Jocelyn breaks down the communication personality types outlined in their book and the importance of not only knowing your own communication type but understanding your partner’s.
[27:17] A love bank account: The Freemans break down the concept of a “love bank account” and how the metaphorical idea of depositing and withdrawing energy from one another is applicable to relationships in crisis.
[30:32] On feeling like a burden: Dr. Lakhia reveals his own struggles with feeling like a burden to his family when he suffered a disc injury.
[35:15] Authentic conversations on Clubhouse: Aaron mentions he got on Clubhouse recently and was surprised at the vulnerable conversations people were having about their relationships.
[37:45] Healthy habits: Dr. Lakhia asks Aaron and Jocelyn about their personal workout and health routines.
[40:15] Words have meaning: Dr. Lakhia explains why the most important book in his life is “Autobiography of a Yogi,” by Paramahansa Yogananda.


Subscribe & Contact
If you enjoyed this episode of Back Talk Doc, check out our recent episode Ins and Outs of Spinal Fusions with Dr. Hunter Dyer.

For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

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​Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.
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Intro:                  00:30                 
Welcome, you're listening to Back Talk Doc, where you'll find answers to some of the most common questions about back pain and spine health, brought to you by Carolina Neurosurgery and Spine Associates, where providing personalized, highly skilled and compassionate spine care, has been our specialty for over 75 years. Now, it's time to understand the cause of back pain, and learn about options to get you back on track. Here's your Back Talk Doc, Dr. Sanjiv Lakhia.

Sanjiv Lakhia:                  01:03                 
Thank you for tuning into this edition of Back Talk Doc. As you know, I'm your host Sanjiv Lakhia. My goal with this podcast has always been to provide you with the most comprehensive tool set to deal with pain, injury, dealing with your spine care. Again, I work at Carolina Neurosurgery and Spine Associates in Charlotte, North Carolina. In fact, my office is in Rock Hill, South Carolina, just over the border. I believe we have the best group, because we provide the most comprehensive care to spine issues, really anywhere in the country. As I got to thinking, we've covered a lot of material over recent weeks and months, and I myself, personally, am involved in a business management program, and through that, I got exposed to a couple of people who are basically living out a life mission to improve our ability to be in healthy relationships. I was able to listen to them talk, and take one of their courses, and I really feel what they have to say is very applicable to those of you out there who are suffering with back pain, or pain of any kind. My hope for today is to introduce you to some tools that you can apply right away to help you cope with what I call the other side of pain, and that's managing your relationships. I want to welcome to the show, Aaron and Jocelyn Freeman. Guys, welcome to the show.

Jocelyn Freeman:                  02:19                 
Thanks for having us. We're glad to be here.

Aaron Freeman:                  02:21                 
Yes, thank you.

Sanjiv Lakhia:                  02:22                 
All right. Let me introduce you to the listeners, for those who aren't familiar with you. They're the authors of two books, The New Power Couple, and The Argument Hangover, which I just received and I've been going through, and I'm excited to go through that. With much excitement, they founded and launched The Empowered Couples University. It's an online university, where busy couples unlearn unhealthy patterns, and gain modern relationship skills. They're really sought after relationship coaches, and they've worked with celebrity couples, public figures, thousands of couples around the world. They've shared the stage with Tony Robbins and we're nominated as Arizona's 40 under 40 influencers, and have been features in national media for teaching couples modern, practical skills, and tools, to work together through any life challenge. They've reached hundreds of thousands of people around the world with their message, had dozens of sold out live events, before COVID, and then now, sold out online events. They're passionate about training and leading future relationship coaches, and they have an accredited coaching certification program. Jocelyn and Aaron are ordained, and their vision is to make relationship development the new personal development, and lower the divorce rate in their lifetime. They've also recently moved to the Charlotte area. Welcome to the region.

Jocelyn Freeman:                  03:40                 
Thank you so much. We're glad to be here.

Aaron Freeman:                  03:42                 
We've been down in Rock Hill as a little trip, too.

Sanjiv Lakhia:                  03:45                 
It's really close. I think today, I'm real excited to get into this, because we've talked a lot over my previous episodes about medical intervention, surgical interventions, injections. This is just a way to look at health through a different lens. In my career, over 15 plus years, I've definitely observed that when people come in the office with back pain, or injury of any type, that it doesn't just effect that individual. It has a real dynamic effect across their relationship with their spouse or significant other. I can speak to that as a clinician, and also on a personal level, as I've had some back issues of my own that I dealt with, and I'm blessed to have a wife that's basically an angel, and handles everything. Having an injury or illness is not without consequence to those that you live with. Jocelyn, you were sharing, before we came on, a little bit about your own personal experience. I don't know if you want to start with that, just so the listeners can relate a little bit.

Jocelyn Freeman:                  04:41                 
Oh, absolutely. Man, it's going on over a decade, or right about a decade now, that I broke L1 to L4, the transverse processes. It was sudden. I fell down a flight of stairs. My life was changed, just one morning that I was not expecting. Afterwards, I was obviously, as many of you listening, in a ton of pain. I had several bulging discs afterwards. I was one of those patients that the doctor is like, "Lay low on the exercise." I'm going back to squats. Of course, once the bones healed. I did push my body a little bit too hard. I was very much into fitness. Luckily, I did recover, but in those months that it took for everything to really heal, my body and spine to get back in alignment, it was definitely impacting my romantic relationship at the time. It's not my partner now, my husband wasn't with me at the time. It definitely impacted that relationship. I think, part of that relationship ending. Now, of course, there were other things going on in that relationship. I can talk about the emotional impact it had on me, and how that had me show up less of a great partner, and project that pain into my relationship.

Sanjiv Lakhia:                  05:55                 
Yeah. It's interesting you would say that. I had forwarded you guys, not as anything I expect you to memorize, but I had forwarded you an example of references in the medical literature about the effects of pain on a spouse. It's pretty clear there are correlations that those that are suffering with pain and injury, it makes sense, it puts stress on the relationship. It's not something we talk about a lot in our 15 minute encounters in the office. I do see it. Oftentimes, to be frank, it is the spouse who brings the patient into the office, basically dragging them by their hair, because their pain is effecting their sleep, effecting their mood, and they want something done to fix it. I hope you're doing well now with your back.

Jocelyn Freeman:                  06:44                 
Yes, I am. Thank you.

Sanjiv Lakhia:                  06:46                 
Okay. I'll share a few observations I have from the clinical side, and then you guys can share with me your response. When I have patients that come into the office with back pain, a couple things I notice right away. Number one, often accompanied by a lot of fear, and number two, it's accompanied by a lot of impatience. I can see it translate into their relationship with their spouse. Right off the bat, I want to get your thoughts as relationship coaches, what would you say to people who are going through pain, in terms of how to mitigate it and develop a conscious awareness of how it can effect their loved ones?

Aaron Freeman:                  07:29                 
This is such a great question, and Sanjiv, I appreciate you bringing this together, because as we're not specifically in the medical field, we don't often correlate a spouse being in real physical pain, and the impact on their relationship, and vice versa, as you were talking about. I think the place to really start to make a differentiation here, between the impact on the person that has the ailment, and is actually in physical pain versus the spouse. It is the difference. This is, I think to me, really huge. The difference between pain being of the body and suffering being of the mind. Then, we get an opportunity to talk about how emotions are really playing into that. You have a spouse or partner that's in physical pain. Now, you can for sure be in pain and be suffering. Now, it's probably a smaller amount of people, but you can be in pain but not be suffering. The difference is, suffering is of the mind, it's the meaning you're giving it. It's probably more so the future that you're focused on being not at all what you expected. Maybe having to care more for a spouse. When you have a spouse that's in pain, they're probably also suffering. The real impact on the other spouse, like you said, is bringing them in, they're probably suffering because of the pain of the other partner.

Jocelyn Freeman:                  08:58                 
I think that in anything that's going on with a partner, stress at work, children. We have clients of ours who they find out their children are autistic. Any stress in your external life is going to have some impact on the relationship, because sometimes unconsciously the relationship can become the place you act out what's going on in your life, because you feel somewhat safe in that relationship. Sometimes people can let down their guards. They can act out what's going on in their life, out in their relationship, when they're not intentional. I think some of the impacts that we see, regardless of what the stressor is, but you work specifically with pain, is a feeling of sense of powerlessness. I know that one thing that impacted me, not only in my romantic relationship, but with how I was acting with my friends, with anyone, I felt a sense of powerlessness. Like you said, a sense of urgency, feeling impatient.

Sanjiv Lakhia:                  09:57                 
Impatient.

Jocelyn Freeman:                  09:58                 
For me, I was feeling a sense of powerlessness, because I couldn't control the pace of my healing. I couldn't control that I couldn't walk faster than a mile per hour. That powerlessness showed up in how I was or was not expressing my needs in the relationship. There were different seasons for me, or stages. There was a sense of that powerlessness, acting out as neediness. I was almost overly expressive and somewhat passive aggressive, "Come on. Give me the attention." I needed the attention to help me feel less powerless. There was another stage of my powerlessness, which became more repressive, which is where I wasn't expressing my needs, and I felt hopeless. I was sinking down, I was not as engaged in the relationship, and I wasn't expressing my needs. Both of those stages impacted the relationship negatively.

Aaron Freeman:                  11:00                 
Not to do too much here, Sanjiv, I'll let you jump back in. I think the summary of why I wanted to start with this, is because pain being of the body, is the aspect that you probably don't have a lot of control over, hence why you end up going to see someone like yourself. Whereas, suffering, is actually a place you do have control. That was the differentiation I wanted to make to summarize that whole section.

Sanjiv Lakhia:                  11:25                 
That's excellent. The distinguishing features between pain and suffering. I like to think about it as we can be in pain, but we don't suffer unless we label it bad. That's an interesting rabbit hole to go down through, but one of the things I think, and it's whether it's pain or stress, or what have you, and why I thought it would be appropriate to have you guys on, you are very good at providing couples with tools to process things. I feel when someone has pain and injury, it's critically important that they have proper communication established to help work through that health crisis. It is often in my office, I'll quite simply say to a patient or spouse, I'll be like, "How are you doing with this?" I may be talking to the spouse sitting in the other chair. And say, "How are things going? Are you dealing with the emotional side of this? I'm just checking in with y'all." Just having a venue that someone can even just talk about it. I'll hear stuff like, "It's very hard. I feel I have to take care of a lot more things around the house. I'm worried about him losing his job." Sometimes, just the process of expressing how you feel, can actually reduce some of the pain.

Sanjiv Lakhia:                  12:42                 
I think for you, particularly in your book, and this is where I want to tie in a little bit and let you guys introduce it. You just came out with this book, The Argument Hangover, and the title is The Argument Hangover: Empowering Couples to Fight Smarter and Overcome Communication Pitfalls. What really struck me, and I wanted to get your opinion on, was the chapter five, Before Conflict. I think this is where if you guys can share some of the tools you talk about in that chapter with my listeners, these are things I think they can apply right away to help mitigate some of the collateral damage of having to go through a physical injury, and make sure it doesn't actually leak out into their personal relationship.

Jocelyn Freeman:                  13:21                 
Yeah. Several come to mind, but one that jumped out right at the top of mine, was about expectations. Before conflict even arises, or you could call high emotion, or there becomes this point in your relationship where the tension can get so high from the pain you're in, we have to really check out our expectations in the relationship. When there's a sudden change in your dynamic, like an injury, and the other partner is needed to take on more, if it wasn't discussed, it can feel more like a burden, or a lot of pressure, because there wasn't an actual discussion about expectations. Not only that, but if the partner who's injured didn't express their expectations, said in another way, they withhold them, and they hope their partner will just figure it out or anticipate what their needs are, that will only lead to disappointment and frustration, and can lead to a sudden unexpected disagreement.

Jocelyn Freeman:                  14:20                 
You want to be able to prevent some of that tension by having a very explicit conversation about what are the expectations here. Not only with roles around the house and specific needs, but also emotional expectations. "Hey, do you need me to check in on you emotionally daily? Do you want me to ask you how you're feeling daily?" For the other partner, "Hey, it would mean so much if you'd ask me every night if I need to talk about how I'm doing." Being able to talk not only about physical expectations, but also emotional expectations, will prevent there from being those repressed disappointments and create that disconnection.

Aaron Freeman:                  15:00                 
I can't say from my own experience, but we talk with many, many couples in many different circumstances, it might seem like, and let me know if I'm stepping over any bounds here, but most of the attention would go on the partner that's feeling the physical pain. Then, it seems all the expectations and the expression of how you're doing is focused on the partner that's in physical pain. Where, if it were still more open, the communication was such that you expressed your expectation to the partner that has the physical illness, that they check in on you, maybe that sounded a little bit chaotic.

Sanjiv Lakhia:                  15:37                 
That's interesting you say that, because I've got a lumbar disc issue and late last year, doing some squats, working out, my morning routine, I just did it wrong and all heck broke loose. It was probably the worse flare I've ever had. I had a little bit of guilt with my wife, Theresa, having to do so much with the kids, around the house. I think I shared with you guys before, it changes, I got three beautiful kids, and one of my daughters has some developmental challenges that already add a layer of stress to our relationship. I was really, personally, concerned with the excessive burden. I felt a little guilt. I would say from two angles. Number one, just placing that on her. Quite frankly, also, Aaron you can comment on this, as a dude. I can't lift that right now, and that makes you feel not so good about yourself. I was just intuitively just checking in with her, "How you doing? Do we need to get help?" She would never ask for it, which is the thing.

Sanjiv Lakhia:                  16:39                 
I really like, Jocelyn, the idea of number one, setting expectations. I'm actually looking at page 78 in your book. I love the diagrams, the pictures you guys use. This picture, again, we'll put a link to the book in the show notes, you guys should definitely purchase it if you're listening. You have an example of a subject is the conflict is really the same, money, and you have one area where the conversation is just a free for all discussion, back and forth, reactionary. It leads to an argument that lasts multiple days versus another scenario where you already have agreements and ground rules established, and you have a little dispute, but it lasts three hours. You can go back to that framework. I think a take home tip, an action item, if you're listening with back pain, you're going through a health crisis, is take the time, do the exercise, literally write out the day to day things that you need to get done with your family and your spouse, your loved ones, and leave no room for confusion about who's doing what, and when you want to check in with each other. For me, at least from relationship side, I get in trouble when I make assumptions about what I think she's thinking and vice versa.

Sanjiv Lakhia:                  18:00                 
The process, we use in medicine for people with pain, we encourage them to write out pain diaries. Pain diaries are ways that you can get from your conscious mind, onto paper, express yourself, and there's therapeutic value just by going through the process. That's why there's lots of data on the benefits of journaling to start your day. It's all over the personal development space. I think for what you guys advocate, correct me if I'm wrong, also extending that to the relationship side, where you go through the process of creating these agreements so they're on paper, they're visible, they're transparent, and that will extinguish, or at least minimize, the intensity of future disagreements. Is that a good summary?

Aaron Freeman:                  18:41                 
This is really great. Yeah. I'll have Jocelyn more about the specific agreements, but I want to take one step further back to what you were saying, especially for that feeling as a male of maybe being... I don't know if you'd want to call it emasculated, or just not being able to do things on your own.

Jocelyn Freeman:                  19:00                 
Uphold.

Aaron Freeman:                  19:01                 
It's obviously going to challenge your identity. I know Jocelyn shared that with me, that was one of your biggest challenges was coming up against the identity you had created for yourself, was one around your physical health and your fitness. Now, you broke your back and you almost lose yourself because you're not sure who you are without that. I think to your point, I love the pain journal. Getting really specific, if you're already doing the pain journal, I would really write down these couple of steps, as well. It's not that you don't have expectations, you shouldn't have an expectation to not have expectations. In the season of getting hurt, those are going to change. Disappointment comes from expectations being unmet. Not to go too far, but what causes unmet expectations is often that they are unexpressed. That's what you were talking about, Sanjiv, you make assumptions. I could be where you were with my back issue thinking, "I'm such a burden on Jocelyn. I can't ask her to do more for me. She's already doing things for the kid." If you do not express your assumptions and your expectations, they will only turn into disappointments.

Aaron Freeman:                  20:17                 
The first place to write what are my new expectations, secondly, have I expressed them or are these unexpressed. You really can create an opportunity to have your partner just know a lot more about you. "Hey, Jocelyn. I realized, I have a new expectation. I have some fear about asking you to do more because I see how much you're doing already." Just starting to share some of that, then what can happen is once an expectation is expressed, now it's a good place to look at, which Jocelyn can go into, what agreements can we put in place for that such that it doesn't lead to a disappointment or a broken promise or agreement.

Sanjiv Lakhia:                  20:56                 
I really like that process. In fact, applied that at home after we did your live day training. When I went through that exercise with my wife, we had two immediate issues that were recurrent, that quite simply, I think were due to a lack of communication on the issue. Once we put it pen to paper, it's been pretty good. It's been pretty good. I think that is a really good tool that my patients can utilize as a process and go through their healing journey. The other thing you guys talked about, and I want to give you some space to elaborate on, that I think can be helpful, and probably gets very magnified in any stressful situation, and again, we're talking about pain and back pain, but you could replace that with job loss, you can replace it with any stressful event. You talked about the importance, in your book, of the communication type. You outlined several different types. Do you think it's important for people to understand their own, and their spouses communication type? Would that be useful in the event that they have to go through a medical crisis?

Jocelyn Freeman:                  22:08                 
Great question. And 100%, everyone in any circumstance would benefit from understanding their communication personality type, which is a whole framework we created, because what we realized after thousands and thousands of conversations. In the relationship space, there's this beat of the drum, communication is the key to a relationship, communication is the key to a relationship. When one partner doesn't implement the communication tool they learn the same way they do, you're not doing the communication the way. We realized after... We're big data people and really looking at what trends we're seeing, we really found four communication personality types, which there's a visual in the book, but there's assertive to reserved, and flexible to inflexible. You can fall into one of the four boxes there. Your partners communication personality type definitely impacts the way you are processing and communicating your needs when you are in pain, or when you're the other partner really taking care of a lot of the things going on. The impact would be, if one of you, or both of you, tends to be more on the reserved side, that means you've silently processed your thoughts, your needs, your desires, or things you're frustrated about.

Jocelyn Freeman:                  23:25                 
Reserved types without awareness can withhold that for a long period of time, and then can be expressed at a later date when they're already frustrated. They're already disappointed. That can feel like a blindside to the partner. Where's this coming from? You haven't expressed this the whole time. An assertive partner, who might be in pain, will be very expressive about their needs, their wants, and that can feel overwhelming to the partner, as well. It's useful for both of you in that relationship to understand your communication personality type so that you, number one, have awareness of what your default tendencies are, but also, you're aware of how can I make slight adjustments so that my partner understands me better, so that I don't overwhelm them, or I don't withhold from them and keep them in the dark, depending on what your type is. It drastically helps prevent disconnection, frustration, unmet expectations. Anything else you'd add, Aaron, about that?

Aaron Freeman:                  24:28                 
No. It's funny, I was laughing to myself because I thought of something I hadn't thought of before. We are not advocates of anticipating what your partner needs. We think that leads to assumptions and expectations. However, it can help. I do actually realize if you had a reserved partner, that happened to be the one that got-

Jocelyn Freeman:                  24:49                 
In pain.

Aaron Freeman:                  24:50                 
Hurt, and was in crisis, and you have another partner, the one that is helping, being assertive. If you know that your partner is reserved, it can help you anticipate a little bit.

Jocelyn Freeman:                  25:00                 
Or ask more questions.

Aaron Freeman:                  25:02                 
Exactly. You're going to ask more questions. You're not going to just sit back and assume.

Jocelyn Freeman:                  25:05                 
You'll tell me if you-

Aaron Freeman:                  25:05                 
You know that they're reserved. Exactly. You know they're reserved, so it's going to spur you, or to initiate some more conversations because you'll know there's probably some things they're not communicating. I think that can also be leveraged to have you feel more loved and more taken care of because you will be able to anticipate that little bit. I don't want to say that because you still want to communicate, and not expect your partner to anticipate.

Jocelyn Freeman:                  25:32                 
I'd even do a word swap. What if it wasn't anticipate, it was ask. Just truly, if your partner is reserved, it's asking them more questions of what they might need during those times.

Sanjiv Lakhia:                  25:45                 
Is there a link where people can go online and go through a little quiz and figure out their type?

Jocelyn Freeman:                  25:49                 
Yeah. It's like you read our minds. We actually did develop one online because people are loving this whole framework. That's at mycouplesquiz, it does have an S in there. Mycouplesquiz.com. You can find out your partners communication personality type, as well as some mistakes you might make unknowingly, and some ways you can communicate better with them.

Sanjiv Lakhia:                  26:10                 
I got to go do that. We'll link to that in the show notes. I think that's a great exercise. If you're listening, or you don't have an injury and you're just listening because you have a family member who does, or there's other topics on the podcast, when people come to us with questions about their spine, obviously we love to prevent back injuries. We'll talk about maintaining flexibility, core strength, don't sit too much, watch how much you bend, lift, and twist. Just occurs to me that learning this type of information, could be really good ahead of time, and not necessarily waiting until you're in crisis mode. I think learning the communication type is probably applicable to anyone listening. The other thing, the other concept you mentioned that I want to get your thoughts on, was the whole idea of love bank account. To me, when you go through back pain, that's a depleter. That's a depleter of your energy, and at a minimum, it's going to prevent you from making a whole lot of deposits in someone else's bank account. For those who aren't familiar with that concept, can you briefly explain that, and discuss why you think it's an important topic.

Jocelyn Freeman:                  27:17                 
Yeah. You can imagine that each of you in the relationship have an invisible bank account measuring how loved and connected you feel. Now, everyone has different desires for what fills your love account. The thing is, when someone is an injury, or again, if more of your attention goes towards a child who was diagnosed autistic, or a family member is unwell, anything that's taking your attention away from your relationship, we can make less and less deposits to that love account. Like you said, that injury can deplete. In my own experience, when I was injured, I was not initiating sexual intimacy. I wasn't feeling great myself. My confidence was low. That was not filling that partners love account at the time. Then also, when I'm not bringing attention to it, or even the other partner, because now maybe they feel like they're having to do a lot around the house, then they have less attention on you, they can be making less deposits for you. The thing is, research shows this, and this is from the Gottman Institute, who's been researching couples for decades, interestingly the feeling of being connected to your partner has less to do with the big things. Less to do with, "I planned a trip for us. I got you this gift. We had a weekend away as a date."

Aaron Freeman:                  28:39                 
Or even how much time you spend together, or even how "meaningful" your conversations are.

Jocelyn Freeman:                  28:46                 
It has less to do with those big things, and actually has much more to do with all of the small deposits that you make, more frequently. It's walking by them and brushing your hand on their back. It's getting them a cup of water. It's saying you look great today. It's all of the small things throughout the day, and you ideally want to make how many deposits is it per day?

Aaron Freeman:                  29:07                 
I don't know if there was a number, but they did study and say a healthy couple would deposit up to 40 times during a dinner.

Jocelyn Freeman:                  29:15                 
During a dinner.

Aaron Freeman:                  29:16                 
That is a lot. Maybe as a number, 20 to 25 would be a really good number to shoot for to really fill that tank.

Jocelyn Freeman:                  29:25                 
Even if you are the one in pain listening, or again, the other partner, just think about how can I, I may not be full on ready for sexual intimacy because my confidence is low, or maybe it's not physically realistic right now because of my pain level, can I still make love deposits in other ways to my partner.

Sanjiv Lakhia:                  29:43                 
That's very powerful. It is something, I think, you have to be intentional with, even as you're going through the episode. The more effort you put into that, the less likely, I think, you are to feel disconnected and develop conflict. I was happy to see you guys writing about that topic.

Aaron Freeman:                  30:04                 
I guess if I could add one more quick think, Sanjiv, because it was interesting what you brought up, going through your own experience of that. Maybe even a question for you. My guess would be that when you're someone that's feeling the pain, and injured, and limited, you have that sense of already being a burden. My guess would be, and correct me if I'm wrong, that you probably don't make as many deposits towards your partner then, too?

Sanjiv Lakhia:                  30:32                 
Yeah, that's totally correct. In fact, to be totally honest, and people that listen to me know I share quite a bit. I think it's important that we do that. You put things out there and people can learn and grow from your own experience. To be perfectly honest, when I hurt my back, in addition to feeling the physical pain, and then the emotional pain with my family from letting them down, there's a little bit of embarrassment. I'm the Back Talk Doc. This is what I do for a living. I help people recover from their injuries, and I'm the "expert" on spine care, and here we go, I got my own injury. Now, I've had it before, so it's not new. It's something that flares every now and then, but it would be akin to you guys are the relationship power couple, and then you split up. How deflating would you feel with that? For me, personally, as I've gone through my 45 years of life and been very blessed with a wonderful life, I've learned more and more that at least through my lens, that things happen for us not to us.

Sanjiv Lakhia:                  31:37                 
I was telling a friend of mine recently that was going through something really rough. I told him that. I said, "Even the horrible crappy stuff that we go through, I think, over time, it teaches us things. You can't understand it why you go through it. Maybe you can't even understand it as you go through your entire life. But on some deeper subconscious level, I think there's lessons that we all have to go through." I think that's part of what brings patients into our office. Their injuries are physical injuries, but they're metaphors for other things going on in their life. For me, as I process the initial emotions, absolutely, I wasn't putting a lot of deposits, at least openly. I fluctuate as most men do in terms of how expressive I can be. I know internally I was expressing a lot of gratitude. I think, for me, that was about what I could do at the time going through it. It's a good question. One thing, if you guys look at the research, you're aware of this, when you do express gratitude, it boosts your immune system. There's good data that shows that people who express daily gratitude, they have elevated antibody levels. It's a really good strategy as you go through these crazy times.

Sanjiv Lakhia:                  32:47                 
If you're in a state of gratitude, you cannot be in a state of fear. You cannot be in a state of worry, simultaneously. To me, that is one strategy that... I'm not a relationship coach like you guys are, but that's one strategy that I recommend do my patients who are really... Some of them come in and they're really down. They're going through major stuff. They have back surgery coming up. They're out of work. They've got nerve damage. It's a life altering event. Sometimes I'll say, "As you go through your day, find one thing that you can be appreciative for, that puts a smile on your face." That's a lifeline for people. I think it can apply to their relationship. Make sure you find one thing each day to be thankful for in the midst of your relationship, you can appreciate it. I would say this, when you go through pain and injury, there's a little bit of you take for granted the other side of this, your family, your spouse, and how it affects them because that pain can be so distracting.

Jocelyn Freeman:                  33:42                 
To really just acknowledge what you're saying, funny enough, when I was in the midst of my injury and my self-esteem was very low. I really did feel a loss of self and identity. My family initiated it because I was really getting down emotionally and mentally, and we started a group text thread of daily gratitude. Every single morning, every single one of us in the family texted three things we were grateful for. I can say that was a huge contributor to me coming out of the depression, emotions, and stepping into the light. I really echo what you're saying about gratitude.

Aaron Freeman:                  34:23                 
One other thing, just made me think of then, too, there are base human needs beyond the ones of survival. One of those is contribution. My guess would be that that is probably something that goes down, too, when you're not as mobile, maybe you're not seeing people, and probably even the contribution to the family. That tank goes down, too, and I know that puts people into a state of not being very valuable. You feel how that would lead to a diminished mental state, as well. I guess I would encourage people, again, I haven't been there myself, but we do have technology that can allow you to contribute to other people, even while you're experiencing that pain. Maybe not right in the moment. Jocelyn is going to think this is funny. I just got on Clubhouse two days ago. Clubhouse is an app where it's all audio, and you can get into these rooms about any topics.

Aaron Freeman:                  35:25                 
The conversations are very real, they're very authentic, from what I have found, and there were rooms where people were sharing about what they were going through. To jump into something like that, where you can immediately connect with a group of people, maybe even going through a similar thing, share your story, and actually hear how that might make a difference for another, I think you increase that contribution. I think you naturally increase that feeling of gratitude. Probably those hormones and chemicals that get released into your body. You're contributing when you're being of service. I think little bumps like that would probably also help your mental state, your emotional state, and then your being, which we know also influences partner. I know I went long there.

Sanjiv Lakhia:                  36:09                 
That's good. It's almost the modern day version of medical support groups. More and more now, when people just can't get together, or too uncomfortable to get together, I think that's a good idea. We'll definitely link to that, and I'll take a look at that. I think we've covered a lot of stuff here, guys. I've been real excited about this. I like going off topic a little bit. I actually did an episode, several episodes ago, with my partner John Welshofer, physician, and we just talked about spirituality and pain. I think it's very productive and useful to honor and recognize the multi-dimensional characteristics of health. Relationship is a big one.

Sanjiv Lakhia:                  36:50                 
I'm in the Weil Integrated Medical Fellowship right now, we just finished our first year of two, and we've had several great speakers that have talked to us about this. I feel it's important because as physicians if all we do is heal their physical injury, but totally neglect every aspect otherwise, then we really haven't done our job. I know people are going to listen like, "Come on, man. We got 15 minutes per encounter." It doesn't take much. It can be one simple question, just acknowledging someone's pain and injury, just acknowledging the effect on the relationship. It's got a domino effect that as providers, some times we can't even see. I really appreciate you guys just adding to it. Adding your expertise to the arena, jumping into the conversation. You may not have known what you were getting into.

Jocelyn Freeman:                  37:38                 
Thank you. You sound like an incredible doctor that I wish I could have seen.

Aaron Freeman:                  37:41                 
Absolutely.

Jocelyn Freeman:                  37:41                 
My doctor didn't ask me any of those questions. I would have preferred to see you.

Sanjiv Lakhia:                  37:45                 
I always like to close my episodes with a couple of questions, just about... I'm a big health nut. That's how I got introduced to you through the Innovative Functional Medicine mentorship. I know you're in Charlotte now, and I see on Instagram you love working out. I love picking the brain of people's morning routines, or personal health habits. I'll let each of you take a turn. If you want to share one aspect about your personal health routines or health habits that you think other people would benefit from. Go ahead, here's the floor.

Jocelyn Freeman:                  38:20                 
I think you mentioned exercise already, so that's covered. I think that one thing that got really introduced to me around the time of my injury, was self-development, and was working on my mind. Now, every single morning, we do this together, we created this as a habit, before work hours, before we are accessible to the world, we spend time with ourselves as individuals. Even before we're totally available for each other and our relationship, we spend time in our own separate corners, meditating, journaling, sometimes we're listening to an audio. We're focusing on our mind, our spirit, we're also very spiritual, and really making sure our connection to ourselves and our higher source is strong, and that influences every other element of our health. What about for you, Aaron?

Aaron Freeman:                  39:11                 
I guess I'm just feeling called to give three particular resources, given the audience is probably listening. You probably already know, but Dr. Joe Dispenza called Becoming Supernatural, it's going to be really empowering to start to create that mind-body connection. Where I would go next then, is an author whose now passed away, but Wayne Dyer. Wayne Dyer brings in this entry level spiritual conversation with something like the book, The Power of Intention, then from there, where I'm really at every single morning, I'm reading an author that was alive back in the 30s and 40s, and 50s, Neville Goddard. He talks about the power of imagination, a book called Awakened Imagination. He starts to make amazing correlation between God, even the God of the Bible, and how that correlates to the conscious, subconscious mind, and how you access that through the power of your imagination. Those are resources that have changed my life.

Sanjiv Lakhia:                  40:15                 
That's fabulous. I'll add to the list, since you mentioned some books. If I was to be asked, the most defining book for me in my life, it would be an Autobiography of a Yogi, by Paramahansa Yogananda. I don't know if you're familiar with that. The story goes, it was the one book on Steve Jobs kindle when he passed away. It just speaks to, if you have a chance to read the book, it really speaks to me, as I've gone through my life, now as a physician, the incredible untapped healing potential of our body, how we know very little of it. I do think as you enter these topics of engaging and relationship discussion, and setting your mindset and intention, it just adds to our capability. I really appreciate you guys sharing those personal tips. I want to honor your time today. I know you have very busy schedules as you are saving the world, promoting healthy relationships, and smarter relationships. We'll link to your two books in the show notes, link to your website and your quiz. If people want to get in touch with you, how would you like to leave that?

Jocelyn Freeman:                  41:21                 
I think two other places besides those you already mentioned would be our podcast, if you want to listen to more relationship content, that's The Empowered Couples podcast. We're also very social on Instagram. If anyone listening is an Instagram person, we're Meet the Freeman's on Instagram.

Sanjiv Lakhia:                  41:37                 
Please check them out. I love talking to people who have such a laser focused purpose. That is one of the things that attracted me to the work that you're doing. Guys, go check out their website, check out their why that they wrote, it's really cool. Again, I hope you guys in the Charlotte area, hope we can connect again, on a personal level. If you ever need anything, feel free to reach out to me. Thank you for your time.

Jocelyn Freeman:                  42:02                 
Thanks for having us. Just incredible questions.

Aaron Freeman:                  42:04                 
Great to know you're just right here in the local area.

Outro:                  42:10                 
Thank you for listening to this episode of Back Talk Doc, brought to you by Carolina Neurosurgery and Spine Associates. With offices in North and South Carolina. If you'd like to learn more about Dr. Lakhia, and treatment options for back issues, go to backtalkdoc.com. We look forward to having you join us for more insights about back pain and spine health on the next episode of Back Talk Doc. Additional information is also available at carolinaneurosurgery.com.

Top quotes from the episode:
 
Dr. Lakhia:
[18:05] “Pain diaries are ways that you can get from your conscious mind, onto paper, express yourself, and there's therapeutic value just by going through the process. That's why there's lots of data on the benefits of journaling to start your day.”
​
Aaron:
[19:41] “Disappointment comes from expectations being unmet. Not to go too far, but what causes unmet expectations is often that they are unexpressed.”
 
Jocelyn:
[23:54] “It's useful for both of you in that relationship to understand your communication personality type so that you, number one, have awareness of what your default tendencies are, but also, you're aware of how can I make slight adjustments so that my partner understands me better? So that I don't overwhelm them, or I don't withhold from them and keep them in the dark — depending on what your type is. It drastically helps prevent disconnection, frustration, unmet expectations.”
 
Dr. Lakhia:
[31:42] “Even the horrible crappy stuff that we go through, over time, it teaches us things. You can't understand it while you go through it. Maybe you can't even understand it as you go through your entire life. But on some deeper subconscious level, I think there's lessons that we all have to go through. I think that's part of what brings patients into our office — their injuries are physical injuries, but they're metaphors for other things going on in their life.”
 
Jocelyn:
[38:37] “[B]efore we are accessible to the world, we spend time with ourselves as individuals. Even before we're totally available for each other and our relationship, we spend time in our own separate corners, meditating, journaling, sometimes we're listening to an audio. We're focusing on our mind, our spirit, we're also very spiritual, and really making sure our connection to ourselves and our higher source is strong, and that influences every other element of our health.”
Picture
Dr. Sanjiv Lakhia is a board certified physiatrist with Carolina Neurosurgery & Spine Associates, one of the oldest and largest private neurosurgical practices in the country. The practice has offices in North Carolina and South Carolina, and offers comprehensive diagnosis and treatment of spine injuries and disorders. To learn more or schedule an appointment, call 1-800-344-6716, or visit cnsa.com.

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