Deb Malkin's Story - knee pain and perfectionism

Welcome to the fourth episode of Your Stories

In these casual conversations, I talk to members of the chronic pain / TMS community, to discover what worked for them in their stress illness recovery. Watch the video above or click through to YouTube using the button below the video, to watch there if you prefer.

In this episode, I talk to Deb Malkin, who shares her fairly recent recovery story of recovery from knee pain, but also many years of self-sabotaging thoughts and criticism on how her body was functioning. Watch her interview above, or read about her story and testimony below in Deb's words:

History, symptoms and the impact on my life

I have had on and off chronic knee pain since an impact injury in a movement training class years ago. But I recovered from that original injury and since that time I climbed Kilimanjaro and have done lots of hiking and as a bodyworker (massage therapist), in general, I do a lot of movement.

Suddenly last year my pain shot through the roof, I thought that I was on course for a knee replacement. I got x-rays that showed Osteo-Arthritis. As a fat person, I've had it drilled into me that my joints were going to be compromised by my weight, even though I have direct experience that has told me otherwise, that fear was definitely in there.

So right after the x-ray I found the work of Curable and Dr Sarno and took myself on a walk that created the belief in safety in my body. I unravelled a story that I was always getting injured, that I didn't know how to trust myself. After what I'm calling my "safety walk" I had a 50% reduction in pain and by the next day, I had 95% less pain.

Then I did a deep dive into this work for myself and I started changing the way I did bodywork with my clients.

Various symptom imperatives

I had the knee pain on and off for years. I had torn my meniscus on my left knee 10 years ago and had surgery but it took 2 years for the pain to go away.

When I was younger I had a round of plantar fasciitis that caused me to stop moving a lot. I've had times with a lot of chronic back pain. My pain was always attributed to my weight. I didn't believe I had a lot of options around getting out of the pain that wasn't related to losing weight. But every time I've lost a considerable amount of weight I've gained it back, sometimes with a lot more. I've since stopped tying together movement with weight loss and have rekindled a love of movement for its own intrinsic benefits and pleasures.

It was after getting rid of the knee pain in 2019, that my physical symptoms of anxiety went through the roof. I woke up 5 days in a row with vertigo. I had been having issues in my new relationship and I knew that my brain was trying to distract me from the stress with the vertigo symptoms. Thank goodness I knew that a symptom imperative was happening.

I stopped my symptoms each time within 15 minutes by telling my brain, 'we are not doing this'. It actually listened!

My current anxiety symptoms have been happening since June. They were much worse in the beginning. There was a time I thought I was possibly dying.  I have been deep in eldercare since March 1st and had to leave my work and home to care for my father after he fell and broke his hip. It's been a very challenging experience. I was right to screen to rule out medical issues, but I am also aware that I have a tendency to somaticize my stress and have been treating my physical symptoms like TMS with slow success.

Creating my online coaching course and coaching program has been a huge stressor which amplified my symptoms but also gave me a lot of opportunities to work with my mind and beliefs. It's helped me invest more time and energy into non-judgement and self-compassion practices and more meditation.

Fast forward to this pandemic. I've been having a lot of anxiety symptoms like chest and neck tightness. I got screened for thyroid nodules/cancer, clogged carotid arteries, a pulmonary embolism and heart disease. All my tests came back normal and I'm still experiencing symptoms although they're much diminished and on occasion, they're gone. I had a good 2 weeks of smelling cigarette smoke every day even though no one was smoking around me. That was pretty disgusting.

My personality traits are bang-on typical TMS

I am very much a people pleaser, perfectionist, all-or-nothing thinker.  I have a lot of thoughts about what other people are thinking of me. I really need to have other people think of me as helpful, kind, or a good person. When I became a bodyworker/movement teacher I found myself getting stuck by believing that it was my job to fix other people. 

And I needed to be healed so I can help others. I created a lot of pressure on myself, a pressure that was impossible to live up to. My ex-partner has intense chronic pain and my desire to help her created so much conflict in our relationship that it ended. 

My favourite mind-body resources

I've listened to a lot of podcasts - The Cure for Chronic Pain with Nicole Sachs, Eddie's Mind & Fitness podcast, joined Curable. I enjoy Dan Buglio's YouTube videos. I really value Alan Gordon's work and worked with a therapist from the Pain Psychology Center for a little while which was very helpful. I've definitely sampled it all. I read some of Dr Sarno's books and have read Nicole Sach's book. 

I am a part of a coaching community from Kara Lowentheil called The Clutch which has a particular style of self-coaching work that has been very helpful in understanding the links between my life circumstances and thoughts and feelings. And lately, I've been inspired by the work of Mark Freeman and his book called You Are Not A Rock which gets into the compulsive thoughts and desire for control that I believe is behind a lot of my catastrophizing and physical symptoms.

Now that I'm working with clients doing pain coaching, I completed the PPDA course and took a class for hands-on practitioners with Charlie Merrill and Dr. Schubiner.

One of the more interesting books I've read recently which is helping me bridge the gap between what feels like two camps of viewing pain in relationship to Adverse Childhood Experiences and Trauma and that of a more pure Neuroscience lens is How Emotions Are Made by Lisa Feldman Barrett which discusses the idea of the predictive brain and how we create meaning/story with our thoughts but what the body is actually trying to achieve is to manage its sense of homeostasis and the brain can misinterpret the neutral messages that it's receiving from our senses and deliver us pain or other symptoms.

Key Milestones for me

I believe strongly that the messages that fat people receive around their bodies and weight has strong nocebo effects and that it is medical negligence for the medical world to believe that instilling fear is any kind of useful medical treatment. I've had to do a lot of internal work on untangling my beliefs about what is possible for my body to do and that when I feel instances of pain, it's not always true that I am overloading a joint or that there's a biomechanical problem happening.

In my study of biomechanics, I realized I was training my mind to be continuously scanning and scrutinizing everything that was happening inside my body. My interoception skills were very high but it was also like a broken alarm bell going off every time I noticed something. That alarm bell was sensitized by the biomechanical model of musculoskeletal pain, weight stigma, thoughts about ageing. 

Advice and suggestions

Practice surrendering. Practice unravelling your pain stories, when something hurts what are you making it mean about you as a person. Practice delivering your body-mind a sense of safety, not just in your body but for your whole wellbeing.

Share your story

What an incredible story, and relatively fast recovery thank you, Deb. You can find Deb here on Instagram. I hope you enjoy this video and testimony! If you'd like to submit your story for this series, please click here, whether you're comfortable on camera or not, I would love to hear from you.

Check out my Recovery Journey Roadmap if you would like more details about exactly how I became chronic pain free. Find out more about my Yoga for TMS classes that we discussed in this episode and follow me on Facebook or Instagram for more resources and updates on everything chronic recovery.