Bite Back with Abbey Sharp - "Doctors Couldn't Explain My IBS Symptoms - Until A Psychologist Did" - How Stress & Trauma Makes You Sick with Dr. David Clarke

Episode Date: October 21, 2025

Here’s a run down of what we discussed in today’s episode:IntroductionWhat Exactly Is Stress Illness?Common Physical Symptoms with Emotional RootsHow Dr. Clarke Became the Mind-Body DetectiveDiagnosing Stress Illness: It’s Not ‘All in Your Head’How Childhood Experiences Shape Adult PainParenting and Prevention: Raising Resilient KidsTreatment Strategies That Actually WorkReal-Life Recovery Stories That Will Blow Your MindHealing the Mind-Body ConnectionCheck in with today’s amazing guest: Dr. David ClarkeWebsite: stressillness.comDisclaimer: The content in this episode is for educational and entertainment purposes only and is never a substitute for medical advice. If you’re struggling with with your mental or physical health, please work one on one with a health care provider.If you have heard yourself in our discussion today, and are looking for support, contact the free NEDIC helpline at 1-866-NEDIC-20 or go to eatingdisorderhope.com.  🥤 Check out my 2-in-1 Plant Based Probiotic Protein Powder, neue theory at www.neuetheory.com or @neuetheory and use my promo code BITEBACK20 to get 20% off your order! Don’t forget to Please subscribe on Apple, Spotify or wherever you get your podcasts and leave us a review! It really helps us out. ✉️ SUBSCRIBE TO MY NEWSLETTERS ⤵️Neue Theory newsletterAbbey's Kitchen newsletter 🥞 FREE HUNGER CRUSHING COMBO™ E-BOOK! 💪🏼 FREE PROTEIN 101 E-BOOK! 📱 Follow me! Instagram: @abbeyskitchenTikTok: @abbeyskitchenYouTube: @AbbeysKitchen My blog, Abbey’s Kitchen www.abbeyskitchen.comMy book, The Mindful Glow Cookbook affiliate link: https://amzn.to/3NoHtvf If you liked this podcast, please like, follow, and leave a review with your thoughts and let me know who you want me to discuss next!

There are 50 million people in the United States alone, one in five adults who are suffering from this, and they don't have to. Welcome to another episode of Bite Back with Abby Sharp, where I dismantled die culture rules, call out the charlatans spinning the pseudoscience, and help you achieve food freedom for good. If you've ever gone to the doctor with a complaint or pain, only to be told, it's all in your head, you're not alone. The global prevalence of physical pain is on the rise, from 26% to 32% from 2009 to 2021. And unfortunately, not a lot is being done about it. Some reports estimate that between 25 to 50% of all patients in primary care present with symptoms that can't clearly be linked to an organic physical cause, which ultimately, makes treatment either inadequate or non-existent.

Joining me today to unravel this massive medical mystery is gastroenterologist and author of the book, They Can't Find Anything Wrong, Dr. David Clark. Clark has spent his career digging up cold cases on patients' unexplained aches and pains. While other doctors would have brushed off folks' symptoms as being imagined or fake, Clark has called it out for what it is, stress illness. Also known as psychophysiologic disorders or PPD, stress illness causes real physical symptoms that are either triggered, worsened, or maintained by emotional stress rather than a structural or organic disease. Common stress illnesses include migraines, IBS, psoriasis, and vaginismus, just to name a few. But I'll give a more comprehensive list at the end of the show if you're curious about where your pain lands.

Today, Dr. Clark and I are going to talk about how to diagnose and differentiate stress illness from general stress or pain of physical origin, the role of childhood trauma and early experiences in a lot of unexplained ailments, strategies for parents for preventing future PPDs, and how to treat these ailments when everything else has failed. Dr. Clark will also be sharing some wild success stories that will honestly blow your mind. if you've ever been gaslit by a health care provider that your physical pain or symptoms are in your head this episode is for you now a quick reminder that the content in this episode is never a replacement for one-on-one health care advice so always speak to a health care provider

about your unique symptoms and concerns all right folks let's get into it all right dr clark thank you so much for joining me great to be with you abby thank you so much so much so most of us know that stress isn't great for our body you know it can suppress our immune system it can negatively affect our hormones or sleep our heart weight everything but how is stress illness different than the negative outcomes that you know we all know and expect from chronic stress Yeah, there's a whole other category, unfortunately, that we have to think about. But the good news is that there's a lot we can do about it. But we'll start with the idea that most people have, which is the assumption that if you've got pain or illness, you must have an organ disease or structural damage that explains it. And it turns out that that's not true. It turns out there's a whole other category of causes of real physical symptoms in the body, literally from head to toe. And that's a is brain-generated symptoms. Symptoms that come about because there are changes in the nerve circuits in the brain. These are not, quote-unquote, in your head. These are actually based on

physical changes in the structure of how the brain processes signals. And you can get migraines from this, ringing in the ears, dizziness, temperamentibular joint problems, swallowing difficulties, visual disturbances, fibromyalgia, many cases of long COVID and chronic fatigue. irritable bowel, pelvic pain, bladder spasms, back pain is a huge one, certain kinds of rashes, brain fog. I mean, the list just goes on and on. But the good news is if you know what to look for, you can uncover the psychosocial stresses in a person's life that are responsible for these physical changes in the brain, and you can successfully diagnose and treat them. So there are 50 million people in the United States alone, one in five adults who are suffering from this. And they don't have to.

And that's really hopeful news. And I need to kind of understand how you got here because, you know, you started your career as a gastroenterologist. And I've been going to, you know, gastroenterologist for years because I have IBS. And, you know, I get my colonoscopy and assuming there's nothing physical to see, they like right on my form, symptoms are from stress. And then off I go, no, you know, roadmap of what to do about it. How did you end up being like the go-to guy for these like pain cold cases? Yeah, that's the unfortunate thing is that doctors are not trained to take the next step. And I wasn't either. I mean, it's embarrassing to admit this, but I went through very traditional Western training in medicine, four years of medical school and then three years of hospital-based

residency for internal medicine, and then two more for gastroenterology. And it was only a only in the eighth year of all that that I first discovered that this was even possible. I mean, I had the training that, you know, it's organ diseases, it's structural damage, and that if somebody's got stress-related illness, well, you know, they're probably not very strong mentally. They're probably neurotic. There aren't very many of them. You can't diagnose them. There's nothing more for us to do if you've got stress-related illness. You're just going to have to live with it. And it turns out none of those assumptions is just, true, in fact, for most of them. The exact opposite is true. And I found out this, you know,

because I encountered a patient, I didn't know the first thing about diagnosing or treating, which is a bit of a shock when you're eight years in. But that's what happened. There was a patient 37 years old who was averaging one bowel movement per month for two years. And the other university that was evaluating her could not find anything wrong, which happens to be the title of my first book. They can't find anything wrong. And they sent her to us for some specialized testing. That was also normal. I was doing her exit interview and stumbled on the fact that she was dealing with a severe stress, which happened to be from her childhood, which turns out to be a very common phenomenon. People who went through adversity as kids, and it's still affecting

them many years later. One of my patients, it was affecting her at age 87. But I didn't know what to do with that. I had no training in that. Again, kind of embarrassing that, you know, so many millions of people suffered adversity when they were young. And nobody had told me I should be looking for this. Nobody had told me what I should do about it when I found it. But there was a psychiatrist at UCLA where I was in training. Her name was Harriet Kaplan. I knew she had an interest in this. I sent this patient with this horrible constipation to her thinking, you know, maybe she might learn how to live with this a little better. The last thing I expected was to, when I ran into Harriet three months later in an elevator, elevator ride that changed my career, I found out she had cured this patient

with less than three months of weekly counseling sessions. And that just shocked me. I mean, the idea that you could alleviate a serious, real physical symptom just by talking to somebody. Again, nobody had ever mentioned, even hinted that such a thing was possible. But Harriet became a mentor for me and gave me a framework for how to think about this. I started using it in my practice and people were getting better. And I really professionally and personally loved to be able to do that. And now, you know, sitting here today, 7,000 patients later, three books, three documentary films, the Association for Treatment of Neuoplastic Symptoms, which is our nonprofit at Symptomatic.me. All of these things have come from that.

Wow. What a success story. And like you mentioned, most doctors just are not trained in, you know, the role of the mind-body connection. So, you know, it sounds like a lot of folks who end up in your office have probably spent their entire lives being gaslit into believing that their pain or their symptoms are in their head. They're not real. Are there any sorts of biological or physiological evidence or biomarkers of stress illness that patients can like show to the physicians to, prove that it's not in their head, or is this more of a diagnosis of exclusion? It is a diagnosis of exclusion, but if you've got symptoms, they're real. I mean, there is no pain that is imaginary. All pain actually is generated in the brain. If you whack your thumb with a hammer, you're not feeling that, you know, the pain signal is not generated in your thumb. A damage signal is generated in your thumb, and that goes up to the brain, and your brain has to actually decide if it's going to give you a pain signal. And if you whack your thumb with a hammer,

it's going to decide to give you a pain signal. But if you sprain your ankle while you're running from a predator, it's going to decide, you know what? You need to get to safety. I am not going to give you a pain signal until you are in a safe place. So that enables you to keep running as fast as you can to get to a safe place.

And then it's going to decide, okay, now it's all right for you to get that pain signal. So these are all generated in the brain, but they're 100% real. And the level of severity that you can get from this process is every bit as significant as people with organ disease or structural damage. One of my patients, for example, had a completely paralyzed stomach, not the abdomen, but the organ of digestion. The muscles were completely essentially frozen. And I know this was from stress because when we uncovered the issue that he was dealing with, stomach went back to normal. Another patient I was asked to see, this was a 17-year-old girl,

I was asked to see her on her 70th day in the hospital. She was getting massive doses of morphine around the clock for unexplained abdominal pain that she'd had for the previous year and a half. She had already seen six other gastroenterologists, but it also turned out to be 100% stress when the issue was uncovered and the family dynamics were altered favorably. She began turning down her own morphine dose. She was out of the hospital in a week and she was off of all opioids in 30 days. But you're never going to convince a patient like that that her symptoms weren't real. So there's tremendous hope here, but you have to know what to look for. Wow. And so this actually just got me thinking how you're describing that, you know, all pain is in the head. And we often

hear colloquially people say, oh, I've got a low pain tolerance. I've got a high pain tolerance. does that say anything about the state of the brain or mental health or anything like that if you have a low or high pain tolerance? I would guess that most people who feel like they have a low pain threshold or low pain tolerance are probably dealing with one or more sources of stress and they can be in the present day. One of my patients, this is embarrassingly simple, but none of his other doctors had asked him about this. He only got his pain when he was driving to work. you know, when he was driving home from work, he was fine. So that kind of gives you a clue about where his condition was coming from.

Other people, it's, you know, slightly more complicated. A patient with 25 plus years of daily low back pain. You know, once people found out I was taking care of these mystery cases, they started sending me patients who didn't even have a gastrointestinal condition. And this man had unexplained back pain, his spine x-rays, even though he was in his 70s, really didn't look that bad. But he told me, and this was the giant screaming clue, that two weeks out of the year, he felt fine.

He had no pain. And so what was he doing during those two weeks out of the year? You can probably guess he was on vacation. So I didn't want to immediately jump to conclusion. I was thinking, well, you know, maybe he's lying on a warm beach somewhere and he's carefully resting his back, and that's why he doesn't have back pain. But that wasn't true.

He was actually fly fishing in British Columbia, and of course, he's, you know, waiting out into the stream, and he's twisting around to cast the rod, and he's bending down to net the fish, and then he tells me at the end of the day, he helps the lodge owner clear brush from behind the lodge. And is he having any pain when he's doing this? Not a bit of it. So clearly not structural back pain. And then there's a, you know, the biggest single category is people who went through some kind of adversity when they were children, a parent being an alcoholic, for example. It can be much more subtle than that. It can be anything that makes you feel like you're less than as good a person as others. And that turns out to be very, very common as well. Yeah, I wanted to ask more about that because, you know, and, you know, I'm listening to you talk about some of these case studies and I can identify some with IBS. You know, I know that there are certain situations that going into, I'm going to have an IBS flare. I'm going to feel nauseous. I'm going to, you know, just all of my symptoms flare up.

And it's like clockwork every single time it happens. So I totally fully appreciate that mind-body connection, especially with the gut, right, the bi-directional gut brain axis and the stress can impact digestion. Our gut microbiome can affect our mental state. And so this childhood trauma piece and early life stressors, can you give us more information of like how how does that kind of play a role in future adult stress illness like years and years and years down the road like what is happening to because obviously we can't go back and change we can't change what happened to a person in the past but we absolutely can help people with

the long term impacts and those fall into three major categories one you've alluded to already which is triggers these are people situations or events that are in some way linked to the past, to the past experiences or past traumas. And consequently, they are highly stressful as a result. And the most common of those is an adult who mistreated you as a kid who is still in your life today. One of my patients had been hospitalized at a prestigious university 60 times in 15 years, and they had no idea why she was having attacks of severe dizziness and vomiting. She saw a dozen specialists.

They even had a psychiatrist interview her, who pronounced her mentally healthy. But it turned out all of her attacks were linked to direct or indirect encounters with her verbally and emotionally abusive mother. And as soon as I was able to show her that connection, she had one of these light bulb moments. I can still remember her looking up at the ceiling and saying, oh, my God, I can't believe it. And in her case, just recognizing that was enough to alleviate her symptoms. She never had another attack. Second major area are personality traits. Many people who grew up in challenging home situations developed certain characteristics

to help them endure that and survive that situation. And these include trying to be the best little kid you can be. And that can lead to being very self-critical when you. you fall short or being a perfectionist in some cases. Having low self-esteem is another one. People who are kids who are trying to solve an adverse situation are typically not going to succeed. And so they're going to feel like failures.

They're going to feel like second-rate human beings. They often choose close personal relationships with people who have problems and issues and need lots of support so they end up in unbalanced relationships. And a big one is that they are so focused on solving everybody else's problems in their world that they fail to put themselves on the list of people they take care of. So they end up living lives as if on a treadmill that they never step off. And sooner or later, the body is going to protest over that. And then the third major long-term impact of childhood adversity are the emotions.

And these are typically emotions that most of us would have if we were in an adverse. childhood situation, but it doesn't do you any good as a kid to express those, so they end up getting repressed. And when you learn how to do that as a kid, you get very good at it. So adults who experience anger, fear, shame, grief, guilt, they can experience those emotions physically when they're not aware of them consciously. So my patient who was admitted to that prestigious university all those times, this amount of anger at her mother for having verbally and emotionally abused her throughout her entire life. And she was 50 years old. But she wasn't aware of it. You know, she was telling me about her mother in the same tone of voice you'd used to read a grocery

list. But there was a tremendous emotion there. It was like she was a dormant volcano on the outside with boiling magma on the inside. And all that emotion was getting expressed physically. but she wasn't consciously aware of it. So I help people get connected with that, put those emotions into words. And the more you can put them into words, the less they need to express via the body. Okay, that is so fascinating. I have so many questions. I don't know where to start.

But, okay, so in some of these situations, like you mentioned a trigger, being a person, a parent, or, you know, you can't always so easily cut people or situations out of your life. I mean, sometimes you can, but sometimes it's hard. So, you know, what is the treatment here? Like, what are folks options for those who are struck with existing stress? One of the foundational treatments is that I want people to recognize. at a real level, how much they've, most of us, you know, none of us has a parallel life to compare ourselves with. And my patients, when they look back, they don't see it as being all that bad. And they'll tell me, you know, it wasn't so terrible. And other people have been through

worse than me. And I think I'm over it now. And so what I'll do in that situation is I'll ask them to imagine a child they care about, either their own child or another one that they know. and imagine that child is back in the home environment that the patient was in when they were a kid. And that my patient is then a, let's imagine, a butterfly on the wall of their childhood home, and they're watching this kid try to cope with that, even for just a week or 10 days. And people, when they think about that, when they think about an innocent child, having to cope with everything they did, you'll see their facial expressions change. They will get hit pretty hard by the idea of watching an innocent child have to do everything that they had to do.

And it gives them a much more realistic sense of the magnitude of what they had to overcome. And the purpose of that exercise is not to re-traumatize people. It's to help them appreciate the heroic perseverance that they must have had to come through that experience and to give themselves some credit. I like my patients to think of themselves as Olympic weightlifters who've had to carry 50 pounds more than the world record for their weight class. And anybody's body is going to break down under that kind of a load. And I'm trying to teach them how to see the load first of all and then to learn how to put it down. And it starts, again, with that realistic sense of, you know, you went through a lot more than you think you did.

And when you have that growth in self-esteem, that growth in appreciation for yourself as a result of this, then it makes it a lot easier to make other changes. You know, if you're in a relationship that's unbalanced, that, you know, you're giving a lot more than you're getting back. When you appreciate yourself for what you've been through, you're not going to put up with that quite as much. And if you've got somebody who is a toxic parent, for example, and you're struggling with, with how to set boundaries. If you feel like you as a person are worthy and that you deserve not to have to put up with the toxicity, it's going to give you a lot of strength in setting boundaries that protect yourself. If I have a time of story as a...

Okay. And I, you know, I'm a parent. And I feel like the crushing anxiety of just trying to raise like healthy, happy, successful, competent kids, all the things. And again, I'm definitely a perfectionist, but I feel like in a lot of ways motherhood has kind of like tempered my perfectionism because like kids are just so freaking unpredictable and uncontrollable at times. So I try to remind myself that we're just like all fumbling through this, just making mistakes as we go, just doing the best job that we can. But obviously I don't want to give my kids stress illness. So what can we as parents do today or do differently to give our kids the best chance of a stress illness free life? Yeah, perfectionism and parenting are not a good mix. You know, all of us

want our kids to succeed. All of us as adults can see when our children have fallen short. And it's very easy, especially, you know, for someone like myself, I'm very detail oriented in the workplace, obviously. But if I'm detail-oriented with my kids, then, you know, yes, I'm giving them advice and I'm helping them every little time I see them in an area where they could improve. But every time I do that, I am sending them a message that they're not measuring up, that they're not good enough. Excuse me, not good enough. And that's, you know, not a message that we want to send, especially for adolescents. One of the things that I am grateful to have learned from my patients is that when an adolescent goes out into the world, they are constantly hearing about their

shortcomings. They're getting it from their peers, from their teachers, from their coaches, or if they're in the arts, you know, for whomever their instructor is, they're constantly getting these messages on multiple dimensions, whether it's their clothing or their grades or their bodies, their facial appearances, you know, just an endless list of areas in which they can be made to feel their own shortcomings. And so what I decided, my wife decided, was that when our boys came home, we wanted our home to be an oasis of support. You know, definitely if there was a major transgression, we could let them know. But even there, they usually knew already. And, you know, often I would respond to that by just telling a story

about how I had messed up when I was their age. And, you know, just to let them know that, you know, making mistakes is part of life and that they were good kids. And even the best people make mistakes, even as an adult, even somebody highly educated and focused on details can still mess up. And, you know, that was a kind of a counterweight to the messages that they would get when they were out there in the world. And it was, the other side of it, too, is that I would notice whenever they did something well.

I wouldn't, you know, jump up and down or give them a medal or any of that. But I would certainly let them know that I had noticed when they did something well. And that was a strong motivator for them. And at the same time, I'm overlooking, you know, minor mistakes. Yes. I am admittedly so scared of, like, passing my own perfectionistic tendencies and traits on to my kids. I'm just constantly trying to, you know, celebrate the wins and normalize, even celebrate all the little like whoopsies and mistakes, you know, the beautiful oops as we call them.

But ultimately, you know, it is, it is so hard when life for kids these days like feels so competitive. But I try to remind myself that we obviously need to balance success on paper with six. in our kids mental state. Yeah, and it gives them a platform of confidence when they go out into the world and they face all the negativity. And it gives them armor against bullying. And it also gives them a platform to say no to doing things that are dangerous, stupid, or illegal. You know, because every kid, when they're out of your sight, they're going to have opportunities to do things that have those characteristics and what's going to make them say no it's having that that personal confidence that they get from their parents and this this is hard i mean you know you just said it

yourself how hard this is you know when i'm being such a detail oriented person in the workplace to switch that off when i get home and i had practically had to choke myself sometimes not to say anything but it was for the best yeah oh that's amazing and such a fascinating conversation. I really appreciate all this insight. And of course, I'm going to be leaving some links below to where people can learn more and also to your book, they can't find anything wrong. So thank you so much for your time again. Thank you, Abby. I appreciate your sharing this with your audience. Okay. As an IBS girly who can absolutely see the connection between my mental state and my digestion, this was a fascinating conversation to unpack.

I want to close off here just with a more comprehensive, but certainly not complete list of ailments that may be considered potential stress illnesses, just as a jumping off point for conversations with your physician. So the first category are the neurological and pain disorders. So these typically include tension headaches, migraines, chronic back neck and shoulder pain, fibromyalgia, TMJ, tingling or numbness, and chronic fatigue syndrome. Then we have our GI disorders like IBS, functional dyspepsia, chronic nausea, and reflux. There may also be cardiovascular or respiratory symptoms like heart palpitations, situational hypertension, cardiac syndrome X, hyperventilation syndrome, air hunger, or chronic cough,

dermatological conditions like eczema, psoriasis, unexplained itching or hives, and hair loss, and genitone urinary symptoms like chronic pelvic pain, vaginismis, painful bladder syndrome, and erectile dysfunction. Keep in mind that in a lot of cases, there can be interplay between physical and psychological origins for a lot of these conditions. But if all physical origins are ruled out, a deep dive into one's hidden stress may help determine next steps. In Clark's book, he shares a brief questionnaire to identify the role of hidden stress in your symptoms

with questions like, how often do you neglect your own needs because you're taking care of others? In the past month, how much have you been bothered by repeated, disturbing memories, thoughts, images, or dreams of a stressful experience? And most provocatively, how would you feel if you discovered that a child you care about was experiencing everything that you did as a child? As the prevalence of chronic pain increases and the opioid crisis continues to take lives, research on stress illness is going to be paramount. And I'm so grateful to have Dr. David Clark's contribution to this field and, of course, our discussion today.

If you like this episode, please don't forget to share and subscribe and also leave me a little comment and a five-star review if you enjoyed it. But I'm signing off with Science and Sass. I'm Abby Sharp. Thanks for listening. Thank you.