Your Daily Routine to Manage Pain, Stress, And Anxiety (Really)

This is an annotated transcript of my recent interview with Meredith Arthur, which you can listen to here. Read on for a super-practical, highly effective daily plan.

Morra: I'm so happy to see you always. You are the person whose content and contribution I find literally the most valuable in managing not just my anxiety, but my physical pain.

Meredith: Honored. One word response, honored.

Morra: I'm sure I'm not the only person who would say that. What I wanted—we've talked many times before, but I wanted to sort of have a little bit of a session that I'm calling What Morra and Meredith Do to Manage. Because you wrote—and listeners, please go check out Meredith's site—you recently wrote this series that you called the ultimate stress relief cheat sheet, three articles that are like a go-to guide. Why don't you orient us really quickly around who you are and why you do all this research and write what you write?

Meredith: It's a good question. One that I ask myself frequently. I am a wife, mother, and tech worker living in San Francisco. I work as the chief of staff of a product incubation lab at Pinterest and have been jumping around this world of content and product and tech for a long time and have been in many different work situations. Through that process, I've been forced to learn a lot about myself. In particular in 2015, after a series of startup adventures and misadventures, I was diagnosed with generalized anxiety disorder. Learn more about Meredith here: https://bevoya.com/about. I created Beautiful Voyager, which is a content site and community for overthinkers, people pleasers and perfectionists. And wrote a book called Get Out of My Head, Inspiration for Overthinkers in an Anxious World. That came out in March of 2020, which was an interesting time to release a book. My journey has never ended. I spend time working on a nonprofit with the founder of Pinterest, Ben Silbermann. The nonprofit is called How We Feel. It is a free emotion tracking app meant to help build emotional literacy. Along with Dr. Marc Brackett, who I work very closely with, I've been very lucky to spend a lot of time with a variety of academics. As well as non-profits. I've had an unusual seat of learning, and I am extremely curious. I get a lot of energy and motivation from learning. Through this process, I've just been very proactively trying to learn and understand what does anxiety mean? What is perfectionism? Where do these things come from? More importantly, what are we supposed to do about them? I'm almost 10 years into this now, spending a lot of time experimenting on myself, talking to others who are experimenting, trying to learn what it takes to get better. In the past year, I feel like I finally have hit some very sustainable new approaches.

Pain is at the center of this for me. Pain has always been at the center of it for me, but I never articulated it well. The weird thing about pain is it's the same thing whether you're having an emotion or a thought that's inside of your head that is painful—emotionally painful—or that same thing is expressing itself through your body in chronic pain.

Morra: Physical pain.

Meredith: That's all the same thing. It's a matter of understanding how to read that signal, to understand what you're supposed to do with this, wherever the pain lives. That has been just a major unlock for me to understand what this pain was and what it was trying to tell me.

Morra: It's trying to tell you something. In your philosophy behind your incredible cheat sheet, you say that if you can stop your nervous system from trying to protect you, you'll lessen your pain and quell your anxiety. Teaching yourself you're safe is where this work begins.

Meredith: I had no idea until I did. And then when I learned that, everything changed. So it was like a before and an after of understanding that I really only have one goal - introducing more attention into my nervous system or learning to find safety internally in order to navigate everything that comes up in every human life. What is my window of tolerance, which comes up in the piece - the window of tolerance is your ability to navigate all of the things that are inevitably going to come up every single day of your life and your ability to move through, to allow your nervous system to have its response, which it is supposed to have. It's supposed to protect us - to be able to move back into what nervous system people call regulation. So just sort of a state of flexibility. Polyvagal theory gets into this deeply - there are different states of our nervous system. Understanding how to navigate those different states and read them in yourself. If you are in this dorsal state in polyvagal theory, dorsal (meaning back), meaning I'm flattened, I'm laying down, I'm almost playing dead. I was in dorsal for quite a while. It doesn't mean it's singular, you're moving back and forth, but if a lot of your time is spent in that state, you're dysregulated. Or you've heard about the sympathetic nervous system where fight or flight, you're stressed and tense and anxious.

If you're just flying back between those two, which I was for quite a while, you're never in a regulated nervous system state. Everyone thinks they want to be in ventral all the time. It's just not how the nervous system works. We're supposed to go into these different states. Things are coming up. But ventral is the one you want to bring a lot more into your life, interestingly, socially connected. So you start to understand, as I start to feel better, as I'm more regulated, I want to see people, I want to connect with people. And you can start to read these things in yourself as you understand the framework.

Morra: I want to talk about polyvagal theory. I want to go through your day because I think that's a really great way to structure it. I want to say though by starting out that the thing that really changed a lot of my nervous and anxiety life was polyvagal theory years ago with Captain Tom Bunn, who is a former airline pilot who is a social worker and therapist and early proponent of polyvagal theory. The thing that he taught me and his book Panic Free, I talk about it all the time, listeners, if you have trouble flying or being claustrophobic or just dealing with panic where you get extremely hyper aroused and upset and dysregulated - it's basically the simple exercise of connecting someone I love to a feeling state that stresses me out. I always say this, when I couldn't fly when I was a new mother, he taught me how to summon oxytocin, the love hormone. And when we have oxytocin flooding in our body, we cannot feel stress. I would be on a plane, I would look at a photo of my baby, and I can feel a letdown, like I'm about to nurse that baby. I can do it right now. I can look at a glass of water. I can look at a pen and I can summon that feeling. Now I've been doing this for probably 12 years. It's been the single biggest trick because polyvagal theory means we are summoning that relational love that lowers our stress, right?

Meredith: That's amazing. I had no idea that you had been using this for that long. Because what you're trying to do is - our brains are incredibly plastic. They will imprint, they will take on information. If you read about side effects of something and you think you may have it, your body will conjure those side effects. That pain could come from that sort of place - that's how smart and incredible our brains are at trying to protect us. And what you do in that moment is to create a different internal space. You're shifting yourself intentionally. That's a strategy to help you shift into ventral.

Morra: Absolutely. And also, I just want to say one thing. You do not have to be a mother who has breastfed a child to feel this. You can see the face, the voice, the touch of your dog, your father, your spouse, your good friend. I had a friend who used the method. She couldn't go on the New York City subway after the pandemic, and she trained her subway claustrophobia with the image of her sister who she loved singing a silly song.

Meredith: That's so beautiful. If you are listening to this right now and you just have one of those beings - I'm looking at my dog right now - you can bring that to your mind. I know that you can feel it. What many people and what I never knew is to pay attention to it, to understand that I can do this intentionally. I can make this decision and I can sort of have a goal. That was really what I was missing. I didn't understand any measurement and I didn't understand goals around this kind of stuff. And now that is how I think about these things. These are really important tools to get out of pain, to help yourself move through pain.

Morra: Should we talk a little bit about polyvagal theory before we go into your day, or should we just dive into your day? What does Polyvagal Theory mean? Why are these exercises effective for you?

Meredith: So polyvagal theory is just one leg of my tripod. When I wrote this ultimate stress relief cheat sheet, I was very hesitant because I thought, okay, now I'm really showing everyone just how in depth I get into these things. And there's this copious information coming forth. I showed it to my husband before I sent it out. And he said, this is actually pretty good. This is really helpful. This is actionable. And then I sent it out nervously. I mean, anyone out there who's listening, who's a writer, you know what it feels like. I haven't read things like this out in the world. They're in pockets for sure. But I haven't read them in this kind of way. And then I got a text from Morra. You read it so quickly and it made me think, you know what, that's all I need. All I need is to know that I'm able to connect with people who understand this world. That's my audience anyway. And so that felt really good. So thank you so much for that. And Polyvagal was one of the three legs of the tripod and the other two are clinical somatics.

Meredith: Clinical somatics, which is a practice of movement, very slow movement that I do in the morning to release tension from my muscles and to give my brain a place to land. Mornings have always been my most anxious time. And for years before my daughter was born was doing a special form of Ashtanga yoga called Mysore. I would get up at 5 a.m. and do it and I always felt really good and I was like, yoga's so amazing. But in retrospect, I realized I always need something. I need something to start my day that centers me, some practice that I can just go to in an almost automatic way. Bringing that back into my life has been just an anchor. That's how the day starts.

And then I incorporate polyvagal exercises into it. And the goal of that is - you may have heard of EMDR, there are eye movements involved. This stuff can sound a little strange if you haven't sort of dug into it. You're thinking, what, I'm gonna move my eyes around and that's gonna change how I feel? It does, it does, it does.

Especially for somebody like me who has some nausea and other issues, it really is helping my vagus nerve basically to function in the best way that I can. And then the third leg of the stool is mind-body syndrome. This is a whole world of work around pain management basically. It starts with Nicole Sachs, who is a disciple of John Sarno. You may have heard of Dr. John Sarno, he did back pain treatments in the 70s and 80s, well through till his death, was a very important figure in this world of mind body science who asserted that basically our nervous systems will make up the space. If we have emotional pain that our brain has decided is dangerous, it will invent new ways for us to feel pain.

Morra: So I want you to talk us through your day. And I know you'll narrate it with resources. I also just want to say for the audience that for me, early morning is my best, least anxious time. The past few years since I sort of stopped drinking, wake up feeling full of possibility. I look forward to my coffee. So I give myself the morning off from exercise. Everyone's different. For me, it's nighttime.

Meredith: Everyone is so different. And that is crucial because culturally, our cultural understanding is this is what happens if you get sick, you do this and you get better. It's not exactly right for emotional well-being, mental health. It's more individual, it's more confusing just as our human brains and our human experiences are so individual. It's so much trial and error, which is why I'm always saying I'm experimenting on myself. If this is better for you in the evening, again, you have to change and clinical somatics may not be for you. Every single person needs a sense of safety internally. That is true universally. But everything about how to get there, how people interpret that, that changes, for sure.

Morra: So, clinical somatics, you wake up.

Meredith: Yes. Okay, so I usually wake up around 5:30 and in the sort of 5:30 to 7 a.m. zone is my practice. So I go into a room, I unroll my yoga mat and over time it's been evolving. It started with me just simply following Sarah Warren's clinical somatics, which I'm linked to and I've done interviews with her.

She is second generation. So the first generation of somatics was Thomas Hannah. He was incredible. He died in a car accident way too young. It's taken time for this understanding of the body and muscles to start to percolate out. So the idea is that for some of us, our muscles are sort of in a hypertonic state. That just simply means it's not fully clenched and tense. It's not fully relaxed, we're sort of like stuck in the middle, which I always felt, but I never had words for.

Morra: I'm literally feeling my trapezoid right now, which is locked up.

Meredith: And so there are many exercises to work on the trapezoids. For example, I did trapezoids this morning. It is not that complicated. The words I'm saying may sound complicated. It's very easy to follow. Sarah Warren (Here is the website.)

Your job is to move very slowly to tense your certain muscle groups, understand what you're focused on, be focused on that muscle group, tense the muscle, and then very slowly relax it. And you're doing that throughout your body. There are two levels of the course, and then you can sort of play with doing different exercises on your own. And so in the beginning, I just followed exactly what she said. And the program is, we're gonna start by learning this, you're gonna do this for three days, next you're gonna do this for three days, until you're getting to a point of facility and understanding.

In the beginning, it's like Dennis Quaid in Inner Space. It was a very long time ago, but I remember it from my childhood, and it was a movie where they were scientists who were shrunk into a tiny capsule and inserted into someone's body and moving around inside the body. And the idea was like inside the body is as surprising and confusing as going to outer space. That's how I feel doing somatics, like what, there's a whole world in here. What is this connected to? And so I started learning how the muscles connect to each other.

What's my attention as I'm thinking about relaxing? Am I allowing it to relax? What does it feel like? You spend some time in the beginning just feeling what you're feeling and then at the end again, you're checking in to be like, how did it change? What changed? So every morning I do that.

Morra: And the course is online, right? You didn't have to go to a fancy spa to do all this. If you want to, you're welcome.

Meredith: You don't have to go to a fancy spa. You can do it. And I think that is one of the things that kept me from finding these things is I never knew where to go or what to do. It's very clear to me now, but it took a lot of trial and error to get there. And finding clinical somatics was the result of being in terrible hip pain, Googling, finding a book that dealt with my exact iliopsoas issue by Sarah Warren, buying it, not touching it, putting it on a shelf. Again, this is how it goes, right? Until it got worse and worse and worse. And I couldn't, I didn't know what I was gonna do. My husband was like - maybe hip replacement? So then I got desperate enough to read the book and Googled again, found this course, did the course and realized, hey, wait, this is changing my relationship to my body. This is changing how I live inside of this body. And that's where it went. The course is online. I think it's $40 for level one. That lasts a month and a half. You do it every day. It's around 20 minutes to a half an hour a day. And if it starts working for you the way it did for me, you'll probably want to do level two as well. Then you have it forever. So you've spent something like $70 total, and this is knowledge you have for the rest of your life.

Morra: So you do the somatics in the morning, and then do you also do polyvagal exercises while you're on the mat?

Meredith: Yes, I do. Over time it's evolved. I've started to incorporate polyvagal into my exercises. So it's sort of a hybrid somatic polyvagal as well as breathing. There's a breathing element at the end, which I go into. Brecka breath. The reason that breathing is so important is that if you tend towards an anxious state or your disposition or your physicality leads you there, dysregulated nervous system, you probably are not getting enough oxygen. You're probably not able to relax and deep belly breathe. I didn't even understand belly breathing. I had to learn how to do all of this. I had to learn to relax my belly. I was not taught to do that.

Morra: Told to suck our bellies in our whole lives.

Meredith: Exactly, and people would say words and I was like, I don't understand what that means. But now I had to learn what it feels like. The first thing I do if I start feeling really tense is to just let the belly out.

Morra: Make a pot belly.

Meredith: Almost like a pot belly and you're not totally pushing it - basically you're trying to allow your diaphragm to - the diaphragm's like a bowl. The diaphragm contraction is flat and that pushes your belly up. These are the kinds of images I needed to have to be able to do this. Everything that I talk about is widely available out in the world. The thing that I try to do is to just tack on a little bit of detailed, digging through reality of like, this is actually what it feels like. This is actually what it took for me to do it. That's what I feel like my addition to this work is.

Morra: Know, but it's so valuable. Let's talk for a minute about the basic exercise.

Meredith: The basic exercise is a polyvagal exercise written up. I learned about it through Stanley Rosenberg. Stanley Rosenberg is a disciple - we're in the second generation terrain. A lot of this stuff was being discovered or learned in the seventies and eighties. And now we have the second generation, second wave that's starting to really interpret it. I'm also excited about the third wave, which I think will be integrating mainstreaming. [Rosenberg] trained as a Rolfer, like very connected, the viscera and working on the viscera and the relationship with the viscera. People that are into this world are like, yeah, of course.

Morra: So I just am throwing this out there for the audience to say that if you feel like physical manipulation is kind of your jam, like if you like going for massages, have a look into all these different kinds of body work because they are connected to the nervous system stuff.

Meredith: You know what's so strange though? I had craniosacral treatments for years in my 20s when I lived in Seattle and was having terrible migraines. I'm not sure if they helped me or not. If they didn't, I will say that I think one of the reasons is that I didn't understand how they were supposed to help me. And the brain - the neuroplasticity of the brain means that our understanding and connection and belief actually makes a huge difference. Belief is everything.

One of the things that I had to do as I was starting to write about this was to accept that there are things that I will be talking about that will cause skepticism in people. I understand that, I accept that. I am married to a very skeptical person. I am a skeptical person, but at some point I understood I will not heal unless I start to truly believe in my tripod, in how these things work. And I'm gonna believe so much that it is gonna be unshakable. And it has worked.

So I think that that element has to go hand in hand when we talk about these treatments, because I think that - and I'm not saying just make yourself believe, that is not gonna work. This has to be so authentic within you. You have to deep down wrestle and think about, or whatever path you use. I'm so cerebrally oriented that I have to really understand the mechanics to believe.

Morra: I'm not. I just believe. I don't think so because you have the discipline. I fall off on the discipline because that is the thing is that you have to do this crap.

Meredith: You have to do this crap. You have to do this crap a lot because you're right, we've only talked about the morning and that is really intense. So basically, I do the morning practice, which ends around 7:15, get my daughter to school, and walk the dogs before my work day starts. My work day usually starts around nine. I'll walk - my last newsletter was about walking.

It's not a sexy topic, but walking actually is incredible for us. Try to walk. What has helped me commit to more walking is a mechanical understanding of the body and understanding how to lower the barrier to entry for myself.

So there's that, then the workday starts. Things are happening, coming in and out. Now, what has changed in the past year about my workday is that I am very intentional about shifting gears throughout the day. Small, steady changes are what help with nervous system dysregulation. This means that any time I notice myself start to get tense, I start to feel the trapezoids like you are, there is a like, okay, we gotta chill it out. What are we gonna do? Are we gonna take five minutes and do a jigsaw puzzle at my table? What am I gonna do to get myself into - again, it does not matter what the action is. All that matters is what's happening internally. Can I get myself into an internal place of a little more ease? And then I can shift back to doing work, but you're basically teaching yourself to shift.

To down regulate, there are different ways of putting it, but yeah, so that happens all day long. And then usually at the end of day, walk again, walk the dogs. And then there's a food component that I'm working on as well. There's a lot of different layers of this. And I don't want anyone to listen to me like, that's overwhelming. That's just so much work. Because it is more about learning to incorporate what works for you. Each person will have different needs and you can start real small. You can start with just some small things to try, knowing again, all that matters the most is that your goal is internal safety. Internal safety is what you're going for. So maybe it's journaling, and definitely journaling practices are important, especially when you're dealing with all of the emotional pain that can come alongside physical pain.

Morra: Talk a minute about that. You use Nicole Sachs's methodology of journal speak?

Meredith: I do journal speak, probably I could do it more, but again, how much time can I spend a day on all these things? But I tend to use Nicole Sachs' journal speak if there's something that is really triggered or flared, if sort of out of the blue, something hits me. It's all about what's the regulation strategy here. Sometimes the regulation strategy is physical. Sometimes it's emotional. If it's an emotional regulation strategy, I'm tapping, I'm journaling. There are all of these different - this is what's so fascinating to me is like, it's like a world. Once you start to, it's a spectrum of many colors that you can try to play with to understand. It smells, that's huge. If you understand the impact of the senses on the nervous system, the same as you described that beautiful image of the oxytocin as you thought about your son. We can transport ourselves with smell, a coffee house. Let me just say like piping hot coffee. Even if I say it, you can feel it. You can feel it. Like if you like coffee, if you don't, maybe it's freshly mowed grass in the summer.

Morra: Orange. I always like to smell orange. Orange peel.

Meredith: Oranges, like it's so evocative. And these are not difficult.

Morra: So what is that doing? What I'm smelling, why is that good for my nervous system?

Meredith: The reason that engaging with our senses is so important - you may have heard of five, four, three, two, one, spot five things in the room, you're using all of your senses, listen for four sounds, smell, look for three smells - that is a very common grounding practice. Grounding brings us into the present moment. So what you're looking to do is to create space for your brain the same way mindfulness does. Many practices are working to help you get out of your own overthinking brain and sort of allow your body and nervous system not to live in the fear, to interrupt the fear. Because often these thoughts are sort of cyclical and they will pass, they will pass. But what are you gonna do to help yourself as you're waiting for them to pass?

Morra: Right, or maybe the way you're currently trying to get through the thoughts isn't helping you, right? Maybe you're drinking, maybe.

Meredith: Exactly. Maybe you're doubling down, or maybe you're doing these coping strategies. Coping strategies are different than regulation strategies. Coping strategies, drinking, whatever, they're not always bad. I always say, if you're under a lot of natural stress that happens in life, coping makes perfect sense. There's nothing wrong with coping. It's just when you're in consistent dysregulation and coping over and over and over and getting into really bad, deep habits that will hurt you quite a bit.

Morra: And I think a lot of us are just sick of taking so much Advil. Like, I think that there's also what I find is sort of, as you would say, a fellow Voyager who deals with chronic pain that is highly sort of psychosomatic also, is like, I don't want to take drugs. Doctors are always giving me muscle relaxants. I mean, I have a cabinet full of pretty powerful drugs. And I can't live that way.

Meredith: I mean, I did live that way for a long time. I have been on so many different migraine meds, have been on opioids for migraines. Like I was there, that was before people sort of - it's really interesting because when I started Beautiful Voyager, I had in mind, I wanna help people who are in pain. I wanna help people with this, what felt like an impending opioid crisis, which did end up happening.

Pain has always been very understandable to me and it's very clear to me, like why people land in addiction behaviors with coping and why they land in opioid issues. It makes total sense, right? And I also have in the past year sort of gone off of my SSRIs, that has been a difficult journey. All of these things are - you use the tools when you need the tools and when you're able to, if you're able to shift that a little bit and improve, you start to be able to get into a virtuous cycle of being able to let go of those things if you can. So I'm with you. Like I was taking things that I know were not great for me to be taking and I'm glad not to have to do them. But I certainly also understand why anyone is in a stage of looking for those things.

Morra: We have to wrap because we're both busy working parents. Thank you so much. I just want to say it was great. And I want to end by saying, you know, the thing I love most about Meredith's approach is that it is a full body experience. You know, I hate when people are like, just go meditate. A lot of us, it doesn't work for. We're already in our heads enough. And so I will share all of your stuff and just encourage the audience to sort of get into your body and start paying attention to your body.

Meredith: I love that, thank you for sharing. And I also hope that people share what's working for them. Because again, if we have this palette of tools, like let's widen our palette, the more we can all just keep telling each other, like this worked for me. You wanna have the biggest toolkit you could ever imagine. So speak up, comment, share what's working. Like we can help each other through this.

Morra: Yes. Speak up.

Read more of Meredith’s work at https://beautifulvoyager.substack.com/