When Your Nervous System Shows the Problem and Has Part of the Solution: MCAS & Mast Cell Disorders
Featuring Dr. Amanda Whitehouse, PhD, Licensed Psychologist
If you're living with MCAS or any kind of mast cell or histamine-related condition, you already know the exhaustion of not having clear answers. You're tracking everything. You're playing detective with every bite, every environment, every symptom. And somewhere along the way, you might have picked up the message that if you just figured out the right protocol, the right elimination diet, the right supplement stack, you'd finally get better.
I sat down with Dr. Amanda Whitehouse, a licensed psychologist who specializes in chronic illness, food allergy and general food anxiety, and medical trauma, to talk about what's actually happening in the nervous system when you're living in this kind of constant uncertainty, and what it looks like to start healing from the inside out without pretending that's a simple process.
The Layer Nobody Talks About
MCAS is already confusing enough medically. Unlike a straightforward food allergy where you avoid the thing and you're mostly fine, mast cell conditions don't play by those rules. You might react to something one day and be totally fine with it the next. The same food, the same environment, different outcomes. Even the diagnostic criteria are still being sorted out, and not every provider is up to speed.
What that creates psychologically is what Dr. Amanda described as constant hypervigilance. You're always scanning. Always logging. Always trying to narrow it down. And that level of alertness, while completely understandable given the circumstances, keeps your nervous system in a threat response state that actually makes things harder.
Please note: this is not your fault. Your nervous system is responding to a real threat. It's just that the threat response itself can become dysregulating over time in ways that compound what's already going on physically.
Why Cognitive Work Alone Isn't Enough
This is something I think about a lot in my own practice, and Dr. Amanda articulated it so well.
Most therapeutic interventions lead with cognitive work. Challenging thoughts, reframing, looking at the evidence. And while that absolutely has its place, you genuinely cannot think your way into feeling safe when your nervous system doesn't believe you. Your brain can know that a food is probably okay. Your nervous system will still sound the alarm.
What has to happen first is that the nervous system needs to receive safety signals. Not safety thoughts, but safety signals. Sensory information that the body can actually interpret as, we're okay right now.
That's where modalities like somatic work, polyvagal-informed approaches, and the Safe and Sound Protocol come in. These aren't fringe tools. They're rooted in how the nervous system actually works.*
*Note: I know about the long-standing criticisms around the polyvagal theory (PVT), and there’s a much larger, more nuanced conversation that needs to be had there. PVT is not the end-all, be-all. PVT is one tool in the toolbox that helps clients regain a sense of control when used appropriately. PVT can be dangerous, like any other tool, when used by untrained facilitators AND when used as a cure-all (because it’s not a cure-all).
What Are Safety Signals, Actually?
Dr. Amanda explained that the vagus nerve is constantly evaluating whether you're safe based on sensory information, not cognitive assessments. And sound is one of the most direct ways to communicate with it.
Here's the breakdown:
Mid-range frequencies (like the calm voice of someone who is warm and engaged with you) signal safety to the nervous system
High-pitched sounds (alarms, screeching) signal danger
Very low frequencies (a deep, stern voice, a rumbling sound) also signal threat
The Safe and Sound Protocol is a therapeutic program built on this. It delivers specially filtered music to help the ear re-learn how to tune into safety signals, and because of where the vagus nerve runs (right through the area where sound enters the skull), it's also directly stimulating vagal tone at the same time.
Now, you might not have access to SSP right now. But you can start paying attention to your sensory environment in daily life. If you're trying to have a hard conversation but a video game is blaring in the background, your nervous system might be registering that even if your conscious mind has tuned it out. Adding warmth in the literal sense, a cozy blanket, a warm drink, soft lighting, is not self-indulgent. It's strategic.
When You've Already Isolated Yourself
One of the things Dr. Amanda talked about that I think gets overlooked in chronic illness spaces is what happens when someone has already had their world shrink significantly. WHen this is the case, they're likely staying home most of the time. They're limiting food, activities, and exposure to anything that might trigger a reaction. Life gets very small.
And while that makes complete sense as a protective response, it's also self-perpetuating. The more you avoid, the more avoidance signals safety, which means you need to avoid even more to feel okay. It's a cycle that, without support, tends to tighten.
The first step out of that cycle, according to Dr. Amanda, is usually social connection. Not jumping back into the world full-force. Just finding one safe connection. That might be:
A podcast community where people understand what you're dealing with
An online group for people with your specific condition
A virtual event or group program with a provider who gets it
One person in your life who you genuinely feel regulated around
That might sound small, but it’s not. Social connection is a biological safety signal. From the time we're infants, proximity to a calm, safe, engaged person tells our nervous system: we're okay. We're not alone. We'll be protected.
Acceptance Is Not the Same as Giving Up
Dr. Amanda said something about acceptance that I want to make sure lands correctly, because I know this word can feel loaded.
Acceptance doesn't mean you like what's happening in your body. It doesn't mean you're okay with it. It means you're distinguishing between I'm uncomfortable and I'm unsafe. Those are different experiences, even when they feel identical.
She gave a really clear example of what meditation is actually doing when it works: you're not calming your nervous system down through willpower. You're practicing tolerating what's present without rushing to fix it. That practice, over time, expands your capacity to be in discomfort without your system treating it as a five-alarm emergency.
I'll add my own version of this. When my daughter was a baby and she was crying constantly, my ears could barely handle it. Literally, not just emotionally. I had to teach myself to widen my visual field, take in the whole room, breathe, and notice that we were both safe even though she was loud and I was activated. That's acceptance in real time. It's not passive. It's actually a lot of work.
Co-Regulation and Why Therapy is Different
Part of what makes therapy effective for nervous system healing is not just what the therapist knows. It's that a trained therapist can stay regulated while you're not.
Dr. Amanda described it as borrowing someone's nervous system. When you're dysregulated and the person with you stays calm and safe, your system starts to learn that being dysregulated isn't dangerous. That you can be a mess and still be held. That you don't have to white-knuckle your way through this alone.
For people whose early experiences taught them that their feelings were too much, or that caregivers couldn't really hold space when things got hard, this is genuinely healing work. And it happens in the body, not just in the intellect.
This is also why we emphasized working with a trauma-trained therapist specifically. Not because everyone with MCAS has experienced overt trauma, but because the kind of somatic work that actually moves the needle requires someone who can recognize when you've hit your window of tolerance and knows when to back off before you get re-traumatized.
What This Means If You Have MCAS (or Any Mast Cell Concern)
Here's what I want you to take from this conversation:
Your nervous system is likely sensitized. That's a real thing with real physiological underpinnings, not a character flaw. It’s literally how your body is trying to keep you safe.
Improving vagal tone (through things like SSP, somatic work, breathwork, safe social connection) can actually reduce the inflammatory cycle. Not cure, but interrupt.
You cannot think your way into feeling safe. The body has to receive it first.
Working on past relational patterns or trauma is not a detour from healing your body. It's often central to it.
All of this is slow. Anyone telling you it's a reset or a quick fix is not being honest with you.
You don't have to be doing all of it right now. You just have to know it exists, and find someone safe to help you figure out where to start.
Disclaimer: Everything we discuss here is just meant to be general education and information. It's not intended as personal mental health or medical advice. If you have any questions related to your unique circumstances, please contact a licensed therapist or medical professional in your state of residence.
Destiny Davis, LPC CRC, is solely responsible for the content of this article. The views expressed herein may or may not necessarily reflect the opinions of the guest.
The content in this blog post comes directly from a real, human interview between Destiny and her guest on The Chronic Illness Therapist Podcast. This written version was formatted using AI. Listen to the full episode to hear the actual conversation.
Listen to my full conversation with Dr. Amanda Whitehouse on Ep 124: When Your Nervous System Shows the Problem and Has Part of the Solution: MCAS & Mast Cell Disorders
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Episode transcribed with AI and may contain errors that are not representative of the actual word or meaning of the sentence.
[00:00:00] The Chronic Illness Therapist Podcast is meant to be a place where people with chronic illnesses can come to feel, heard, seen, and safe. While listening to mental health therapists and other medical professionals talk about the realities of treating difficult conditions, this might be a new concept for you, one in which you never have to worry about someone inferring that it's all in your head.
We dive deep into the human side of treating complex medical conditions and help you find professionals that leave you feeling hopeful for the future. I hope you love what you learned here, and please consider leaving a review or sharing this podcast with someone you love. This podcast is meant for educational purposes only.
For specific questions related to your unique circumstances, please contact a licensed medical professional in your state of resident.
Destiny Davis LPC CRC: Dr. Amanda Whitehouse is a [00:01:00] licensed psychologist specializing in the intersection of chronic illness, anxiety, and medical trauma. She's a mom to three boys of whom has multiple food allergies, and she helps her clients with navigating the psychological impact of chronic illness, helping them build resilience, reduce anxiety, and restore confidence in daily life. She's the creator and host of the Don't Feed the Fear Podcast, where she interviews experts and advocates and provides her own Perspective on the experiences and support needed by the food allergy community. Well, Dr. Whitehouse, thank you for being here again. We, you were on episode 68 of this podcast. Around food allergies and building confidence and safety for our kids. So I'm excited to talk to you today about, um, MCAS because that, you know, is hand in hand with the allergy world, but it's different and it's not at the same time. And so will go over, I think, some of those nuances. First though, I would love for you to maybe share a little bit about kind of, um, your approach to therapy.
Maybe tell us a little bit about like. How you [00:02:00] work with SSP and the different modalities that you kind of bring into, um, to kind of give a holistic picture of how you practice.
Amanda Whitehouse, PhD: Sure, thanks for having me back. Um, I have found, and as you mentioned, there's a lot of overlap and really, you know, I say food allergies 'cause that's what's happening in my house. But really I work with a whole broad, uh, you know, range of people with food related things. So MCA, you know, any kind of mast cell stuff is related.
Celiac, you know, anything where, um, we're kind. Having this extra level of hypervigilance because we're monitoring our food, take intake, right? Food is supposed to be safety and a and a connection, and for us it becomes anxiety and stress and fear. So I found in my work with that, um, we really have to.
Regulate the nervous system. There's a lot of cognitive stuff out there that's shown to be effective for any of this range of, um, medical concerns and anxiety about them. But I found in my work that we can't really cut through what's happening in the brain, that cognitive piece, until we tell the nervous system that it's okay [00:03:00] to relax and receive that exercise and be prepared for it.
So my focus is on a lot of that polyvagal theory, um, somatic work, nervous system regulation, and all of those things that help us get into a state where we can be receptive to learning and change. Because we feel safe enough when we're living lives elsewhere that feel constantly validly unsafe.
Destiny Davis LPC CRC: Thank you for that. And maybe we can go right into how we start to talk to the nervous system or tell, you know, calm the nervous system when there are real threats around us. What are, you know, how do you start to have that conversation? And I think we talked about this a little bit in our last podcast.
We for sure talked about it in our last podcast, but, um, maybe we can talk a little. Yeah. More to the, and you can correct me if I'm using, if, if I'm wrong here, but like when I think about food allergies or when anybody thinks, I think about what we've always known about food allergies. It's like you are allergic to a peanut, you are allergic to gluten, you are allergic to this specific thing.
So just stay away from that and you'll be good. Which of course, you know, you, the, the fear comes in with like, well, did somebody contaminate it or is it in something? I don't know. Right. But with M Cs. There's this whole other layer of like, I don't really know what I'm allergic to anymore and I'm reacting to everything.
And yeah. So how do we start to calm the nervous system down when the threats are really real?
Amanda Whitehouse, PhD: Yeah, maybe I should clarify first too. I think this will be helpful. We say MCAS kind of [00:04:00] interchangeably and, and I'm certainly not a medical doctor here to explain, you know, the differences, but I think this conversation will be relevant to anyone dealing with any kind of mast cell or histamine type of concern.
So whether it's MCAS, whether it's like mastocytosis, which is more of like a, a. Uh, abnormal mast cell production. From what I understand, or like histamine intolerance is something that people talk about a lot too. All of what you said applies because food allergy is stressful, like you said, but sometimes at least hopefully it's clear that, you know, avoid this food and that that's murky.
It's not as easy to avoid a food, um, as it sounds, but then add to all of that confusion that already exists when you're trying to eliminate a food and make sure that your food is actually not coming into cross contact. But then there's all this question about what even foods are causing it. And sometimes, um, this food bothers me, but other times it doesn't.
And sometimes it's this activity. Um, and we fall into this spiral of always playing detective, [00:05:00] always trying to narrow it down, tracking our every move, our every bite, our every symptom, trying to get clarity on it, um, which is necessary to a certain extent, but then it's also. There's a tipping point where it becomes counterproductive because there's not always a clear answer.
One food genuinely might bother you one day and might genuinely not, you know? And the, and then the same goes with how to respond when you are having symptoms. You know, again, not a medical professional here, but it's not as clear. How to respond to a reaction if you're dealing with MCAS or some kind of mast cell situation, if it feels like anaphylaxis, that's not as clear in terms of when to respond in what way?
So I'm not here to tell you the answers to any of those things, but what I am here to acknowledge is that there are so many layers of more confusion, more hypervigilance, more uncertainty that is so difficult and so dysregulating to our nervous systems, we want an answer.
Destiny Davis LPC CRC: Yeah.
Amanda Whitehouse, PhD: add to that too. Then [00:06:00] there's, I'm sorry.
There's also the layer of mm-hmm. We still hardly know anything about it and our doctors are often dismissive or it just is unclear, even if they are supportive and listening. Um, it's really difficult and a lot of times we really have to fight and be our own advocates to get a diagnosis, to get people to hear our concerns and take them seriously.
Not just our medical providers, but people in our lives too, you know? So. Even more so than some other food related things, people really, um, get that feeling that people think we're making it up or, oh, that's just anxiety that caused that symptom in your body, and it's very real, but it's another thing we have to throw into the weight that we are carrying in terms of sorting it out and getting those answers.
It's just so complicated.
Destiny Davis LPC CRC: It. That's exactly spot on. Um, I'm curious if you. Do have either specific types of doctors or different trusted professionals where you have either yourself experienced or with clients experienced some medical professional who actually can give an answer around like, here's [00:07:00] what to worry about and here's not what to worry about as far as physical symptoms go.
Have you? Yeah.
Amanda Whitehouse, PhD: I mean, I think the, the two things that I can say to that are someone who genuinely makes you feel listened to, even if they don't always see things eye to eye, that you have a chance to express yourself. Um, just kind of knowing what kind of response you're getting and being confident enough to find someone else if that person you've already talked to isn't the right person.
But to take the responsibility yourself to go into that with. Some kind of clarity and organization in terms of how I'm gonna make this appointment worthwhile. It's unfortunate that our medical system is the way that it is. We don't, they don't have an hour and a half to sit and talk about all of this laundry list of things.
Um, so if you can organize your thoughts ahead of t time, try to get the anxiety piece of it. It's still gonna be there, but don't let the anxiety present as the primary thing versus, here's what I've recorded, here's what I've observed. Here's the list of medications. You know, all of that factual information that the doctors are going to want and need [00:08:00] in order to make the best, you know, diagnosis or differential diagnosis, and help us start to narrow things down.
Destiny Davis LPC CRC: It's, so, it's interesting. I'll give a personal example, but my son, so he's gonna be two in January. Um, we're recording this in December, so he's almost two. Um. Within the last, within that first, uh, between one and two, like sometime within the last year, he has had two really bad adverse reactions to penicillin. And so the first reaction was, um, a full body rash after like six days. Right. So, um, told the doctor and like, they were just like, okay, you know, they didn't really gimme anything, like any like. Advice around that or what that's supposed to mean. Right. So then when I went back to the doctor, um, I think they kind of were like, well, we're not gonna put it in as an allergy because we don't know.
And I was just like, what do you mean? Like, okay, all right, I'll just, whatever. So then the next time, the second time he needed it, he started throwing up within the first hour after giving him the first [00:09:00] dose. And so I'm just like. That's right. Like what? I would not, would you keep giving it to your child? So nobody had answers. Um, then they finally, then, like one person put it in his chart as an allergy. And then the next time that I went into the doctor and I was talking about it again, they were like, does he have an EpiPen? And I was like, no. And they were like, oh, well we don't really know if he's allergic.
So they took it out of his chart. Now I will say, this is where I'm like, okay, sometimes these doctors do know what they're talking about and they just don't know how to explain stuff because, so I've been like living with this kind of penicillin fear, like what if he gets another infection needs? Well, he swallowed my daughter's dose of my four year old's dose of amoxicillin. Last week. And he actually, nothing happened. Nothing happened. He did not throw up, he did not get a rash. And this was 9.5 gram milligrams, uh, milliliters, which is like. An insane amount. I was surprised that that was even her dose. But yeah, he got ahold [00:10:00] of it. I had put it on like the doctor was like, how did he get ahold of it?
My bad mom guilt was like, like I put it on the counter and before I knew it he was up on the counter and my daughter had not drank it yet 'cause she's four. Um, so yeah, that was my story with that. But it's like. How do you know? Right? How do you, how do you live with, like, I never would've decided to give him penicillin just to try that out again.
Right? So I prob probably would've went for quite a while, just like feeling like, no, he's allergic to it. Don't give it to him. And now I'm like, oh, okay, maybe he's not. But I just wish somebody would explain the medical aspect of that to me. Yeah.
Amanda Whitehouse, PhD: Right. Why are they giving you that recommendation versus just, oh, we're just going to take it out? Because of course, of course, when your child vomits, when they consume something and you already have a suspicion that there's an allergy, and I'm, I'm in that boat with you, my youngest who doesn't have food allergies, has a penicillin allergy.
And for those listening, I know that's not what we're talking about, but I would say to you, and that's what we've done to go to an allergist because there's a lot of false [00:11:00] positive on penicillin. Um. Allergies because of what you're describing, it's so confusing. And also just on your mom guilt, like that doctor is very far removed from having two toddlers in the home because I can picture exactly 20 ways that that would happen.
We, we put everything on ourselves and sometimes the response. You know, that we get from medical professionals doesn't help us to not do that because it's totally, all of your confusion is totally understandable and we wanna know what to do, right? You wanna know, you worry about the next time if this happens.
Like you're saying, all that uncertainty just makes it more confusing and creates anxiety. Even he's not sick right now, but you know he's gonna be again, right? We, we know these things are ahead and we want as much clarity as we can get. Um, and it's not always easy
Destiny Davis LPC CRC: Yeah. Yeah, especially with, I mean, I guess, yeah, I am saying MCAS, but I really am referring to kind of like any histamine intolerance or especially with MCAS, like some people are like, oh, you can only have that if you have high tryptase levels. We do know we have Criterion two, [00:12:00] two now which you don't need, you can, you can get that diagnosis without the tryptase levels being too high, but some doctors are still not on board.
So again, more confusion.
Amanda Whitehouse, PhD: It's so confused. I, so I was so excited. I've got, um, Dr. Zachary Rubin's gonna be on my show and I was so lucky to get like an advanced copy of his book to read before the, yeah. And I was like, yes, there's a good, there's a chapter on MAs cell, like, I'm gonna read this. So I have the most information possible for this recording today, and it's a great book, but it's the same.
Same like as you're describing. We have some more criteria, but it's kind of not really still clear and everyone's not really still following it. So, you know, obviously it's not a criticism of him or the book. That's just up to date.
Destiny Davis LPC CRC: are.
Amanda Whitehouse, PhD: That's where we're at. Yeah.
Destiny Davis LPC CRC: really hoping too, I like last, I have been waiting for this book for like a year
Amanda Whitehouse, PhD: Mm-hmm.
Destiny Davis LPC CRC: was so hoping it was gonna be like, but yeah, again, not a criticism on him. It's like this is just where, where we're at. This is all we know right now.
Amanda Whitehouse, PhD: And it is helpful. It's worth reading because there is, it does. It did [00:13:00] give me more clarity on it too, but yes, there, it's not your fault. Anyone out there listening if you are unclear or haven't been able to, you know, find someone who is understanding you or express it in a way that makes it clarity or doctor, whether or not this is or isn't what you're dealing with.
Because it is, there's a lot to be learned still.
Destiny Davis LPC CRC: So how do you start to work with people then who maybe are like bubbling themselves in their house? They're not going out anywhere. They're limited on their food intake. They're limited on their, uh, medication intake, like they're suffering, but their world has been really reduced to their home because they feel like they'd be suffering more if they were outside of the home exposed to different things.
Amanda Whitehouse, PhD: Yeah, it's, and I think you asked me before too, like how do we start getting their nervous systems regulated? And I totally sidestep that, but it's really tough because when you are at that point of restriction of avoidance, of isolation, genuinely. We're, you're in constant fear. You're, you [00:14:00] don't feel safe.
That's not how we are designed to operate as human beings. Um, so breaking that cycle, which really is self, it's, it perpetuates in itself. The more we avoid, the more we feel safe from avoiding, but then we need to avoid even more because that creates more anxiety. Um, so we have to turn that around. And I have found, um.
This is just my approach, but social connection is really powerful for the nervous system. It's a really strong safety signal to us. Um, it's natural for us as human beings. You know, think of us when we are infants. We are designed to rely on the people who are caregiving and connection with them tells us we are safe, we will be fed, we'll be protected.
We won't be alone. We won't be on our own. So a lot of times when people are as far deep into this as you're describing, finding. A connection socially that is safe, that is obviously validating and understanding, um, is sometimes the first tiny little baby step, and it might be someone in your real life.
But it might not be. So [00:15:00] sometimes it is finding a podcast like yours or a, a, someone on a social media, you know, and that you can follow who's talking about these things or a community. There. There might be groups, you know, um, I know lots of different professionals like you and I have different virtual events for people.
So sometimes that's really the first step out of that is to find those people who get you, who know what you're dealing with, that will validate you, and you don't feel like you're completely alone in it anymore.
Destiny Davis LPC CRC: Yeah, It's really important. Um, and yeah, a lot of times that community is found online. My hope and my hope for clients and and people in my life was, is always that we'll find that. Will it? some of that safety online and then we'll start finding that in real life and the people around us.
But sometimes that just takes some time. Yeah.
Amanda Whitehouse, PhD: It's a slow process and, and even if they're there to trust them again, you know, takes some time for your nervous system to feel safe, establish a little bit of safety, and build on it.
Destiny Davis LPC CRC: Yeah. How, what is kind of [00:16:00] your approach to finding safety when somebody, again is like super, super restricted? Um, is it a, a good cognitive approach of. Helping them, like literally look for signs of safety in their environment mixed with some of the somatic work that you do.
Amanda Whitehouse, PhD: I would, yes and no, because I wouldn't call it cognitive. Now it's, we have to actively think about it to do it, but really it's not cognitive work. We have to learn what the nervous system decides. Is safe, not what our brain says is safe. So we can, you know, cognitive refers to like, okay, I ate this food five times last week.
I'm, you know, it's gonna be safe and challenging ourself with the logical, rational truth, but. We all know from experience that we don't necessarily believe that, right? Our nervous system doesn't trust that and feel safe. So when you, you know, I start with clients just in terms of we're not even gonna talk a whole bunch about this, other than for me to validate what you're experiencing.
I'm going to teach you. This is how you talk to your nervous [00:17:00] system and it's not talking, right? It's it's sensory information. That's what the vagus nerve use is to evaluate constantly in on an ongoing basis whether or not you're safe. So if you can learn to give your nervous system safety signals, it doesn't have to have anything to do with your symptoms or food or histamine or any of those, just general human universal safety signals.
That's how you can get it to shift out of gradually and over time. It's not, you know, I hate when people say like, nervous system reset. It's not a just do this and you'll feel better. It's a slow process of building trust with your nervous system, listening to your body and telling your body, I'm going to listen to you and the signals that you're giving me back.
Destiny Davis LPC CRC: Yeah, thank you for saying that. It's not overnight, it's not a nervous system reset. It's, it's slow and gradual and I know, you know, I'm always talking about that online too. I just rage against it every day because I see it so much online. and it bothers me. So, [00:18:00] yeah. Um. What are some of those social, like you were saying, that's kind of probably why you're saying, you know, good social environments can encourage and foster safety, which just already inherently starts to calm that nervous system down. What about somebody who says, I have good friends. I love my family. good, but that doesn't matter. I still feel like this. Right. What is some, another approach that we might start to look for?
Amanda Whitehouse, PhD: Yeah. So the other, the other forms of safety signals, in addition to the connection is the information that's coming in, um, sensory wise. So you and I have talked about my, my, if there's anything close to, like my magic wand or my secret weapon when it comes to nervous system regulation, it's a program called the Safe and Sound Protocol.
Um, and it's developed on polyvagal theory by, by the creator of Polyvagal Theory. So we don't all have access to that, but the, the. Premise of this is that, um, our ears just to take and isolate one of the [00:19:00] senses. Our ears interpret sounds differently. Some sounds indicate warning or threat and some count sounds, indicate safety.
This is part of why social connection is so important because the voice of a calm, nurturing, receptive, engaged human is a middle range frequency that is a safety signal to the nervous system. High pitch sounds like a tire screeching or an alarm sounding mean that there's danger. Low pitch sounds are things like, um, a dog growling or someone speaking in a really low, you know, think of like a man's very serious deep voice.
Those are warnings, so. Depending on what we're hearing, we're going to interpret. Our nervous system is going to interpret it as safe or not safe regardless of what we cognitively know is going on. So we can choose to incorporate some of that. Um, but the problem is once we get kind of habituated to drowning out the safety signals, and this applies for all of the senses, um, but once we kind of stop [00:20:00] looking, our ears stop focusing in on those safety signals and are on high alert all the time for the high and the low.
Um. Signals of SA of danger or threat, then we kind of start blocking it out. So that's when probably like you're saying, those people who are like, I've got great friends, my family's supportive, but when we sit down and have a conversation, even though they probably are talking in those supportive ways, the nervous system isn't receiving it.
So that is a, you know, a one example of ways that we need to rethink how we're communicating with it and re not relearn, but make it safe enough for our ears literally to start hearing and receiving those safety signals again. Not just, you know, searching for danger all the time, the way that they tend to do.
Destiny Davis LPC CRC: Yeah, that, um, makes me think like, so the cognitive piece, the cognitive work sometimes might be, we do have to evaluate the people around us, like. Do you actually like the people that you're around? Do you feel safe around them? Um, and and [00:21:00] from the, from a mental, like from a cognitive standpoint, do you feel safe around them?
And they might say, you know, of course, yeah, I don't think my husband would ever harm me. Right? Like, that might be true. And yet when they're sitting down, their ears might be picking up on the, not, on the safety part of the, not on the safety signals. Um. And so a program like Safe and Sound Protocol, we haven't introduced that yet, but you, you offer safe and sound protocol, and that is, uh, something that can help people's ears start to become attuned to safety signals.
Can you, can you, um, explain that a little better than I just did?
Amanda Whitehouse, PhD: Absolutely. Well, you're explaining it wonderfully, but it is, it's a very slow, gentle program that basically it filters out what's not a safety signal to the ears and delivers this specially filtered music to the ears to. It's like exercise, exercising, you know, the ear has all these moving parts and different pieces and to help it remember how to receive that signal again, and then to gradually add back in over [00:22:00] time the high and the low frequencies that signal danger.
But to still be able to focus on the middle sounds, the middle range, while the, the concerning signals are added back in. But the added bonus of that and why sound is one of the best ways to do this is because, um, the sound waves going into the ears. Hit where the vagus nerve crosses down from the skull and, and through the neck and into the body.
And so we can actually literally physically stimulate the vagus nerve with the sound vibrations at the same time. It's kind of a double whammy. Do you know? Double powerful, uh, signal to the nervous system. The o the only other way we can directly. Stimulate the vagus nerve. A lot of people hear about vagus nerve stimulators and there's devices on the market.
They might, they're sending vibrations through the muscles or the tissue, but they're not directly hitting the vagus nerve. So I'm not knocking any of those things, but there's too many for me to know about each one, but they don't as short of implanting an electro. Stimulating the vagus nerve, which is the way they do it in research, in animal subjects.
This is the most direct [00:23:00] way to do it. But you don't have to have the program, uh, you know, like in the example that you are talking about, like maybe the husband's voice, even though the husband is being supportive, maybe the, the frequency of his voice is, so, some men just have those low voices that no matter how kind they're being, our bodies will interpret it differently.
So being aware of it in your daily life is part of it too. And maybe like asking. The people that you interact with to be aware of it, educating them too, um, that you really trust and are safe with in terms of how they can enhance that, you know, safety, sense of safety between you and your interactions.
Destiny Davis LPC CRC: Yeah, like maybe there. They can do about their voice, but maybe certain tones of voice or certain ways that they speak or even just, um, bringing in additional elements of safety into a conversation. Like, um, additional, like words of affirmation or additional, like if that's what somebody appreciates.
You know, some of us really like to have like a softened like. Before [00:24:00] they, before we tell you criticism, we might say, Hey, I really liked this thing that you did. This one could use some work over here. Other people are like, just give it to me straight. I don't need to hear all of that. Like, so it's a very individual process and I think it's a, it just requires knowing what it is that you like and don't like. Yeah.
Amanda Whitehouse, PhD: Yeah, and adding, like you said, eliminating and adding to it other factors that might be part of it. So if I'm sitting with my spouse having a conversation about something that's challenging for me, and my kids are playing a video game in the background with screeching noises, it's not about the way that he's interacting with me.
Even if that doesn't. Within my awareness bother me. My nervous system is picking up on it. Um, and we can add in safety signals from other, other senses too. So if we're gonna have a hard conversation, even if we want 'em to tell it to us straight, we might have a cozy blanket, we might have a warm cup of tea, we might do other things to add to or enhance the sense of safety in that interaction.
Action.
Destiny Davis LPC CRC: Yeah, that reminds me of how I, of how I practice somatic work. I don't practice the and sound protocol yet, but [00:25:00] maybe soon. Um, uh, I. Um, in somatic experiencing one of the, well, like the techniques kind of all lead to figuring out where in your body you have a sense of safety or a sense of neutrality. So maybe my skin has, you know, rashes, it, tingles, it burns, things like that. if I go deeper and notice my breath, or if I notice maybe my leg, or if I notice like my heartbeat, and maybe that does or doesn't have. What we wanna do is for each individual find what doesn't have a negative charge. so we're looking for the areas of your body that feel neutral or positive. Bringing attention there, not because we're trying to say, oh, just think about the positive, but because we're trying to say, as you're experiencing this really painful sensation in your body, can you find the areas of your body that are not burdened by that pain so that it can help? Can you carry that pain?
Um, it can help carry that pain so that the, the weight is evenly distributed. [00:26:00] And it sounds like Yeah, just like a very, very common underlying Yeah.
Amanda Whitehouse, PhD: Absolutely. And that's so well described. You're giving me the visual of like, literally like the distribution, you know, we think of weight distribution, same thing. And, and I think this, that's the part that's so relevant to people, um, who are dealing with the types of mast cell things, MCAS and um, mastocytosis that we're talking about because there is so much signaling from the body, and that's another part, I'm sure you've found this with your clients too.
There's constant scanning, there's constant awareness and noting and observation of the symptoms. And like you said, it's really hard not to then remain focused on it all the time. Is it getting better? Is it getting worse? Did the thing that I just did or ate or the temperature of that shower make it worse?
Um, and so I. Love the way you're describing it, and I really even try, I'm sure you do this too, to use the word safety. Like are there signals in other areas of your body that are telling you, even though you're experiencing those symptoms right now, you are [00:27:00] safe in this moment. You might be uncomfortable, you might feel itchy.
There might be pain you and. You can know that you're safe. So breath, as you mentioned, is such a good one because the breath is always with us, and if we're breathing, we know we're doing pretty well, right? Even if some other things are happening, that's the most important factor. So that's why meditation and breathing is so effective, and that's something that nobody wants to do, but it, it really is.
That's as, that's as simple as it gets when you're meditating. It's just focusing on that breath and knowing in this moment, I'm still breathing.
Destiny Davis LPC CRC: Yeah. And I think people, I do think people get, um, some, sometimes people get really hung up on when we say like, meditation or breathing is effective. 'cause they're like, what do you mean it's effective? I'm still experiencing this thing here. And like you said though, one, it's a very slow process. And two, these practices. Don't necessarily cure what you're dealing with, and so it's an effective tool for helping you through, but it doesn't mean it's effective at curing your chronic condition.
Amanda Whitehouse, PhD: [00:28:00] Definitely, and I think they are a really good metaphor for, we talked earlier about then what cognitively thinking wise do we shift? But the, the physical work of the meditation and breathing is a good metaphor for that because we are learning not to feel great or cure what's going on, but to tolerate it.
So if you can breathe and focus on your breathing, you might not feel magically calm and peaceful while you're meditating for five minutes, but you're practicing. Tolerating whatever's going on in your body without resisting it. Without rushing to solve the problem or change something to fix it. And ultimately that is what we have.
Once the body is receptive through those exercises, that's when people are more receptive to the cognitive work you mentioned, because then the bigger picture that we have to do is learn some acceptance of. The constant uncertainty and shifting that is a reality of, of the medical, you know, diagnoses or, or search for diagnoses that we're finding ourselves in.
Destiny Davis LPC CRC: Yeah, [00:29:00] absolutely. Um. Because when you get curious and you accept kind of what is, that's when your body starts to
Amanda Whitehouse, PhD: Mm-hmm.
Destiny Davis LPC CRC: down a little bit and not be on high alert and not, you know, we talked just now about safe and sound protocol and how that, um, how that affects the ears and how that plays a part somatically, same thing with your eyes, and I think this is why I, I'm not an EMDR practitioner, but why it can be so effective, like you are just teaching your body and your brain to have a wider. Capacity for stimuli, for emotions, for stress. And that larger capacity gives you a larger bucket, which might mean that now you need less. Um, you can experience more stressors before the bucket overfills and gives you a symptom. So I know that's been the case for me, especially since becoming a parent. Noise. Um, I mean, I know I'll, I'll talk freely about when my daughter was born and [00:30:00] the crying like it, it was, it was so triggering because not just like all the emotional stuff that come along comes along in childhood trauma and what that all means from a cognitive perspective, but literally physically my ears could not tolerate it.
And so it was very difficult. Um, and one of the things that I did to kind of combat that was. Sitting down with her and like as she was crying. Just reminding myself it's okay that she's crying, like she's allowed to cry. She's, uh, you know, this doesn't mean that she, it doesn't even necessarily mean that something's wrong.
She's just a verbal and she still is just like her mom, a verbal processor. So she was crying, crying, crying all the time. And, um. I had to learn how to literally just be able to tolerate that. Like, can I sit here and breathe, look at the room around me, notice that I am safe because when she was crying, my eyes would just narrow to her and like, frantic.
How can I fix [00:31:00] this? How can I make this go away? And if you sit down, expand your visual field and actually allow yourself to be. Take in the whole room around you, you realize like, this is just uncomfortable. This isn't unsafe. So that's my personal anecdote.
Amanda Whitehouse, PhD: It is such a good example because yeah, people don't like that word acceptance. Like, how can I just accept this really horrible thing that I'm dealing with? But you describe it. It's not that you're, you know, you don't have to like it. You don't have to enjoy it. But we're distinguishing between whether or not we're okay, even though this thing is happening.
And Okay. Is a spectrum, right?
Destiny Davis LPC CRC: Yeah, it's relative, right? Like Yeah, exactly. And, and we get to make meaning of that. We get to decide what okay is for us. That's the
Amanda Whitehouse, PhD: Mm-hmm.
Destiny Davis LPC CRC: piece of the work. But, um, yeah. Yeah.
Amanda Whitehouse, PhD: Definitely. I I just had a thought though that I wanted to go back to, um, 'cause we were talking about obviously all of this stuff can't, we're not saying this will heal your mast [00:32:00] cell disorder, whatever's going on, but. Truly, you know, vagal stimulation and improving vagal tone. Does they call it the break, the vagal break?
And so that spiral that we talked about, about how stress and, um, you know, constant regul, uh, dysregulation in the body creates inflammation and it fuels the cycle. So. To some extent, not cure, but improve symptoms. Improving your vagal tone can put that break on in terms of turning around the cycle of things getting worse and worse and reversing some of that, not necessarily healing at all, but um, not escalating the situation as it is real genuine, you know, physical shifts in the body can occur from this.
So I, I did wanna clarify that even though I know you are, I are not claiming this is a cure for MCAS by any means.
Destiny Davis LPC CRC: not. But yeah, I think that's, that's a good thing to put in here because it's also like, you know, why practice this if it's just some whatever and it, it does have effects. But again, one doesn't mean [00:33:00] cure, two doesn't mean like you're gonna feel better tomorrow. It's a long term kind of thing.
And it's, it's wrapped up with, this is why it's so important to, in my opinion, do it with a therapist. Because even people like I just. You, you bring something up with a, with a sound and then all of a sudden you're in a traumatic memory from childhood and like Right. And not, not all therapists are even trained with how to, how to handle that.
It really is important to work with a trauma trained therapist. Yeah.
Amanda Whitehouse, PhD: Such a great point. Yeah, because we can create a safe container and when you lose the ability or are still learning to recognize what those signs and symptoms are for your body, we are trained to recognize it in the moment and steer the conversation in the session accordingly. So people who don't do what we do might not know about the window of tolerance, but we are trained to.
Recognize when we're working on something that might be challenging or new or stretching you, but how far is too far? And we can see based on your body language or your facial expressions [00:34:00] or your tone of voice or you know, so many things when it's time to back off of that and when we've pushed it far enough or you know, when, when you can tolerate a little bit more.
Because like you said, it's, it's, it's expanding that container, but we have to do it safely. If we don't, we can create more trauma. We can definitely re-traumatize.
Destiny Davis LPC CRC: Yeah. I don't think people realize too that part of our is not just this like textbook knowledge about It's can you visually see it? Can you tolerate it yourself? I mean, I know even in my tr like. When I was newer and even still now, like there will be experiences where I'm having an experience in session, like, oh, I am at my tolerance level with what they are dealing with, but what I, the difference between, you know, uh, someone who has not only the training that we have and also the containers we have, we have built in supervision. We have other colleagues we know we can go to. We are not siloed unless we make ourselves siloed. Um, so. When [00:35:00] that happens to me, I know immediately I need another professional to help me support. And then, I mean now it's a, after six years of practice, it's like. I, all I need is like one, one session of that before I'm like, oh, I'm, I'm good.
I've built a tolerance for this now and I can go right in the next week with that client and not be triggered. Whereas, you know, my year one, like, yeah, it would be like week after week after week, like anxious to see this client and am I gonna be able to handle this? And, you know, that's just a part of the learning process. Um. And if you're, again, if you don't have the built-in support for that, like our profession does, then you're gonna either quit or do a lot of harm, because you have to be able to tolerate that.
Amanda Whitehouse, PhD: Yeah, and that touches on a piece of back when we were talking about the importance of social connection. We didn't really talk about that word that we both love and people talk about all the time and what co-regulation actually is. And that's what we're doing as therapists. We are, it's like you're borrowing our nervous systems and we have intentionally, with [00:36:00] education and support and resources increased our tolerance and capacity to stay regulated even when we are with.
Interacting with a person who is dysregulated. So instead of like what often happens in our relationships, one person becomes dysregulated and the other person joins them in it. We are reteaching your nervous system by staying calm when you are not calm, and then helping. Your nervous system lean on us for regulation, and that helps both with the stressors that you're dealing with.
But that's part of what helps. You know, you mentioned trauma informed, that's what helps heal. Stuff that maybe even be pre-verbal memories or traumas from you, from caretakers or whatever you might have experienced, you know, medical events when you were a child maybe. But then. You know, being, knowing that you can be upset and be dysregulated, and there will be a safe person who will stay calm and regulated and safe and create a safe environment for you to experience that, then.
Dysregulation itself doesn't feel so unsafe. 'cause many of us, especially, you know, you and I [00:37:00] like have talked about attachment styles in the past too. That's another thing we could bring in. But many of us feel like if we, our attachment style to others says however they feel, I feel, and I have to stay okay in order to make everyone else okay and vice versa.
But what really heals that is learning like. Having someone safe in the room with you to say, it's okay. You can get as upset as you want. I am here. I'm supporting you. Everything is okay, even if you don't feel like it is right now. Because if we don't do that, just being upset or just being dysregulated can feel unsafe because we're afraid that people are going to detach or pull away from us.
So it's so healing, you know, in therapy to have someone that you can totally trust not to do that.
Destiny Davis LPC CRC: That's a really good point. That's a really good point. Um, because yeah, that if you grew up with, let's say a parent who said like. You can come to me with anything or like, but then they were very like emotionally unstable. When you were feeling emotionally unstable. Then you have learned that, um, anybody, a [00:38:00] professional, um, a person you love who says, I'm here for you, may not be actually there for you.
And so then putting the work in to try to rebuild that trust with a nervous system that just inherently does not trust that anyone is trustworthy is long-term work. Like, and it's so. Subconscious too. 'cause like that can be really confusing. Like, wait, but my, my mom was always there for me. She always told me she was right, but then you never quite felt safe with her for some reason or another.
And so it, that can be definitely re-traumatized even in the therapeutic relationship. And that's something I just wanted to point out. I think everybody needs to be aware of.
Amanda Whitehouse, PhD: Absolutely. And I, yeah, because I think there are always unspoken rules or qualifiers, you know, with, with, even with parents, with the best of intentions. I mean, people think we as therapists always just. Blame the parents. And it's not that simple, but you know, all of our parents were doing the best they could.
And so it doesn't necessarily mean that they were flat out cold or rejective of you. But again, if they never got the tools to regulate their nervous [00:39:00] systems, they can mean it 100%. But if they can't stay regulated when you're sharing something difficult or scary, your nervous system feels that even if they maintain a calm demeanor and they don't raise their voice and they don't.
Respond in any way that's traumatic or abusive to you. Your nervous system still understands. Boy, I talked to my mom about that and she was a mess. I could feel it, you know? Um, so I, I think it's really important for people to know that, you know, we're not necessarily talking about really big. Dramatic traumas that can create this dysregulation chronically in your system.
It's, it's little moments like that and, you know, the, the byproduct of existing in a world that does not support our nervous systems, that doesn't teach us the skills. You know, everyone is lacking in this unfortunately.
Destiny Davis LPC CRC: Yeah, I agree. Yeah. And you know, you get to decide, you get to decide like what you wanna work on, when you wanna work on it. You don't have to feel like you're always broken or, you know, needing to do your next self-help project. Um, that that's not what we're advocating for [00:40:00] Here. It, it's. Really about figuring out what's just not working for you.
And then now can I go and find those tools to, to help me? So in, in, in the realm of MCAS, I know we went really far off into the attachment world because we're therapists, but, um, you know, in the world of I think, or, or, or any, uh, mast cell kind of disorder. Yeah, your nervous system is on high alert and that's not the fault of your yours.
It's not the fault of your parents. It's not anybody's fault. Like your, your nervous system is perceiving a threat that is truly there. Um, also we can do work around helping to calm that threat response down. 'cause sometimes it is just way higher than what the actual safety protocol like to keep yourself safe from the danger requires.
Amanda Whitehouse, PhD: Right. And I think, you know, we did get off the rails 'cause, so we do, but I, I, I think I wanna validate it for people, the stuff that we're talking about. Is relevant to that because people who have experienced those types of things and [00:41:00] chronic p you know, traumatic events or C-P-T-S-D, um, throughout their lives are more prone to these diagnoses and these types of problems.
So even if you, you know, it's not just work on the medical piece specifically, or the diet or the restrictions, working on some of that past stuff can genuinely start to shift the way your nervous system works, because it's a, it's. A sensitized trigger, right? So it, it just jumps into it, um, more regularly, more easily, more sensitively and has trouble backing down out of it or turning the off switch on because of all these things that have primed your system.
So it's, uh, it's not irrelevant or, or aside. Story, it's, it really is kind of part of the core. Um, and I would encourage people if they feel they can find a safe relationship to explore that with a therapist, because it's not just about healing emotionally. It literally, it's about healing your body and your nervous system.
And I took that way away from your question. I'm sorry.
Destiny Davis LPC CRC: That was said. Thank you for saying that. Um, yeah, I mean, I feel like that even just wraps us up. It, it feels like, unless there's something we haven't talked about, but. Like this feels,
Amanda Whitehouse, PhD: Think so. I mean, the big thing that I think we touched on just. Briefly that I want, that's also [00:42:00] validating for people to hear is that there is so much stigma. There is so much like, um, you know, we got all these internalized messages and ableized messages about people who are able to, you know, exist in a certain way in the world and they are harmful.
And so I wanna acknowledge that for everybody listening. If you find yourself dealing with something like this, try, that's another thing to work on with your therapist, right? Like. Teasing those out of your internalized belief because we really do sometimes then can get in our own, um, patterns of self-judgment and self-criticism and disappointment and guilt and shame for what we're not able to do or what's different about us.
Um, and everyone's body is different. Unfortunately, this is not in your head. It's your body and your your, we're just encouraging you to listen to your body and do what it needs in every way, not just with your food intake.
Destiny Davis LPC CRC: Absolutely. Yes, perfectly said. Thanks so much Amanda. I am looking forward to putting this one out there and um, people can find you at food allergy psychologist.
Amanda Whitehouse, PhD: Yep. I'm [00:43:00] on Instagram and Facebook and my podcast is called Don't Feed the Fear. That's easy to find too. Um, so yeah, I talk about all this stuff too.
Destiny Davis LPC CRC: Tell and talk a little bit about maybe some of the groups that you have coming up. 'cause I know you do like a food allergy support group and you do a couple other things. So what are some of the groups that you have?
Amanda Whitehouse, PhD: Yeah, so I do occasionally run, um, a group where we guide each other through, um, the Safe and Sound Protocol, the SSP, which we're talking about. I like doing that in a group setting. You could do it individually with a therapist who offers it, and I would encourage you to find that if it's available. It's hard to find people.
Um, but I find it's more effective when we are doing it as a group and we get that social connection piece and we get the validation and, and support. Um, so I. I'm in the midst of one starting now by the time this episode comes out. But follow me and you'll see about the next one. And then I do also do, um, group, you know, it's more, it's not therapy, but it's educational support and coping skills and nervous system education.
Um, for all of these types of things we're [00:44:00] talking about. Any food related medical concern to help you learn everything that you and I are talking about today in terms of how your nervous system operates, how you can support it, and how you can heal it.
Destiny Davis LPC CRC: Well, anybody who, um, signs up for your groups I know will not be disappointed 'cause you do such a wonderful job at explaining these things in a very, like, easy to understand, down to earth way, which sometimes when, when you're trying to explain it without the jargon, sometimes it gets muddied and I just feel like you do a really good job at not doing that.
So it's just honestly such a pleasure to know you. So thank you.
Amanda Whitehouse, PhD: Thanks for saying that, and I'm so glad to know you too. I love, always love chatting with you. We could go on for hours.
Destiny Davis LPC CRC: Yes.
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Listen to Dr. Amanda’s interview with me, Destiny Davis, on Ep 124: When Your Nervous System Shows the Problem and Has Part of the Solution: MCAS & Mast Cell Disorders
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Dr. Amanda Whitehouse, PhD is a Licensed Psychologist based in New York who has been practicing since 2008, specializing in anxiety and trauma related to food allergies and chronic illness. Her work sits at the intersection of personal and professional — her son was diagnosed with severe food allergies in 2012, and that experience shifted the entire focus of her practice. She brings polyvagal theory, somatic approaches, and trauma-informed care into her work with children, adults, and families, and she hosts the Don't Feed the Fear podcast.
Meet Destiny - The host of The Chronic Illness Therapist Podcast and a licensed mental health therapist in the states of Georgia and Florida. Destiny offers traditional 50-minute therapy sessions as well as therapy intensives and monthly online workshops for the chronic illness community.